Customer_ID|Client_ID|Prior_Authorization_Required|Step_Therapy_Required|Quantity_Limit_Required|Plan_Id|Drug_Tier|RxCUI_Descr|Member_Benefit_Group 632|1001|N|N|N||Preferred Generic|979492-LosartanPotassium50MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2256943-lasmiditan100MGOralTablet[Reyvow]|ADULT 2020 632|1001|N|N|N||Preferred Generic|328160-Cyclosporine100MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|310364-Fluocinonide0.5MG/MLTopicalSolution|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1487076-DiclofenacSodium20MG/MLTopicalSolution[Pennsaid]|ADULT 2020 632|1001|N|Y|N||Preferred Generic|1368410-alogliptin12.5MG/pioglitazone30MGOralTablet|ADULT 2020 632|1001|N|Y|N||Preferred Generic|855178-tolterodinetartrate1MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|890786-Butoconazolenitrate20MG/MLVaginalCream[Gynazole-1]|ADULT 2020 632|1001|Y|N|N||Preferred Generic|2198370-pretomanid200MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2058950-0.5MLomalizumab150MG/MLPrefilledSyringe[Xolair]|ADULT 2020 632|1001|N|N|N||Preferred Generic|1052760-magnesiumcitrate58.2MG/MLOralSolution|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1745114-1MLixekizumab80MG/MLPrefilledSyringe[Taltz]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|860898-Vigabatrin500MGPowderforOralSolution[Sabril]|ADULT 2020 632|1001|N|N|N||Preferred Generic|856724-PropranololHydrochloride4MG/MLOralSolution|ADULT 2020 632|1001|N|N|N||Preferred Generic|1648759-NITROFURANTOIN,MACROCRYSTALS100MGOralCapsule|ADULT 2020 632|1001|N|N|Y||Preferred Generic|349594-atomoxetine40MGOralCapsule|ADULT 2020 632|1001|N|N|Y||Preferred Brand|213442-insulinisophane,human70UNT/ML/insulin,regular,human30UNT/MLInjectableSuspension[Novolin]|ADULT 2020 632|1001|N|N|N||Preferred Generic|197887-Hydrochlorothiazide25MG/Lisinopril20MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|199889-topiramate100MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|197454-Cephalexin500MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1605455-Otezla28-DayStarterPack|ADULT 2020 632|1001|N|N|Y||Preferred Generic|1091225-8HRMethylphenidateHydrochloride20MGExtendedReleaseOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|310459-Gemfibrozil600MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|861064-Sertraline20MG/MLOralSolution|ADULT 2020 632|1001|Y|N|N||Preferred Generic|1373483-dimethylfumarate120MGDelayedReleaseOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|997226-Donepezilhydrochloride5MGDisintegratingOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|903843-PyridostigmineBromide12MG/MLOralSolution|ADULT 2020 632|1001|N|N|N||Preferred Generic|995241-HydroxyzineHydrochloride2MG/MLOralSolution|ADULT 2020 632|1001|N|N|N||Preferred Generic|832909-CalciumCarbonate1250MG/Cholecalciferol100UNTChewableTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|867506-pazopanib200MGOralTablet[Votrient]|ADULT 2020 632|1001|N|N|Y||Preferred Brand|1046920-Nicotine4MGInhalationSolution[Nicotrol]|ADULT 2020 632|1001|N|N|N||Preferred Generic|198089-Phenobarbital60MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|198107-Piroxicam10MGOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2359290-24HRempagliflozin12.5MG/linagliptin2.5MG/metforminhydrochloride1000MGExtendedReleaseOralTablet[Trijardy]|ADULT 2020 632|1001|N|N|N||Preferred Generic|861430-PropafenoneHydrochloride300MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|241527-168HREstradiol0.00312MG/HRTransdermalSystem|ADULT 2020 632|1001|Y|N|N||Preferred Brand|643173-dasatinib20MGOralTablet[Sprycel]|ADULT 2020 632|1001|N|N|N||Preferred Generic|1367410-Ergocalciferol1.25MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|858625-Pramipexoledihydrochloride0.75MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|886666-FlecainideAcetate100MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|351114-5MLzoledronicacid0.8MG/MLInjection|ADULT 2020 632|1001|N|N|N||Preferred Brand|201338-Nadolol80MGOralTablet[Corgard]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1925255-0.4MLabatacept125MG/MLPrefilledSyringe[Orencia]|ADULT 2020 632|1001|N|N|N||Preferred Generic|239191-Amoxicillin50MG/MLOralSuspension|ADULT 2020 632|1001|Y|N|N||Preferred Brand|848164-0.5MLgolimumab100MG/MLPrefilledSyringe[Simponi]|ADULT 2020 632|1001|N|N|N||Preferred Generic|861424-PropafenoneHydrochloride150MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|999991-Amlodipine10MG/Hydrochlorothiazide25MG/Olmesartanmedoxomil40MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|856773-AmitriptylineHydrochloride150MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|310964-Ibuprofen200MGOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1482814-1MLgolimumab100MG/MLPrefilledSyringe[Simponi]|ADULT 2020 632|1001|N|N|N||Preferred Generic|310155-Erythromycin250MGDelayedReleaseOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2395775-30ACTUATfluticasonefuroate0.2MG/ACTUAT/umeclidinium0.0625MG/ACTUAT/vilanterol0.025MG/ACTUATDryPowderInhaler[Trelegy]|ADULT 2020 632|1001|N|N|N||Preferred Generic|313291-Theophylline400MGExtendedReleaseOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|1193358-100MLLevetiracetam10MG/MLInjection|ADULT 2020 632|1001|N|N|N||Preferred Generic|205284-leflunomide10MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|1099026-Loryna28DayPack|ADULT 2020 632|1001|N|N|N||Preferred Brand|207864-crotamiton100MG/MLTopicalCream[Eurax]|ADULT 2020 632|1001|N|N|N||Preferred Generic|197939-Methazolamide25MGOralTablet|ADULT 2020 632|1001|N|Y|N||Preferred Generic|1368424-alogliptin25MG/pioglitazone15MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|199058-mycophenolatemofetil250MGOralCapsule|ADULT 2020 632|1001|N|N|Y||Preferred Generic|1806191-30/70Release24HRMethylphenidateHydrochloride40MGExtendedReleaseOralCapsule|ADULT 2020 632|1001|N|N|Y||Preferred Brand|1667882-60ACTUATtiotropium0.00125MG/ACTUATInhalationSpray[Spiriva]|ADULT 2020 632|1001|N|N|N||Preferred Generic|1000135-medroxyprogesteroneacetate2.5MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|993755-Acetaminophen24MG/ML/CodeinePhosphate2.4MG/MLOralSolution|ADULT 2020 632|1001|Y|N|N||Preferred Brand|902624-dexlansoprazole30MGDelayedReleaseOralCapsule[Dexilant]|ADULT 2020 632|1001|N|N|N||Preferred Generic|831109-CromolynSodium40MG/MLOphthalmicSolution|ADULT 2020 632|1001|N|N|N||Preferred Generic|351250-Escitalopram20MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|351109-Budesonide0.25MG/MLInhalationSuspension|ADULT 2020 632|1001|N|Y|N||Preferred Generic|239239-Griseofulvin250MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|577957-Amphetamineaspartate3.75MG/AmphetamineSulfate3.75MG/Dextroamphetaminesaccharate3.75MG/DextroamphetamineSulfate3.75MGOr|ADULT 2020 632|1001|N|Y|N||Preferred Generic|204119-Malathion5MG/MLTopicalLotion|ADULT 2020 632|1001|N|N|N||Preferred Generic|1099569-24HRDivalproexSodium500MGExtendedReleaseOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1649996-0.5MLInterferonbeta-1a0.044MG/MLAuto-Injector[Rebif]|ADULT 2020 632|1001|N|N|N||Preferred Generic|197862-Leucovorin25MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|2045958-avatrombopag20MGOralTablet[Doptelet]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|616283-sunitinib12.5MGOralCapsule[Sutent]|ADULT 2020 632|1001|N|N|N||Preferred Generic|992447-PromethazineHydrochloride25MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|1874553-24HRdesvenlafaxinesuccinate100MGExtendedReleaseOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|197931-mercaptopurine50MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1593831-24HRdapagliflozin5MG/Metforminhydrochloride500MGExtendedReleaseOralTablet[Xigduo]|ADULT 2020 632|1001|N|N|N||Preferred Generic|1359117-{24(EthinylEstradiol0.02MG/norethindroneacetate1MGOralTablet)/4(Ferrousfumarate75MGOralTablet)}Pack|ADULT 2020 632|1001|N|N|N||Preferred Generic|1923426-SotalolHydrochloride80MGOralTablet|ADULT 2020 632|1001|N|Y|N||Preferred Generic|1368438-alogliptin25MG/pioglitazone45MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|349407-Treprostinil1MG/MLInjectableSolution|ADULT 2020 632|1001|N|N|N||Preferred Generic|1801289-SmokingCessation12HRBupropionHydrochloride150MGExtendedReleaseOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1946520-3-Month1.5MLLeuprolideAcetate20MG/MLPrefilledSyringe[Lupron]|ADULT 2020 632|1001|N|N|Y||Preferred Brand|998666-carboxymethylcellulosesodium0.01MG/MGOphthalmicGel[TheraTears]|ADULT 2020 632|1001|N|Y|N||Preferred Generic|855194-tolterodinetartrate2MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|750243-Ogestrel28DayPack|ADULT 2020 632|1001|N|N|N||Preferred Generic|200064-letrozole2.5MGOralTablet|ADULT 2020 632|1001|N|Y|N||Preferred Generic|996594-24HRMemantinehydrochloride14MGExtendedReleaseOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|308867-Calcitriol0.00025MGOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1302845-24HRPhentermine3.75MG/topiramate23MGExtendedReleaseOralCapsule[Qsymia]|ADULT 2020 632|1001|N|N|N||Preferred Generic|403853-Hydrochlorothiazide12.5MG/Olmesartanmedoxomil20MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|312835-rivastigmine3MGOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Generic|577348-ramelteon8MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|310191-estradiolvalerate40MG/MLInjectableSolution|ADULT 2020 632|1001|N|N|Y||Preferred Generic|200285-Hydrochlorothiazide12.5MG/valsartan160MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|103456-Fluocinonide0.5MG/MLTopicalCream|ADULT 2020 632|1001|N|Y|N||Preferred Brand|1992691-ertugliflozin2.5MG/Metforminhydrochloride1000MGOralTablet[Segluromet]|ADULT 2020 632|1001|N|N|Y||Preferred Brand|999965-Glycopyrrolate0.2MG/MLOralSolution[Cuvposa]|ADULT 2020 632|1001|N|N|N||Preferred Generic|863636-24HROxybutyninchloride5MGExtendedReleaseOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Brand|798482-0.5MLHepatitisAVaccine(Inactivated)StrainHM1751440UNT/MLPrefilledSyringe[Havrix]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|991528-DextromethorphanHydrobromide3MG/ML/PromethazineHydrochloride1.25MG/MLOralSolution|ADULT 2020 632|1001|N|N|N||Preferred Generic|1014673-cetirizinehydrochloride1MG/MLOralSolution|ADULT 2020 632|1001|Y|N|N||Preferred Generic|200328-capecitabine500MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Brand|1656346-sacubitril24MG/valsartan26MGOralTablet[Entresto]|ADULT 2020 632|1001|N|N|N||Preferred Brand|150840-Estrogens,Conjugated(USP)0.625MGOralTablet[Premarin]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|197591-Diazepam5MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|198427-lamotrigine100MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|310157-Erythromycin500MGDelayedReleaseOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|349593-atomoxetine25MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|313306-Theophylline5.33MG/MLOralSolution|ADULT 2020 632|1001|N|N|N||Preferred Generic|314106-Metronidazole250MGOralTablet|ADULT 2020 632|1001|N|Y|Y||Preferred Generic|856481-24HRPropranololHydrochloride160MGExtendedReleaseOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|199245-glimepiride1MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|283672-Citalopram10MGOralTablet|ADULT 2020 632|1001|N|Y|N||Preferred Generic|1368392-alogliptin12.5MG/Metforminhydrochloride500MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|197541-Colchicine0.6MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|1360304-Budesonide0.08MG/ACTUAT/formoterolfumarate0.0045MG/ACTUATMeteredDoseInhaler|ADULT 2020 632|1001|N|N|N||Preferred Brand|206314-Hydrocortisone0.01MG/MGTopicalOintment[Cortizone]|ADULT 2020 632|1001|N|N|N||Preferred Generic|966225-LevothyroxineSodium0.15MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|313423-Tolnaftate10MG/MLTopicalSolution|ADULT 2020 632|1001|N|N|N||Preferred Generic|749157-{7(EthinylEstradiol0.025MG/norgestimate0.18MGOralTablet)/7(EthinylEstradiol0.025MG/norgestimate0.215MGOralTablet)/7(Et|ADULT 2020 632|1001|N|N|N||Preferred Generic|312635-Prochlorperazine5MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|198108-Piroxicam20MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|198013-Naproxen250MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1115456-1MLLeuprolideAcetate15MG/MLPrefilledSyringe[Lupron]|ADULT 2020 632|1001|Y|N|N||Preferred Generic|656659-bosentan125MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|860707-24HRgalantaminehydrobromide24MGExtendedReleaseOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|1099681-ValproicAcid250MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|722137-Amlodipine5MG/valsartan320MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|402695-24HRFelodipine10MGExtendedReleaseOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|1119400-everolimus7.5MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|1745091-Lidocaine0.05MG/MGMedicatedPatch|ADULT 2020 632|1001|N|N|N||Preferred Brand|2563002-0.5MLinfluenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.09MG/ML/influenzaAvirusA/Wisconsin/588/2019(H1N1)antigen0.09MG/|ADULT 2020 632|1001|N|N|N||Preferred Brand|616444-mycophenolatemofetil200MG/MLOralSuspension[Cellcept]|ADULT 2020 632|1001|N|N|N||Preferred Generic|309680-Dexamethasone1MG/ML/Neomycin3.5MG/ML/PolymyxinB10000UNT/MLOphthalmicSuspension|ADULT 2020 632|1001|N|N|Y||Preferred Generic|283407-Mirtazapine30MGDisintegratingOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|1000114-medroxyprogesteroneacetate10MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|311264-lamotrigine25MGChewableTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|197732-Furosemide80MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1145932-1MLabatacept125MG/MLPrefilledSyringe[Orencia]|ADULT 2020 632|1001|Y|N|N||Preferred Generic|597770-deferasirox250MGTabletforOralSuspension|ADULT 2020 632|1001|N|N|N||Preferred Generic|359601-Guaifenesin400MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|310792-Hydrochlorothiazide12.5MG/irbesartan150MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|1440184-hydrocortisoneacetate0.01MG/MGTopicalOintment|ADULT 2020 632|1001|N|N|N||Preferred Generic|197919-Melphalan2MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|845305-Nonoxynol-90.04MG/MGVaginalGel[Conceptrol]|ADULT 2020 632|1001|Y|N|N||Preferred Generic|1100075-abirateroneacetate250MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|810096-{7(EthinylEstradiol0.01MGOralTablet)/84(EthinylEstradiol0.02MG/Levonorgestrel0.1MGOralTablet)}Pack|ADULT 2020 632|1001|N|N|N||Preferred Generic|315134-Levocarnitine100MG/MLOralSolution|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1046402-1.7MLdenosumab70MG/MLInjection[Xgeva]|ADULT 2020 632|1001|N|N|N||Preferred Generic|197625-Doxazosin1MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|197319-Allopurinol100MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|197787-Hydrocortisone5MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|857340-BethanecholChloride50MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|825429-eltrombopag50MGOralTablet[Promacta]|ADULT 2020 632|1001|N|N|N||Preferred Generic|308973-Carbamazepine100MGChewableTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|628953-PotassiumChloride10MEQExtendedReleaseOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|403884-Levetiracetam100MG/MLOralSolution|ADULT 2020 632|1001|Y|N|N||Preferred Generic|153823-candesartancilexetil8MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|198188-Ramipril2.5MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|1085640-TriamcinoloneAcetonide0.005MG/MGTopicalOintment|ADULT 2020 632|1001|N|N|N||Preferred Generic|197905-Lovastatin40MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|207478-Primidone50MGOralTablet[Mysoline]|ADULT 2020 632|1001|N|N|N||Preferred Generic|197388-Azathioprine50MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|251156-ferroussulfate75MG/MLOralSolution|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1999389-symdeko100MG/150MGand150MGPack|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2473042-ponatinib10MGOralTablet[Iclusig]|ADULT 2020 632|1001|N|N|N||Preferred Generic|897722-Verapamilhydrochloride40MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|310430-gabapentin100MGOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Generic|311204-Itraconazole100MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|1655968-8MLMethotrexate25MG/MLInjection|ADULT 2020 632|1001|N|N|N||Preferred Generic|1738495-ParoxetineHydrochloride20MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|830845-24HRDiltiazemHydrochloride180MGExtendedReleaseOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|432400-cinacalcet90MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|1098924-SodiumFluoride11MG/MLOralSolution[Flura-Drops]|ADULT 2020 632|1001|N|N|Y||Preferred Brand|351433-24HRNicotine0.292MG/HRTransdermalSystem[NicodermC-Q]|ADULT 2020 632|1001|N|N|N||Preferred Brand|2562995-0.5MLinfluenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Washington/19/2020(H1N1)antigen0.03MG/|ADULT 2020 632|1001|N|N|N||Preferred Brand|404476-Azathioprine100MGOralTablet[Azasan]|ADULT 2020 632|1001|N|N|N||Preferred Generic|847121-CalciumCitrate1500MG/Cholecalciferol250UNTOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|1100457-PyridoxineHydrochloride25MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|349198-Clonazepam0.5MGDisintegratingOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|351133-Fenofibrate54MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|349194-Clonazepam0.125MGDisintegratingOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|860244-interferonbeta-1b0.3MGInjection[Extavia]|ADULT 2020 632|1001|N|N|N||Preferred Generic|348472-Theophylline600MGExtendedReleaseOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|896273-120ACTUATFluticasonepropionate0.23MG/ACTUAT/salmeterol0.021MG/ACTUATMeteredDoseInhaler[Advair]|ADULT 2020 632|1001|N|N|N||Preferred Generic|432402-cinacalcet30MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|205912-EpoetinAlfa10000UNT/MLInjectableSolution[Epogen]|ADULT 2020 632|1001|N|N|N||Preferred Generic|197682-Ethosuximide250MGOralCapsule|ADULT 2020 632|1001|N|Y|N||Preferred Generic|996609-24HRMemantinehydrochloride28MGExtendedReleaseOralCapsule|ADULT 2020 632|1001|N|N|Y||Preferred Generic|349094-Budesonide0.125MG/MLInhalationSuspension|ADULT 2020 632|1001|N|N|N||Preferred Generic|197745-Guanfacine1MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|858828-EnalaprilMaleate10MG/Hydrochlorothiazide25MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|141963-Azithromycin40MG/MLOralSuspension|ADULT 2020 632|1001|N|N|N||Preferred Generic|197973-Methylprednisolone8MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|1047895-HyoscyamineSulfate0.125MG/MLOralSolution|ADULT 2020 632|1001|N|N|N||Preferred Generic|1738483-ParoxetineHydrochloride10MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|197746-Guanfacine2MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|198555-Capsaicin0.25MG/MLTopicalCream|ADULT 2020 632|1001|N|N|N||Preferred Generic|198144-Prednisone1MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|402506-12HRCarbamazepine400MGExtendedReleaseOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|197904-Lovastatin20MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|763181-{21(Prednisone5MGOralTablet)}Pack|ADULT 2020 632|1001|N|N|N||Preferred Generic|312962-Simvastatin5MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|198046-Nortriptyline50MGOralCapsule|ADULT 2020 632|1001|N|Y|N||Preferred Brand|1551300-0.5MLdulaglutide1.5MG/MLAuto-Injector[Trulicity]|ADULT 2020 632|1001|N|N|N||Preferred Brand|1112715-Amethyst28DayPack|ADULT 2020 632|1001|N|Y|Y||Preferred Generic|1111339-olopatadine1MG/MLOphthalmicSolution|ADULT 2020 632|1001|Y|N|N||Preferred Brand|901614-Aztreonam75MG/MLInhalationSolution[Cayston]|ADULT 2020 632|1001|N|N|N||Preferred Generic|284184-Didanosine250MGDelayedReleaseOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|312941-Sertraline50MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|860225-MegestrolAcetate40MG/MLOralSuspension|ADULT 2020 632|1001|N|Y|N||Preferred Generic|996603-24HRMemantinehydrochloride21MGExtendedReleaseOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1551888-0.2MLadalimumab50MG/MLPrefilledSyringe[Humira]|ADULT 2020 632|1001|N|N|N||Preferred Generic|313581-24HRvenlafaxine150MGExtendedReleaseOralCapsule|ADULT 2020 632|1001|N|N|Y||Preferred Generic|904589-SotalolHydrochloride240MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|979409-MetaproterenolSulfate10MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|1013629-{24(drospirenone3MG/EthinylEstradiol0.02MG/levomefolatecalcium0.451MGOralTablet)/4(levomefolatecalcium0.451MGOralTabl|ADULT 2020 632|1001|Y|N|Y||Preferred Generic|892646-MorphineSulfate200MGExtendedReleaseOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|995624-MeclizineHydrochloride12.5MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|1870230-NDA0208000.3MLEpinephrine1MG/MLAuto-Injector|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2174390-symdeko50MG/75MGand75MGPack|ADULT 2020 632|1001|N|N|N||Preferred Generic|1095725-ClemastineFumarate1.34MGOralTablet[Dayhist-1]|ADULT 2020 632|1001|N|N|N||Preferred Generic|309679-Dexamethasone0.001MG/MG/Neomycin0.0035MG/MG/PolymyxinB10UNT/MGOphthalmicOintment|ADULT 2020 632|1001|N|Y|Y||Preferred Generic|197979-Metolazone2.5MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|203088-Ketoconazole20MG/MLTopicalCream|ADULT 2020 632|1001|N|N|Y||Preferred Generic|311265-lamotrigine5MGChewableTablet|ADULT 2020 632|1001|N|Y|Y||Preferred Brand|1716215-patiromer8400MGPowderforOralSuspension[Veltassa]|ADULT 2020 632|1001|N|N|N||Preferred Generic|979485-LosartanPotassium25MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|834061-PenicillinVPotassium250MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|562510-SodiumFluoride2MG/MLMouthwash|ADULT 2020 632|1001|N|N|Y||Preferred Generic|862013-24HRGuanfacine2MGExtendedReleaseOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2359358-24HRempagliflozin5MG/linagliptin2.5MG/metforminhydrochloride1000MGExtendedReleaseOralTablet[Trijardy]|ADULT 2020 632|1001|N|N|N||Preferred Generic|312362-Phenobarbital30MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|858813-EnalaprilMaleate5MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|197956-Methyldopa250MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|237776-vitaminB121MGExtendedReleaseOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2203897-ledipasvir45MG/sofosbuvir200MGOralTablet[Harvoni]|ADULT 2020 632|1001|N|Y|N||Preferred Brand|2395785-0.5MLdulaglutide9MG/MLAuto-Injector[Trulicity]|ADULT 2020 632|1001|N|N|N||Preferred Generic|861753-Glyburide5MG/Metforminhydrochloride500MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|381056-IsosorbideDinitrate10MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Brand|2047639-sodiumzirconiumcyclosilicate5000MGPowderforOralSuspension[Lokelma]|ADULT 2020 632|1001|N|N|N||Preferred Brand|692694-thyroid(USP)65MGOralTablet[Westhroid]|ADULT 2020 632|1001|Y|N|N||Preferred Generic|1426600-{24(EthinylEstradiol0.02MG/norethindroneacetate1MGChewableTablet)/4(Ferrousfumarate75MGOralTablet)}Pack|ADULT 2020 632|1001|N|N|N||Preferred Generic|314241-Theophylline450MGExtendedReleaseOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|312137-oxcarbazepine300MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|856429-Hydrochlorothiazide25MG/PropranololHydrochloride80MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1442143-Macitentan10MGOralTablet[Opsumit]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|238003-168HREstradiol0.00208MG/HRTransdermalSystem|ADULT 2020 632|1001|N|Y|Y||Preferred Generic|2001568-BXRating24HRMethylphenidateHydrochloride54MGExtendedReleaseOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|617310-atorvastatin20MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|562524-12HRAcetazolamide500MGExtendedReleaseOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1726639-ponatinib30MGOralTablet[Iclusig]|ADULT 2020 632|1001|N|N|N||Preferred Generic|905222-HydralazineHydrochloride100MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|283406-Mirtazapine15MGDisintegratingOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1114074-Vandetanib100MGOralTablet[Caprelsa]|ADULT 2020 632|1001|N|N|N||Preferred Generic|104884-Metoclopramide1MG/MLOralSolution|ADULT 2020 632|1001|N|N|N||Preferred Generic|861448-ClobetasolPropionate0.0005MG/MGTopicalOintment|ADULT 2020 632|1001|N|N|N||Preferred Generic|476576-cefdinir50MG/MLOralSuspension|ADULT 2020 632|1001|N|N|N||Preferred Brand|206208-aluminumchloride200MG/MLTopicalSolution[Drysol]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|577961-Amphetamineaspartate5MG/AmphetamineSulfate5MG/Dextroamphetaminesaccharate5MG/DextroamphetamineSulfate5MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|313428-Toremifene60MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1649593-0.5MLpeginterferonbeta-1a0.25MG/MLAuto-Injector[Plegridy]|ADULT 2020 632|1001|N|N|N||Preferred Generic|311353-Lisinopril2.5MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|313219-Terazosin5MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|895487-Fluticasonepropionate0.00005MG/MGTopicalOintment|ADULT 2020 632|1001|Y|N|N||Preferred Generic|1607796-deferasirox90MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|1095362-Balziva28DayPack|ADULT 2020 632|1001|N|N|Y||Preferred Generic|242892-84HREstradiol0.00417MG/HRTransdermalSystem|ADULT 2020 632|1001|N|N|N||Preferred Brand|1594673-amylase105000UNT/lipase25000UNT/protease79000UNTDelayedReleaseOralCapsule[Zenpep]|ADULT 2020 632|1001|N|N|N||Preferred Generic|198086-Phenobarbital16.2MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|349514-celecoxib400MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|197861-Leucovorin15MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|311372-Loratadine10MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1726846-0.4MLadalimumab100MG/MLPrefilledSyringe[Humira]|ADULT 2020 632|1001|N|N|N||Preferred Generic|197782-Hydrocortisone10MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|1043690-hydrocortisoneacetate10MG/MLTopicalCream|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1486981-dapagliflozin5MGOralTablet[Farxiga]|ADULT 2020 632|1001|N|N|N||Preferred Generic|403855-Hydrochlorothiazide25MG/Olmesartanmedoxomil40MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|312750-quinapril5MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1801278-HumiraPsoriasisStarterPack40MG/0.8MLPen(4count)|ADULT 2020 632|1001|N|N|N||Preferred Generic|855671-Phenytoinsodium100MGExtendedReleaseOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Generic|1050493-{21(drospirenone3MG/EthinylEstradiol0.03MG/levomefolatecalcium0.451MGOralTablet)/7(levomefolatecalcium0.451MGOralTabl|ADULT 2020 632|1001|N|Y|Y||Preferred Generic|2001565-BXRating24HRMethylphenidateHydrochloride27MGExtendedReleaseOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|311237-Ketotifen0.25MG/MLOphthalmicSolution|ADULT 2020 632|1001|N|N|N||Preferred Generic|857305-ClomipramineHydrochloride75MGOralCapsule|ADULT 2020 632|1001|Y|N|Y||Preferred Generic|891881-MorphineSulfate15MGExtendedReleaseOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|199163-Melatonin3MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|1860148-Abuse-Deterrent12HROxycodoneHydrochloride80MGExtendedReleaseOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|1193362-100MLLevetiracetam5MG/MLInjection|ADULT 2020 632|1001|Y|N|N||Preferred Brand|731245-0.42MLdarbepoetinalfa0.06MG/MLPrefilledSyringe[Aranesp]|ADULT 2020 632|1001|Y|N|N||Preferred Generic|861370-sevelamercarbonate2400MGPowderforOralSuspension|ADULT 2020 632|1001|N|Y|N||Preferred Generic|198373-calcipotriene0.00005MG/MGTopicalOintment|ADULT 2020 632|1001|N|N|Y||Preferred Brand|1547672-30ACTUATfluticasonefuroate0.2MG/ACTUATDryPowderInhaler[Arnuity]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|1000153-1MLmedroxyprogesteroneacetate150MG/MLPrefilledSyringe|ADULT 2020 632|1001|Y|N|N||Preferred Brand|540181-alosetron0.5MGOralTablet[Lotronex]|ADULT 2020 632|1001|Y|N|N||Preferred Generic|854894-Zolpidemtartrate6.25MGExtendedReleaseOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|1298070-Cyclopentolatehydrochloride20MG/MLOphthalmicSolution|ADULT 2020 632|1001|Y|N|N||Preferred Brand|731229-0.6MLdarbepoetinalfa0.5MG/MLPrefilledSyringe[Aranesp]|ADULT 2020 632|1001|N|N|N||Preferred Generic|861427-PropafenoneHydrochloride225MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2359285-24HRempagliflozin10MG/linagliptin5MG/metforminhydrochloride1000MGExtendedReleaseOralTablet[Trijardy]|ADULT 2020 632|1001|N|N|N||Preferred Generic|314165-prednisolone10MG/MLOphthalmicSolution|ADULT 2020 632|1001|N|N|N||Preferred Generic|885857-Balsalazidedisodium750MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Brand|751884-Lutera28DayPack|ADULT 2020 632|1001|N|N|N||Preferred Brand|2563031-influenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.03MG/ML/in|ADULT 2020 632|1001|N|N|N||Preferred Generic|198223-Spironolactone50MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|1087964-hydroxyprogesteronecaproate(USP)250MG/MLInjectableSolution|ADULT 2020 632|1001|N|N|N||Preferred Generic|993503-12HRBupropionHydrochloride100MGExtendedReleaseOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|615979-sorafenib200MGOralTablet[Nexavar]|ADULT 2020 632|1001|N|N|N||Preferred Brand|1000491-Prempro0.3/1.528DayPack|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1242611-Isotretinoin10MGOralCapsule[Myorisan]|ADULT 2020 632|1001|N|N|N||Preferred Generic|198232-Sulfasalazine500MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|308078-AluminumHydroxide64MG/MLOralSuspension|ADULT 2020 632|1001|N|Y|N||Preferred Generic|996615-24HRMemantinehydrochloride7MGExtendedReleaseOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|197405-Betamethasone0.0005MG/MGTopicalOintment|ADULT 2020 632|1001|N|N|N||Preferred Generic|197577-Dexamethasone0.5MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|197411-Bromocriptine2.5MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1235267-CamreseLo91DayPack|ADULT 2020 632|1001|N|N|N||Preferred Generic|997223-Donepezilhydrochloride10MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1592748-nintedanib100MGOralCapsule[Ofev]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1045408-dasatinib80MGOralTablet[Sprycel]|ADULT 2020 632|1001|N|N|N||Preferred Generic|309313-Citalopram2MG/MLOralSolution|ADULT 2020 632|1001|N|N|N||Preferred Generic|1150836-LevobunololHydrochloride5MG/MLOphthalmicSolution|ADULT 2020 632|1001|N|N|N||Preferred Generic|1099316-DesipramineHydrochloride75MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|205918-1MLEpoetinAlfa2000UNT/MLInjection[Procrit]|ADULT 2020 632|1001|Y|N|N||Preferred Generic|1860157-Abuse-Deterrent12HROxycodoneHydrochloride10MGExtendedReleaseOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|856834-AmitriptylineHydrochloride25MGOralTablet|ADULT 2020 632|1001|N|Y|Y||Preferred Generic|854868-Rabeprazolesodium20MGDelayedReleaseOralTablet|ADULT 2020 632|1001|N|Y|N||Preferred Generic|857564-24HRtrospiumchloride60MGExtendedReleaseOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1592752-nintedanib150MGOralCapsule[Ofev]|ADULT 2020 632|1001|N|N|N||Preferred Generic|312136-oxcarbazepine150MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|866924-MetoprololTartrate25MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1243848-24HRMetforminhydrochloride500MG/sitagliptin50MGExtendedReleaseOralTablet[Janumet]|ADULT 2020 632|1001|N|N|N||Preferred Generic|1291082-hydrocortisoneacetate25MGRectalSuppository|ADULT 2020 632|1001|N|N|N||Preferred Generic|856762-AmitriptylineHydrochloride100MGOralTablet|ADULT 2020 632|1001|N|Y|Y||Preferred Generic|856460-24HRPropranololHydrochloride120MGExtendedReleaseOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|197391-Baclofen10MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|349373-Olmesartanmedoxomil5MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|283485-Mirtazapine45MGDisintegratingOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|197408-Betamethasone1MG/MLTopicalLotion|ADULT 2020 632|1001|Y|N|N||Preferred Generic|1923826-deferasirox360MGOralGranules|ADULT 2020 632|1001|Y|N|N||Preferred Brand|643488-Isotretinoin30MGOralCapsule[Claravis]|ADULT 2020 632|1001|N|N|N||Preferred Generic|904431-Alendronicacid70MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Brand|752388-InsulinLispro25UNT/ML/insulinlisproprotamine,human75UNT/MLInjectableSuspension[HumalogMix]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|242333-168HREstradiol0.00104MG/HRTransdermalSystem|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2045638-1MLerenumab-aooe70MG/MLAuto-Injector[Aimovig]|ADULT 2020 632|1001|N|N|Y||Preferred Brand|795737-ChantixStartingMonthPAK|ADULT 2020 632|1001|Y|N|N||Preferred Generic|855642-DiclofenacSodium0.03MG/MGTopicalGel|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2045959-Doptelet40MGDailyDoseCartonPack|ADULT 2020 632|1001|N|N|Y||Preferred Generic|197529-Clonazepam2MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|284551-nilutamide150MGOralTablet[Nilandron]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|313412-tizanidine2MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|404475-Azathioprine75MGOralTablet[Azasan]|ADULT 2020 632|1001|N|N|N||Preferred Generic|1193360-100MLLevetiracetam15MG/MLInjection|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1946522-4-Month1.5MLLeuprolideAcetate20MG/MLPrefilledSyringe[Lupron]|ADULT 2020 632|1001|N|N|Y||Preferred Brand|1994352-0.5MLHepatitisBSurfaceAntigenVaccine0.04MG/MLInjection[Heplisav-B]|ADULT 2020 632|1001|Y|N|N||Preferred Generic|260218-modafinil100MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|197381-Atenolol50MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|349287-Fenofibrate160MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1040058-DextromethorphanHydrobromide20MG/QuinidineSulfate10MGOralCapsule[Nuedexta]|ADULT 2020 632|1001|N|N|Y||Preferred Brand|795735-ChantixContinuingMonthsOfTherapy1MGPack|ADULT 2020 632|1001|N|N|Y||Preferred Generic|198318-Triazolam0.25MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|1094543-Briellyn28DayPack|ADULT 2020 632|1001|N|N|N||Preferred Generic|317769-Theophylline300MGExtendedReleaseOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1310138-everolimus2MGTabletforOralSuspension[Afinitor]|ADULT 2020 632|1001|N|N|N||Preferred Generic|1797851-CromolynSodium5.2MG/ACTUATMeteredDoseNasalSpray|ADULT 2020 632|1001|N|N|N||Preferred Generic|855168-levocetirizinedihydrochloride0.5MG/MLOralSolution|ADULT 2020 632|1001|N|N|Y||Preferred Generic|318202-Erythromycin20MG/MLTopicalSolution|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1732161-incobotulinumtoxinA100UNTInjection[Xeomin]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|259081-12HRAspirin25MG/Dipyridamole200MGExtendedReleaseOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|200257-repaglinide0.5MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|687043-Amphetamineaspartate3.125MG/AmphetamineSulfate3.125MG/Dextroamphetaminesaccharate3.125MG/DextroamphetamineSulfate3.125|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2047623-1MLepoetinalfa-epbx40000UNT/MLInjection[Retacrit]|ADULT 2020 632|1001|N|N|N||Preferred Generic|861495-ClobetasolPropionate0.5MG/MLTopicalCream|ADULT 2020 632|1001|Y|N|Y||Preferred Brand|804547-difluprednate0.5MG/MLOphthalmicSuspension[Durezol]|ADULT 2020 632|1001|N|N|N||Preferred Brand|211633-AluminumHydroxide200MG/MagnesiumHydroxide200MG/Simethicone25MGChewableTablet[Gelusil]|ADULT 2020 632|1001|N|N|N||Preferred Generic|197392-Baclofen20MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|861156-12HRPropafenoneHydrochloride225MGExtendedReleaseOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|199888-topiramate25MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|283317-Hydrochlorothiazide12.5MG/telmisartan80MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|1738503-ParoxetineHydrochloride30MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|1085644-TriamcinoloneAcetonide0.25MG/MLTopicalCream|ADULT 2020 632|1001|N|N|N||Preferred Generic|314076-Lisinopril10MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|238006-Estrogens,Esterified(USP)0.625MG/Methyltestosterone1.25MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|903703-liothyroninesodium0.05MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|310386-Fluoxetine4MG/MLOralSolution|ADULT 2020 632|1001|N|N|Y||Preferred Generic|1298088-FlurazepamHydrochloride15MGOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Generic|403930-Isotretinoin30MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|903697-liothyroninesodium0.025MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|485486-tizanidine2MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|996824-MethylergonovineMaleate0.2MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Brand|630981-PolyvinylAlcohol27MG/ML/Povidone20MG/MLOphthalmicSolution[Freshkote]|ADULT 2020 632|1001|N|N|N||Preferred Brand|1359032-Microgestin1.5/3021DayPack|ADULT 2020 632|1001|N|N|N||Preferred Generic|197816-Indapamide2.5MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|313571-Vancomycin250MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|966253-LevothyroxineSodium0.088MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|308459-Azithromycin20MG/MLOralSuspension|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1002300-nilotinib150MGOralCapsule[Tasigna]|ADULT 2020 632|1001|N|N|N||Preferred Generic|897596-24HRVerapamilhydrochloride300MGExtendedReleaseOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Generic|1435115-28ACTUATTeriparatide0.02MG/ACTUATPenInjector|ADULT 2020 632|1001|N|N|N||Preferred Brand|854918-BisoprololFumarate2.5MG/Hydrochlorothiazide6.25MGOralTablet[Ziac]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|310465-Gentamicin0.001MG/MGTopicalOintment|ADULT 2020 632|1001|N|N|N||Preferred Brand|2564021-0.5MLinfluenzaAvirusA/Cambodia/e0826360/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1593833-24HRdapagliflozin5MG/Metforminhydrochloride1000MGExtendedReleaseOralTablet[Xigduo]|ADULT 2020 632|1001|N|N|N||Preferred Generic|310273-Famotidine20MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|197445-Carbidopa25MG/Levodopa250MGOralTablet|ADULT 2020 632|1001|N|Y|N||Preferred Generic|403852-Carbidopa37.5MG/entacapone200MG/Levodopa150MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|197726-Flutamide125MGOralCapsule|ADULT 2020 632|1001|N|Y|N||Preferred Brand|213307-Ciprofloxacin0.003MG/MGOphthalmicOintment[Ciloxan]|ADULT 2020 632|1001|N|N|N||Preferred Brand|201747-Primidone250MGOralTablet[Mysoline]|ADULT 2020 632|1001|N|N|N||Preferred Brand|352210-Mesna400MGOralTablet[Mesnex]|ADULT 2020 632|1001|N|N|N||Preferred Generic|314072-latanoprost0.05MG/MLOphthalmicSolution|ADULT 2020 632|1001|N|N|Y||Preferred Generic|311207-Ivermectin3MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|993943-Acetaminophen325MG/butalbital50MG/Caffeine40MG/CodeinePhosphate30MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Brand|1148646-28ACTUATFluticasonepropionate0.25MG/ACTUATDryPowderInhaler[Flovent]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2058946-1MLomalizumab150MG/MLPrefilledSyringe[Xolair]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1927290-infliximab-abda100MGInjection[Renflexis]|ADULT 2020 632|1001|Y|N|N||Preferred Generic|1607990-{24(EthinylEstradiol0.025MG/Norethindrone0.8MGChewableTablet)/4(Ferrousfumarate75MGChewableTablet)}Pack|ADULT 2020 632|1001|N|N|N||Preferred Generic|313142-Sulfasalazine500MGDelayedReleaseOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|992775-{1(MiconazoleNitrate1200MGVaginalInsert)/1(9000MG)(MiconazoleNitrate20MG/MLVaginalCream)}Pack|ADULT 2020 632|1001|N|N|N||Preferred Generic|748868-{21(EthinylEstradiol0.02MG/Levonorgestrel0.1MGOralTablet)/7(InertIngredients1MGOralTablet)}Pack|ADULT 2020 632|1001|N|N|N||Preferred Generic|310352-Fluconazole10MG/MLOralSuspension|ADULT 2020 632|1001|Y|N|N||Preferred Generic|603203-erlotinib100MGOralTablet|ADULT 2020 632|1001|N|Y|N||Preferred Brand|833146-Milnacipranhydrochloride50MGOralTablet[Savella]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|731241-1MLdarbepoetinalfa0.5MG/MLPrefilledSyringe[Aranesp]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1650282-RebifRebidoseTitrationPack|ADULT 2020 632|1001|Y|N|N||Preferred Generic|603208-erlotinib25MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|898356-Amlodipine5MG/Benazeprilhydrochloride20MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|727316-NDA0194300.3MLEpinephrine0.5MG/MLAuto-Injector|ADULT 2020 632|1001|N|N|Y||Preferred Brand|311036-insulin,regular,human100UNT/MLInjectableSolution[HumulinR]|ADULT 2020 632|1001|N|N|N||Preferred Generic|1085741-TriamcinoloneAcetonide0.25MG/MLTopicalLotion|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1043574-24HRMetforminhydrochloride1000MG/saxagliptin5MGExtendedReleaseOralTablet[Kombiglyze]|ADULT 2020 632|1001|N|N|N||Preferred Brand|207949-Succimer100MGOralCapsule[Chemet]|ADULT 2020 632|1001|N|N|N||Preferred Brand|1536586-168HREthinylEstradiol0.00146MG/HR/norelgestromin0.00625MG/HRTransdermalSystem[Xulane]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|730046-0.5MLdarbepoetinalfa0.2MG/MLPrefilledSyringe[Aranesp]|ADULT 2020 632|1001|N|N|N||Preferred Generic|198371-torsemide20MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|312845-ropinirole0.25MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|707333-SodiumChloride0.111MEQ/MLNasalSolution[AyrSalineNasal]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|905516-ChlordiazepoxideHydrochloride5MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|204135-Desonide0.0005MG/MGTopicalOintment|ADULT 2020 632|1001|N|N|Y||Preferred Generic|198242-Temazepam30MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|1243585-Flurbiprofensodium0.3MG/MLOphthalmicSolution|ADULT 2020 632|1001|Y|N|N||Preferred Brand|213475-1MLEpoetinAlfa40000UNT/MLInjection[Procrit]|ADULT 2020 632|1001|N|N|N||Preferred Generic|310325-ferroussulfate325MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|245135-72HRFentanyl0.05MG/HRTransdermalSystem|ADULT 2020 632|1001|N|N|N||Preferred Generic|309370-Clotrimazole10MG/MLTopicalSolution|ADULT 2020 632|1001|N|N|N||Preferred Generic|1099292-DesipramineHydrochloride100MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|351246-montelukast4MGOralGranules|ADULT 2020 632|1001|Y|N|N||Preferred Generic|477372-solifenacinsuccinate10MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|616114-lenalidomide10MGOralCapsule[Revlimid]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|979115-0.6MLMethylnaltrexonebromide20MG/MLInjection[Relistor]|ADULT 2020 632|1001|N|N|N||Preferred Generic|1047881-HyoscyamineSulfate0.025MG/MLOralSolution|ADULT 2020 632|1001|N|N|N||Preferred Generic|310490-Glipizide5MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1045404-dasatinib140MGOralTablet[Sprycel]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|897630-24HRVerapamilhydrochloride360MGExtendedReleaseOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Brand|861966-Iloprost0.02MG/MLInhalationSolution[Ventavis]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|1244214-Budesonide3MGDelayedReleaseOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|198105-Pindolol5MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|997420-Fexofenadinehydrochloride180MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|855332-WarfarinSodium5MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|724861-armodafinil250MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Brand|1986830-0.5MLVaricellazostervirusglycoproteinE,recombinant0.1MG/MLInjection[Shingrix]|ADULT 2020 632|1001|N|N|N||Preferred Generic|240209-Betamethasone0.5MG/MLTopicalLotion|ADULT 2020 632|1001|Y|N|N||Preferred Generic|968766-PhentermineHydrochloride15MGOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1812470-ivacaftor125MG/lumacaftor100MGOralTablet[ORKAMBI]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|200094-irbesartan75MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|1005928-ulipristalacetate30MGOralTablet[Ella]|ADULT 2020 632|1001|N|N|N||Preferred Generic|309044-Cefaclor25MG/MLOralSuspension|ADULT 2020 632|1001|N|N|Y||Preferred Generic|349592-atomoxetine18MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|198382-famciclovir500MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|748859-Zovia1/35E28DayPack|ADULT 2020 632|1001|N|N|N||Preferred Generic|198293-Tolazamide500MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|260243-Progesterone100MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|308191-Amoxicillin500MGOralCapsule|ADULT 2020 632|1001|N|Y|N||Preferred Generic|1368403-alogliptin12.5MG/pioglitazone15MGOralTablet|ADULT 2020 632|1001|N|Y|N||Preferred Generic|1368431-alogliptin25MG/pioglitazone30MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|311166-isoniazid100MGOralTablet|ADULT 2020 632|1001|N|Y|N||Preferred Generic|284008-travoprost0.04MG/MLOphthalmicSolution|ADULT 2020 632|1001|N|N|N||Preferred Generic|1014678-cetirizinehydrochloride10MGOralTablet|ADULT 2020 632|1001|N|Y|N||Preferred Generic|997406-12HRFexofenadinehydrochloride60MG/PseudoephedrineHydrochloride120MGExtendedReleaseOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|966224-LevothyroxineSodium0.125MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1242233-lenalidomide2.5MGOralCapsule[Revlimid]|ADULT 2020 632|1001|N|N|N||Preferred Generic|312289-Naloxone0.5MG/Pentazocine50MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1439899-riociguat1.5MGOralTablet[Adempas]|ADULT 2020 632|1001|N|N|N||Preferred Generic|197806-Ibuprofen600MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|541878-Amphetamineaspartate1.25MG/AmphetamineSulfate1.25MG/Dextroamphetaminesaccharate1.25MG/DextroamphetamineSulfate1.25MGOr|ADULT 2020 632|1001|N|N|N||Preferred Generic|312301-Pentoxifylline400MGExtendedReleaseOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|206791-mesalamine250MGExtendedReleaseOralCapsule[Pentasa]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1871467-lisdexamfetaminedimesylate60MGChewableTablet[Vyvanse]|ADULT 2020 632|1001|N|N|N||Preferred Generic|312138-oxcarbazepine600MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|197304-Acetazolamide250MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1872980-0.4MLadalimumab100MG/MLAuto-Injector[Humira]|ADULT 2020 632|1001|Y|N|N||Preferred Generic|1988974-24HRpregabalin165MGExtendedReleaseOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|1085636-TriamcinoloneAcetonide0.001MG/MGTopicalOintment|ADULT 2020 632|1001|N|N|N||Preferred Generic|1050077-DiphenhydramineHydrochloride20MG/MLTopicalCream|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1232204-Zolpidemtartrate3.5MGSublingualTablet[Intermezzo]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|853356-1MLustekinumab90MG/MLPrefilledSyringe[Stelara]|ADULT 2020 632|1001|N|N|N||Preferred Generic|859747-Rosuvastatincalcium10MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2283236-bempedoicacid180MG/ezetimibe10MGOralTablet[Nexlizet]|ADULT 2020 632|1001|N|N|N||Preferred Generic|1724481-thyroid(USP)60MGOralTablet[NPThyroid]|ADULT 2020 632|1001|N|Y|Y||Preferred Generic|313159-Sumatriptan5MG/ACTUATNasalSpray|ADULT 2020 632|1001|N|N|N||Preferred Generic|199246-glimepiride2MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|1487361-1MLglatirameracetate40MG/MLPrefilledSyringe|ADULT 2020 632|1001|N|N|Y||Preferred Generic|897618-24HRVerapamilhydrochloride180MGExtendedReleaseOralCapsule|ADULT 2020 632|1001|N|Y|Y||Preferred Generic|200194-zolmitriptan5MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1551886-lanthanumcarbonate750MGOralPowder[Fosrenol]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|857799-Treprostinil0.6MG/MLInhalationSolution[Tyvaso]|ADULT 2020 632|1001|N|N|N||Preferred Generic|755497-Albuterol0.4MG/MLOralSolution|ADULT 2020 632|1001|N|Y|Y||Preferred Generic|200193-zolmitriptan2.5MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|722116-ambrisentan10MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|313092-Sorbitol700MG/MLOralSolution|ADULT 2020 632|1001|N|N|N||Preferred Generic|197558-Dapsone25MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1661567-TOBIPodhalerDailyKit,8|ADULT 2020 632|1001|N|N|N||Preferred Generic|859751-Rosuvastatincalcium20MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|199192-famciclovir125MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|617309-Amoxicillin200MG/Clavulanate28.5MGChewableTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|895996-120ACTUATFluticasonepropionate0.044MG/ACTUATMeteredDoseInhaler[Flovent]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2392142-0.5MLetanercept50MG/MLInjection[Enbrel]|ADULT 2020 632|1001|N|N|N||Preferred Generic|855664-DiclofenacSodium25MGDelayedReleaseOralTablet|ADULT 2020 632|1001|N|Y|N||Preferred Generic|1797863-flunisolide0.025MG/ACTUATMeteredDoseNasalSpray|ADULT 2020 632|1001|N|N|N||Preferred Brand|213510-Auranofin3MGOralCapsule[Ridaura]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|596934-duloxetine60MGDelayedReleaseOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2287905-1.5MLfremanezumab-vfrm150MG/MLAuto-Injector[Ajovy]|ADULT 2020 632|1001|N|N|N||Preferred Brand|1998772-Breath-Actuated120ACTUATBeclomethasoneDipropionate0.08MG/ACTUATMeteredDoseInhaler[Qvar]|ADULT 2020 632|1001|N|N|N||Preferred Generic|855911-2MLPhenytoinsodium50MG/MLCartridge|ADULT 2020 632|1001|N|N|N||Preferred Generic|997491-Fexofenadinehydrochloride6MG/MLOralSuspension|ADULT 2020 632|1001|N|N|N||Preferred Generic|1020477-DiphenhydramineHydrochloride50MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Brand|1190225-120ACTUATAlbuterol0.1MG/ACTUAT/IpratropiumBromide0.02MG/ACTUATInhalationSpray[Combivent]|ADULT 2020 632|1001|N|N|N||Preferred Brand|762334-Velivet28DayPack|ADULT 2020 632|1001|N|Y|Y||Preferred Generic|351134-zolmitriptan5MGDisintegratingOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|990982-2MLphysostigminesalicylate1MG/MLInjection|ADULT 2020 632|1001|N|N|N||Preferred Generic|312749-quinapril20MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2119389-Spravato84MGDoseKit|ADULT 2020 632|1001|Y|N|Y||Preferred Brand|861771-Metforminhydrochloride1000MG/sitagliptin50MGOralTablet[Janumet]|ADULT 2020 632|1001|Y|N|N||Preferred Generic|1796690-1MLhydroxyprogesteronecaproate(USP)250MG/MLInjection|ADULT 2020 632|1001|N|N|N||Preferred Generic|1437702-Albuterol0.833MG/ML/IpratropiumBromide0.167MG/MLInhalationSolution|ADULT 2020 632|1001|Y|N|N||Preferred Brand|847917-60ACTUATexenatide0.005MG/ACTUATPenInjector[Byetta]|ADULT 2020 632|1001|N|N|N||Preferred Generic|1659263-1MLheparinsodium,porcine5000UNT/MLInjection|ADULT 2020 632|1001|N|N|Y||Preferred Generic|801957-0.5MLDiazepam5MG/MLRectalGel|ADULT 2020 632|1001|Y|N|N||Preferred Brand|212219-EpoetinAlfa20000UNT/MLInjectableSolution[Procrit]|ADULT 2020 632|1001|N|N|N||Preferred Generic|311995-NITROFURANTOIN,MACROCRYSTALS50MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|349401-Olmesartanmedoxomil20MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|2563004-0.7MLinfluenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.0857MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.085|ADULT 2020 632|1001|N|N|Y||Preferred Brand|1658150-1MLHepatitisBSurfaceAntigenVaccine0.01MG/MLInjection[Recombivax]|ADULT 2020 632|1001|N|Y|N||Preferred Generic|403850-Carbidopa12.5MG/entacapone200MG/Levodopa50MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1544918-0.65MLexenatide3.08MG/MLPenInjector[Bydureon]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|993781-Acetaminophen300MG/CodeinePhosphate30MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|616287-sunitinib25MGOralCapsule[Sutent]|ADULT 2020 632|1001|N|N|N||Preferred Brand|748865-Trivora28DayPack|ADULT 2020 632|1001|N|N|N||Preferred Generic|1099648-5MLValproicAcid100MG/MLInjection|ADULT 2020 632|1001|N|N|N||Preferred Brand|754766-Metronidazole0.0075MG/MGVaginalGel[MetroGel]|ADULT 2020 632|1001|N|N|N||Preferred Generic|197444-Carbidopa25MG/Levodopa100MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|2178792-0.3MLEpinephrine0.5MG/MLPrefilledSyringe[Symjepi]|ADULT 2020 632|1001|N|N|N||Preferred Generic|310384-Fluoxetine10MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|857336-BethanecholChloride5MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|199167-Phenobarbital32.4MGOralTablet|ADULT 2020 632|1001|N|Y|N||Preferred Brand|539789-rifaximin200MGOralTablet[XIFAXAN]|ADULT 2020 632|1001|N|N|Y||Preferred Brand|1658472-0.5MLStreptococcuspneumoniaetype1capsularpolysaccharideantigen0.05MG/ML/Streptococcuspneumoniaetype10Acapsularpolysac|ADULT 2020 632|1001|N|N|N||Preferred Generic|106258-Hydrocortisone10MG/MLTopicalCream|ADULT 2020 632|1001|N|N|N||Preferred Brand|1359025-JunelFe28DayPack|ADULT 2020 632|1001|N|N|Y||Preferred Generic|993770-Acetaminophen300MG/CodeinePhosphate15MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|205562-Estramustine140MGOralCapsule[Emcyt]|ADULT 2020 632|1001|N|N|N||Preferred Generic|905199-HydralazineHydrochloride10MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|310809-Hydrochlorothiazide25MG/quinapril20MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1666334-Ticagrelor60MGOralTablet[Brilinta]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|200329-Omeprazole40MGDelayedReleaseOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Generic|1092357-rufinamide40MG/MLOralSuspension|ADULT 2020 632|1001|N|N|Y||Preferred Generic|977880-AmilorideHydrochloride5MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|644088-aprepitant40MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|860107-KetorolacTromethamine5MG/MLOphthalmicSolution|ADULT 2020 632|1001|Y|N|N||Preferred Brand|700418-Thalidomide150MGOralCapsule[Thalomid]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|197527-Clonazepam0.5MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|705008-Cefixime40MG/MLOralSuspension[Suprax]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|1918203-60ACTUATfluticasonepropionate0.232MG/ACTUAT/salmeterol0.014MG/ACTUATDryPowderInhaler|ADULT 2020 632|1001|N|N|N||Preferred Generic|198239-Sulindac200MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|992395-gatifloxacin5MG/MLOphthalmicSolution|ADULT 2020 632|1001|N|Y|Y||Preferred Generic|1111343-olopatadine2MG/MLOphthalmicSolution|ADULT 2020 632|1001|Y|N|N||Preferred Brand|352044-1MLdarbepoetinalfa0.025MG/MLInjection[Aranesp]|ADULT 2020 632|1001|N|N|N||Preferred Generic|282401-lamotrigine25MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|1923422-SotalolHydrochloride120MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1870968-deflazacort22.75MG/MLOralSuspension[Emflaza]|ADULT 2020 632|1001|N|N|N||Preferred Generic|857297-ClomipramineHydrochloride25MGOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Generic|1860129-Abuse-Deterrent12HROxycodoneHydrochloride20MGExtendedReleaseOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|646456-Nystatin100UNT/MGTopicalPowder|ADULT 2020 632|1001|N|Y|N||Preferred Brand|1190334-24HRFexofenadinehydrochloride180MG/PseudoephedrineHydrochloride240MGExtendedReleaseOralTablet[Wal-FexD]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|404062-Isotretinoin20MGOralCapsule[Claravis]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1364358-ponatinib15MGOralTablet[Iclusig]|ADULT 2020 632|1001|Y|N|Y||Preferred Generic|198300-Tretinoin1MG/MLTopicalCream|ADULT 2020 632|1001|N|Y|Y||Preferred Generic|2001564-BXRating24HRMethylphenidateHydrochloride18MGExtendedReleaseOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|199884-Levofloxacin250MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|884619-eltrombopag75MGOralTablet[Promacta]|ADULT 2020 632|1001|N|N|N||Preferred Generic|311727-Misoprostol0.1MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|197770-Hydrochlorothiazide50MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1148502-crizotinib200MGOralCapsule[Xalkori]|ADULT 2020 632|1001|N|N|N||Preferred Generic|197854-Ketoprofen25MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|313583-24HRvenlafaxine37.5MGExtendedReleaseOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|197815-Indapamide1.25MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|309594-vitaminB121MG/MLInjectableSolution|ADULT 2020 632|1001|N|N|Y||Preferred Generic|106346-Mupirocin0.02MG/MGTopicalOintment|ADULT 2020 632|1001|N|N|Y||Preferred Brand|1797888-Nicotine0.5MG/ACTUATMeteredDoseNasalSpray[Nicotrol]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|200345-Simvastatin80MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|856853-AmitriptylineHydrochloride75MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|310687-Hydrocortisone10MG/ML/Neomycin3.5MG/ML/PolymyxinB10000UNT/MLOticSuspension|ADULT 2020 632|1001|N|N|Y||Preferred Generic|349200-valsartan320MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|199376-potassiumcitrate5MEQExtendedReleaseOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|311725-Mirtazapine15MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|1731345-deferoxaminemesylate2000MGInjection|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1921240-0.8MLadalimumab100MG/MLAuto-Injector[Humira]|ADULT 2020 632|1001|N|N|N||Preferred Generic|314131-Niacin250MGExtendedReleaseOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|248420-mesalamine1000MGRectalSuppository|ADULT 2020 632|1001|N|N|Y||Preferred Brand|1037181-dabigatranetexilate75MGOralCapsule[Pradaxa]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|198250-tetracyclinehydrochloride250MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|312594-Prazosin2MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|992780-MiconazoleNitrate100MGVaginalInsert|ADULT 2020 632|1001|N|N|N||Preferred Brand|153183-adapalene0.001MG/MGTopicalGel[Differin]|ADULT 2020 632|1001|N|N|N||Preferred Generic|283077-prednisolone3MG/MLOralSolution|ADULT 2020 632|1001|N|N|N||Preferred Generic|311290-Levetiracetam750MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|849599-1MLcertolizumabpegol200MG/MLPrefilledSyringe[Cimzia]|ADULT 2020 632|1001|N|N|N||Preferred Generic|751901-{84(EthinylEstradiol0.03MG/Levonorgestrel0.15MGOralTablet)/7(InertIngredients1MGOralTablet)}Pack|ADULT 2020 632|1001|N|N|N||Preferred Generic|310818-Hydrochlorothiazide50MG/Triamterene75MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|1014571-12HRcetirizinehydrochloride5MG/PseudoephedrineHydrochloride120MGExtendedReleaseOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|825170-HumiraPen40MG/0.8ML-Crohn'sDiseaseStarterPack|ADULT 2020 632|1001|N|N|N||Preferred Generic|1363309-ChlorpheniramineMaleate4MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|200033-carvedilol25MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|616749-12HRranolazine500MGExtendedReleaseOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|1737461-PamidronateDisodium90MGInjection|ADULT 2020 632|1001|N|Y|Y||Preferred Generic|798133-Erythromycin20MG/MLMedicatedPad[Ery]|ADULT 2020 632|1001|N|N|Y||Preferred Brand|847213-3MLInsulinLispro50UNT/ML/insulinlisproprotamine,human50UNT/MLPenInjector[HumalogMix]|ADULT 2020 632|1001|N|N|N||Preferred Generic|856448-PropranololHydrochloride10MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|105590-Thioguanine40MGOralTablet[Tabloid]|ADULT 2020 632|1001|N|N|N||Preferred Generic|197940-Methazolamide50MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|858824-EnalaprilMaleate5MG/Hydrochlorothiazide12.5MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|856364-TrazodoneHydrochloride150MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|2564406-influenzaAvirusA/Tasmania/503/2020(H3N2)antigen158000000UNT/ML/influenzaAvirusA/Victoria/1/2020(H1N1)antigen158000000|ADULT 2020 632|1001|N|N|Y||Preferred Generic|197512-Ciprofloxacin750MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|2561270-0.5MLinfluenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.03MG/|ADULT 2020 632|1001|N|N|N||Preferred Generic|856377-TrazodoneHydrochloride50MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|197735-Gentamicin1MG/MLTopicalCream|ADULT 2020 632|1001|N|N|N||Preferred Generic|310432-gabapentin400MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|855338-WarfarinSodium6MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|617322-Amoxicillin50MG/ML/Clavulanate12.5MG/MLOralSuspension|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1657212-omalizumab150MGInjection[Xolair]|ADULT 2020 632|1001|N|N|N||Preferred Generic|283523-gabapentin50MG/MLOralSolution|ADULT 2020 632|1001|N|N|N||Preferred Generic|993541-24HRBupropionHydrochloride150MGExtendedReleaseOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|1046985-HyoscyamineSulfate0.125MGDisintegratingOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2120195-1MLerenumab-aooe140MG/MLAuto-Injector[Aimovig]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2387331-120ACTUATbudesonide0.16MG/ACTUAT/formoterolfumarate0.0048MG/ACTUAT/glycopyrrolate0.009MG/ACTUATMeteredDoseInhaler[Bre|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1545174-hydrocortisoneacetate100MG/MLRectalFoam[Cortifoam]|ADULT 2020 632|1001|N|N|N||Preferred Generic|863619-24HROxybutyninchloride10MGExtendedReleaseOralTablet|ADULT 2020 632|1001|Y|N|Y||Preferred Generic|891888-MorphineSulfate30MGExtendedReleaseOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|1806189-30/70Release24HRMethylphenidateHydrochloride30MGExtendedReleaseOralCapsule|ADULT 2020 632|1001|N|N|Y||Preferred Brand|1049216-Acetaminophen325MG/OxycodoneHydrochloride10MGOralTablet[Endocet]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1721685-1MLEpoetinAlfa10000UNT/MLInjection[Epogen]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1605075-0.8MLFILGRASTIM-SNDZ0.6MG/MLPrefilledSyringe[Zarxio]|ADULT 2020 632|1001|N|N|Y||Preferred Brand|208821-Dexamethasone0.001MG/MG/Tobramycin0.003MG/MGOphthalmicOintment[Tobradex]|ADULT 2020 632|1001|N|Y|Y||Preferred Brand|1716223-patiromer25200MGPowderforOralSuspension[Veltassa]|ADULT 2020 632|1001|N|N|N||Preferred Generic|314277-venlafaxine50MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|251322-Ethosuximide50MG/MLOralSolution|ADULT 2020 632|1001|N|N|N||Preferred Generic|317173-Captopril25MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1439894-riociguat0.5MGOralTablet[Adempas]|ADULT 2020 632|1001|N|N|N||Preferred Generic|1547771-Tetracainehydrochloride5MG/MLOphthalmicSolution|ADULT 2020 632|1001|N|N|N||Preferred Generic|307730-Acyclovir40MG/MLOralSuspension|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1870960-deflazacort36MGOralTablet[Emflaza]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1648789-30ACTUATfluticasonefuroate0.2MG/ACTUAT/vilanterol0.025MG/ACTUATDryPowderInhaler[Breo]|ADULT 2020 632|1001|N|N|N||Preferred Generic|239238-Griseofulvin25MG/MLOralSuspension|ADULT 2020 632|1001|Y|N|N||Preferred Generic|876519-Amlodipine10MG/telmisartan80MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2173822-1MLmepolizumab100MG/MLPrefilledSyringe[Nucala]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1243833-24HRMetforminhydrochloride1000MG/sitagliptin100MGExtendedReleaseOralTablet[Janumet]|ADULT 2020 632|1001|N|N|N||Preferred Generic|979092-HydroxychloroquineSulfate200MGOralTablet|ADULT 2020 632|1001|Y|N|Y||Preferred Generic|197635-dronabinol2.5MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|857461-ClemastineFumarate2.68MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|855288-WarfarinSodium1MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|198116-PotassiumChloride20MEQExtendedReleaseOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|1049225-Acetaminophen325MG/OxycodoneHydrochloride7.5MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|808118-prednisolone5MGOralTablet[MILLIPRED]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|1091497-MethylphenidateHydrochloride5MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|485465-Eszopiclone3MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|106351-SilverSulfadiazine10MG/MLTopicalCream|ADULT 2020 632|1001|N|N|N||Preferred Generic|197807-Ibuprofen800MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|1000097-DoxepinHydrochloride75MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|310488-Glipizide10MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|991061-DicyclomineHydrochloride10MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|856845-AmitriptylineHydrochloride50MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|899557-dexmethylphenidatehydrochloride2.5MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|486146-24HRNitroglycerin0.6MG/HRTransdermalSystem|ADULT 2020 632|1001|N|N|N||Preferred Generic|993557-24HRBupropionHydrochloride300MGExtendedReleaseOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|198222-Spironolactone100MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|198083-Phenobarbital100MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|205921-1MLEpoetinAlfa3000UNT/MLInjection[Epogen]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|205917-1MLEpoetinAlfa2000UNT/MLInjection[Epogen]|ADULT 2020 632|1001|N|Y|N||Preferred Generic|197551-Cycloserine250MGOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1654079-0.5MLustekinumab90MG/MLInjection[Stelara]|ADULT 2020 632|1001|Y|N|N||Preferred Generic|864681-Atovaquone62.5MG/proguanilhydrochloride25MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|544597-PotassiumIodide1000MG/MLOralSolution[SSKIbrandofPotassiumIodide]|ADULT 2020 632|1001|N|N|N||Preferred Generic|197305-AceticAcid20MG/MLOticSolution|ADULT 2020 632|1001|N|N|N||Preferred Generic|1797913-TriamcinoloneAcetonide0.055MG/ACTUATMeteredDoseNasalSpray|ADULT 2020 632|1001|N|N|N||Preferred Generic|861164-12HRPropafenoneHydrochloride325MGExtendedReleaseOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Generic|485423-24HRdarifenacin7.5MGExtendedReleaseOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|636042-Hydrochlorothiazide12.5MG/valsartan320MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2003757-1.14MLsarilumab132MG/MLAuto-Injector[Kevzara]|ADULT 2020 632|1001|N|N|N||Preferred Brand|2563020-influenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Washington/19/2020(H1N1)antigen0.03MG/ML/in|ADULT 2020 632|1001|N|N|N||Preferred Generic|308512-Bacitracin0.5UNT/MG/PolymyxinB10UNT/MGTopicalOintment|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1373335-Isotretinoin20MGOralCapsule[Zenatane]|ADULT 2020 632|1001|N|N|Y||Preferred Brand|1658106-0.5MLhepatitisAvirusstrainCR326Fantigen,inactivated50UNT/MLInjection[Vaqta]|ADULT 2020 632|1001|Y|N|N||Preferred Generic|485434-entecavir0.5MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|308135-Amlodipine10MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|866419-24HRmetoprololsuccinate200MGExtendedReleaseOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|200133-12HRCarbamazepine200MGExtendedReleaseOralCapsule|ADULT 2020 632|1001|N|N|Y||Preferred Generic|403922-168HREstradiol0.00156MG/HRTransdermalSystem|ADULT 2020 632|1001|N|N|N||Preferred Generic|197884-Lisinopril40MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|198189-Ramipril5MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|308182-Amoxicillin250MGOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1729061-selexipag0.6MGOralTablet[Uptravi]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|809990-lacosamide100MGOralTablet[Vimpat]|ADULT 2020 632|1001|N|N|N||Preferred Generic|1190572-AtropineSulfate0.025MG/DiphenoxylateHydrochloride2.5MGOralTablet|ADULT 2020 632|1001|N|Y|N||Preferred Generic|825130-24HRmesalamine375MGExtendedReleaseOralCapsule|ADULT 2020 632|1001|N|N|Y||Preferred Generic|198241-Temazepam15MGOralCapsule|ADULT 2020 632|1001|N|N|Y||Preferred Brand|797641-0.5MLNeisseriameningitidisserogroupAcapsularpolysaccharidediphtheriatoxoidproteinconjugatevaccine0.104MG/ML/Neisseriam|ADULT 2020 632|1001|N|Y|N||Preferred Brand|833139-Milnacipranhydrochloride100MGOralTablet[Savella]|ADULT 2020 632|1001|N|N|N||Preferred Generic|860215-MegestrolAcetate20MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|242891-84HREstradiol0.00208MG/HRTransdermalSystem|ADULT 2020 632|1001|N|N|N||Preferred Generic|309952-Dipyridamole25MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|198741-MagnesiumOxide400MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2047614-1MLepoetinalfa-epbx4000UNT/MLInjection[Retacrit]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1745108-1MLixekizumab80MG/MLAuto-Injector[Taltz]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1732165-incobotulinumtoxinA200UNTInjection[Xeomin]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1244064-0.4MLMethylnaltrexonebromide20MG/MLPrefilledSyringe[Relistor]|ADULT 2020 632|1001|Y|N|N||Preferred Generic|310437-Galantamine8MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|1490065-RaloxifeneHydrochloride60MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|312075-Ofloxacin3MG/MLOphthalmicSolution|ADULT 2020 632|1001|N|N|N||Preferred Generic|835925-cyclosporine,modified50MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|1245230-chlorhexidinegluconate20MG/MLMedicatedLiquidSoap|ADULT 2020 632|1001|Y|N|N||Preferred Brand|723846-orlistat60MGOralCapsule[Alli]|ADULT 2020 632|1001|N|N|N||Preferred Generic|898372-Benazeprilhydrochloride20MG/Hydrochlorothiazide25MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1990869-0.85MLexenatide2.35MG/MLAuto-Injector[Bydureon]|ADULT 2020 632|1001|N|N|N||Preferred Generic|997220-Donepezilhydrochloride10MGDisintegratingOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|349353-Hydrochlorothiazide25MG/valsartan160MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|312018-Nitroglycerin6.5MGExtendedReleaseOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Generic|313209-temozolomide20MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|311955-Niacin250MGExtendedReleaseOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|310812-Hydrochlorothiazide25MG/Triamterene37.5MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|854905-BisoprololFumarate5MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|313989-Fluoxetine40MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|309367-Clotrimazole10MG/MLTopicalCream|ADULT 2020 632|1001|N|N|N||Preferred Brand|1113046-amylase15000UNT/lipase3000UNT/protease9500UNTDelayedReleaseOralCapsule[Creon]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1307635-bosutinib500MGOralTablet[Bosulif]|ADULT 2020 632|1001|N|N|N||Preferred Generic|105583-Fluorouracil50MG/MLTopicalCream|ADULT 2020 632|1001|N|N|N||Preferred Generic|198509-Bisacodyl10MGRectalSuppository|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1310147-everolimus5MGTabletforOralSuspension[Afinitor]|ADULT 2020 632|1001|N|N|Y||Preferred Brand|351859-insulin,regular,human500UNT/MLInjectableSolution[HumulinR]|ADULT 2020 632|1001|Y|N|N||Preferred Generic|313211-temozolomide5MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|237420-CalciumCarbonate1500MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|1101778-Monobasicpotassiumphosphate0.0408MEQ/MLOralSolution[K-Phos]|ADULT 2020 632|1001|Y|N|N||Preferred Generic|349435-voriconazole50MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Brand|1658155-0.5MLHepatitisBSurfaceAntigenVaccine0.01MG/MLInjection[Recombivax]|ADULT 2020 632|1001|N|N|N||Preferred Generic|308493-Bacitracin0.4UNT/MG/Neomycin0.0035MG/MG/PolymyxinB10UNT/MGOphthalmicOintment|ADULT 2020 632|1001|N|N|N||Preferred Generic|856797-AmitriptylineHydrochloride25MG/Perphenazine2MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|1191310-FluocinoloneAcetonide0.1MG/MLTopicalSolution|ADULT 2020 632|1001|N|N|N||Preferred Brand|209531-Acetaminophen80MGRectalSuppository[Feverall]|ADULT 2020 632|1001|N|N|N||Preferred Brand|861834-amylase82000UNT/lipase15000UNT/protease51000UNTDelayedReleaseOralCapsule[Zenpep]|ADULT 2020 632|1001|Y|N|N||Preferred Generic|310436-Galantamine4MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|854801-DiclofenacSodium1MG/MLOphthalmicSolution|ADULT 2020 632|1001|N|N|N||Preferred Generic|1250490-hydrocortisoneacetate5MG/MLTopicalCream|ADULT 2020 632|1001|N|N|Y||Preferred Brand|1300468-0.5MLHaemophilusinfluenzaetypebstrain1482,capsularpolysaccharideinactivatedtetanustoxoidconjugatevaccine0.068MG/MLInj|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1307630-bosutinib100MGOralTablet[Bosulif]|ADULT 2020 632|1001|N|N|N||Preferred Brand|207136-Methylprednisolone2MGOralTablet[Medrol]|ADULT 2020 632|1001|N|N|N||Preferred Generic|314111-Mirtazapine30MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|198181-Pyrazinamide500MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|253059-Levocarnitine500MGOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2475852-vericiguat10MGOralTablet[Verquvo]|ADULT 2020 632|1001|N|N|N||Preferred Brand|1000158-0.65MLmedroxyprogesteroneacetate160MG/MLPrefilledSyringe[depo-subQprovera]|ADULT 2020 632|1001|N|Y|N||Preferred Generic|857560-trospiumchloride20MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|310261-exemestane25MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|198145-Prednisone10MGOralTablet|ADULT 2020 632|1001|N|Y|N||Preferred Generic|197505-Cimetidine200MGOralTablet|ADULT 2020 632|1001|N|Y|N||Preferred Generic|562806-Pimecrolimus10MG/MLTopicalCream|ADULT 2020 632|1001|N|N|N||Preferred Generic|200256-repaglinide1MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1365866-nepafenac3MG/MLOphthalmicSuspension[Ilevro]|ADULT 2020 632|1001|N|N|N||Preferred Brand|208549-thyroid(USP)240MGOralTablet[ArmourThyroid]|ADULT 2020 632|1001|N|N|N||Preferred Generic|198202-Rifampin300MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Brand|1359027-MicrogestinFe1.5/3028DayPack|ADULT 2020 632|1001|Y|N|N||Preferred Generic|349253-bosentan62.5MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|668606-Vorinostat100MGOralCapsule[Zolinza]|ADULT 2020 632|1001|N|N|N||Preferred Brand|750244-Low-Ogestrel28DayPack|ADULT 2020 632|1001|N|N|N||Preferred Generic|310965-Ibuprofen200MGOralTablet|ADULT 2020 632|1001|Y|N|Y||Preferred Brand|665040-sitagliptin25MGOralTablet[Januvia]|ADULT 2020 632|1001|Y|N|N||Preferred Generic|864718-MethadoneHydrochloride5MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|308868-Calcitriol0.0005MGOralCapsule|ADULT 2020 632|1001|N|N|Y||Preferred Generic|313222-terbinafine250MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|200371-Citalopram20MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|198200-Rifabutin150MGOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2475406-voclosporin7.9MGOralCapsule[Lupkynis]|ADULT 2020 632|1001|N|Y|N||Preferred Generic|403851-Carbidopa25MG/entacapone200MG/Levodopa100MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1012899-fingolimod0.5MGOralCapsule[Gilenya]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1871459-lisdexamfetaminedimesylate40MGChewableTablet[Vyvanse]|ADULT 2020 632|1001|N|N|N||Preferred Brand|209360-Acetaminophen325MGRectalSuppository[Acephen]|ADULT 2020 632|1001|N|N|N||Preferred Generic|308694-BenzoylPeroxide0.05MG/MGTopicalGel|ADULT 2020 632|1001|Y|N|N||Preferred Generic|860695-24HRgalantaminehydrobromide16MGExtendedReleaseOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Brand|836368-200ACTUATIpratropiumBromide0.017MG/ACTUATMeteredDoseInhaler[Atrovent]|ADULT 2020 632|1001|N|N|Y||Preferred Brand|798428-1MLHepatitisBSurfaceAntigenVaccine0.02MG/MLPrefilledSyringe[Engerix-B]|ADULT 2020 632|1001|N|N|Y||Preferred Brand|351427-24HRNicotine0.583MG/HRTransdermalSystem[NicodermC-Q]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2059189-amikacinliposomal70.3MG/MLInhalationSuspension[Arikayce]|ADULT 2020 632|1001|N|N|N||Preferred Generic|866436-24HRmetoprololsuccinate50MGExtendedReleaseOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|314135-naratriptan2.5MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Brand|1300378-0.5MLBordetellapertussisfilamentoushemagglutininvaccine,inactivated0.016MG/ML/Bordetellapertussispertactinvaccine,ina|ADULT 2020 632|1001|Y|N|N||Preferred Generic|1874559-24HRdesvenlafaxinesuccinate50MGExtendedReleaseOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|312087-Ondansetron8MGDisintegratingOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|1731350-deferoxaminemesylate500MGInjection|ADULT 2020 632|1001|N|N|Y||Preferred Generic|834022-KetorolacTromethamine10MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|313586-venlafaxine75MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|308689-BenzoylPeroxide0.025MG/MGTopicalGel|ADULT 2020 632|1001|N|N|N||Preferred Brand|855205-docosanol100MG/MLTopicalCream[Abreva]|ADULT 2020 632|1001|Y|N|N||Preferred Generic|543218-1MLGranisetron0.1MG/MLInjection|ADULT 2020 632|1001|Y|N|N||Preferred Generic|1095229-FlavoxateHydrochloride100MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|351750-podofilox0.005MG/MGTopicalGel[Condylox]|ADULT 2020 632|1001|N|N|N||Preferred Generic|314006-24HRGlipizide5MGExtendedReleaseOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|313472-Trientinehydrochloride250MGOralCapsule|ADULT 2020 632|1001|N|Y|Y||Preferred Brand|1716219-patiromer16800MGPowderforOralSuspension[Veltassa]|ADULT 2020 632|1001|N|N|N||Preferred Generic|861748-Glyburide2.5MG/Metforminhydrochloride500MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2531134-HumiraPen80MG/0.8ML-StarterPackageforPediatricUlcerativeColitis(4count)|ADULT 2020 632|1001|N|N|N||Preferred Generic|198201-Rifampin150MGOralCapsule|ADULT 2020 632|1001|N|N|Y||Preferred Brand|351429-24HRNicotine0.875MG/HRTransdermalSystem[NicodermC-Q]|ADULT 2020 632|1001|N|N|N||Preferred Generic|995599-EthambutolHydrochloride100MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1921245-HumiraPen80MG/0.8ML-StarterPackageforCrohn'sDisease,UlcerativeColitisorHidradenitisSuppurativa(3count)|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2053519-ivacaftor188MG/lumacaftor150MGOralGranules[ORKAMBI]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|197528-Clonazepam1MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2048025-0.6MLpegfilgrastim-jmdb10MG/MLPrefilledSyringe[Fulphila]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2058887-1MLgalcanezumab-gnlm120MG/MLPrefilledSyringe[Emgality]|ADULT 2020 632|1001|N|N|N||Preferred Generic|1011852-LidocaineHydrochloride0.02MG/MGTopicalGel|ADULT 2020 632|1001|N|N|N||Preferred Generic|1006120-SulfacetamideSodium100MG/MLOphthalmicSolution|ADULT 2020 632|1001|Y|N|N||Preferred Brand|727705-0.8MLadalimumab50MG/MLPrefilledSyringe[Humira]|ADULT 2020 632|1001|N|N|N||Preferred Generic|1047905-HyoscyamineSulfate0.125MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|1860151-Abuse-Deterrent12HROxycodoneHydrochloride30MGExtendedReleaseOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|309110-Cephalexin25MG/MLOralSuspension|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1945048-30ACTUATfluticasonefuroate0.1MG/ACTUAT/umeclidinium0.0625MG/ACTUAT/vilanterol0.025MG/ACTUATDryPowderInhaler[Trelegy]|ADULT 2020 632|1001|N|N|N||Preferred Generic|197685-Etodolac300MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|197737-Glyburide1.25MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1302856-24HRPhentermine15MG/topiramate92MGExtendedReleaseOralCapsule[Qsymia]|ADULT 2020 632|1001|Y|N|N||Preferred Generic|477367-solifenacinsuccinate5MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|1855086-thyroid(USP)15MGOralTablet[NPThyroid]|ADULT 2020 632|1001|Y|N|N||Preferred Generic|857216-Sevelamerhydrochloride400MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|403966-zonisamide25MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|198380-tioconazole0.065MG/MGVaginalOintment|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2053512-ivacaftor125MG/lumacaftor100MGOralGranules[ORKAMBI]|ADULT 2020 632|1001|Y|N|N||Preferred Generic|1011736-aliskiren150MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|197741-Guaifenesin200MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|238920-Betamethasone0.5MG/MLTopicalCream|ADULT 2020 632|1001|N|N|N||Preferred Generic|197500-Chlorthalidone50MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|1359020-Microgestin1/2021DayPack|ADULT 2020 632|1001|N|Y|N||Preferred Brand|1991311-0.25MG,0.5MGDose1.5MLsemaglutide1.34MG/MLPenInjector[Ozempic]|ADULT 2020 632|1001|N|N|N||Preferred Generic|1738511-ParoxetineHydrochloride40MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|1801294-MicroencapsulatedPotassiumChloride20MEQExtendedReleaseOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|608143-atomoxetine80MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|310536-Glyburide3MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|903456-liothyroninesodium0.005MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|992481-PromethazineHydrochloride50MGRectalSuppository[Promethegan]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|1812011-Osmotic24HRNifedipine30MGExtendedReleaseOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|855302-WarfarinSodium2MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|617333-Amoxicillin25MG/ML/Clavulanate6.25MG/MLOralSuspension[Augmentin]|ADULT 2020 632|1001|N|N|N||Preferred Generic|831261-CromolynSodium20MG/MLOralSolution|ADULT 2020 632|1001|N|N|N||Preferred Brand|2173508-Nonoxynol-91000MGVaginalSponge[TodaySponge]|ADULT 2020 632|1001|N|Y|N||Preferred Brand|1992700-ertugliflozin7.5MG/Metforminhydrochloride1000MGOralTablet[Segluromet]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1364515-Bedaquiline100MGOralTablet[Sirturo]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1606866-ivacaftor50MGOralGranules[Kalydeco]|ADULT 2020 632|1001|N|N|N||Preferred Generic|198165-Propantheline15MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|1099870-DivalproexSodium500MGDelayedReleaseOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|313888-Cefaclor50MG/MLOralSuspension|ADULT 2020 632|1001|N|Y|N||Preferred Generic|686429-mesalamine1200MGDelayedReleaseOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|349434-voriconazole200MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|992528-Terbinafinehydrochloride10MG/MLTopicalCream|ADULT 2020 632|1001|N|N|Y||Preferred Generic|801961-2MLDiazepam5MG/MLRectalGel|ADULT 2020 632|1001|N|N|N||Preferred Generic|318272-Aspirin81MGChewableTablet|ADULT 2020 632|1001|N|N|Y||Preferred Brand|637190-varenicline1MGOralTablet[Chantix]|ADULT 2020 632|1001|N|N|N||Preferred Generic|748961-{28(Norethindrone0.35MGOralTablet)}Pack|ADULT 2020 632|1001|N|N|N||Preferred Generic|311376-Lorazepam2MG/MLOralSolution|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2121100-siponimod2MGOralTablet[Mayzent]|ADULT 2020 632|1001|N|N|N||Preferred Generic|197379-Atenolol100MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|1923822-deferasirox90MGOralGranules|ADULT 2020 632|1001|N|N|N||Preferred Generic|312940-Sertraline25MGOralTablet|ADULT 2020 632|1001|N|Y|N||Preferred Generic|197418-Bumetanide1MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|309290-ciclopirox7.7MG/MLTopicalLotion|ADULT 2020 632|1001|N|N|N||Preferred Brand|751890-Portia28DayPack|ADULT 2020 632|1001|N|N|Y||Preferred Generic|636045-Hydrochlorothiazide25MG/valsartan320MGOralTablet|ADULT 2020 632|1001|N|Y|N||Preferred Brand|833149-Milnacipranhydrochloride25MGOralTablet[Savella]|ADULT 2020 632|1001|N|N|N||Preferred Generic|241834-cyclosporine,modified100MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Brand|896019-60ACTUATFluticasonepropionate0.05MG/ACTUATDryPowderInhaler[Flovent]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|608139-atomoxetine100MGOralCapsule|ADULT 2020 632|1001|N|N|Y||Preferred Generic|197589-Diazepam10MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1923347-1.14MLsarilumab175MG/MLPrefilledSyringe[Kevzara]|ADULT 2020 632|1001|N|N|N||Preferred Generic|197579-Dexamethasone1MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|830861-24HRDiltiazemHydrochloride120MGExtendedReleaseOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|903887-FluvoxamineMaleate25MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|199150-Acarbose100MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|313564-valacyclovir1000MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Brand|830253-0.5MLHepatitisBSurfaceAntigenVaccine0.01MG/MLPrefilledSyringe[Recombivax]|ADULT 2020 632|1001|N|N|N||Preferred Generic|402696-24HRFelodipine5MGExtendedReleaseOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|905158-Sirolimus0.5MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|854880-Zolpidemtartrate12.5MGExtendedReleaseOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|198317-Triazolam0.125MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|313165-0.5MLSumatriptan12MG/MLInjection|ADULT 2020 632|1001|N|N|N||Preferred Generic|308976-Carbamazepine20MG/MLOralSuspension|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1011715-aliskiren150MG/Hydrochlorothiazide25MGOralTablet[TekturnaHCT]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2463737-epoetinalfa-epbx20000UNT/MLInjectableSolution[Retacrit]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1729057-selexipag0.4MGOralTablet[Uptravi]|ADULT 2020 632|1001|N|N|N||Preferred Brand|208551-thyroid(USP)300MGOralTablet[ArmourThyroid]|ADULT 2020 632|1001|Y|N|N||Preferred Generic|1728055-5MLpalonosetron0.05MG/MLInjection|ADULT 2020 632|1001|N|N|N||Preferred Generic|309098-Cefuroxime500MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|314077-Lisinopril20MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|999996-Amlodipine5MG/Hydrochlorothiazide12.5MG/Olmesartanmedoxomil40MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|750264-Necon7/7/728DayPack|ADULT 2020 632|1001|N|N|Y||Preferred Generic|199381-potassiumcitrate10MEQExtendedReleaseOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|206842-IsosorbideDinitrate20MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|993456-1MLdenosumab60MG/MLPrefilledSyringe[Prolia]|ADULT 2020 632|1001|N|N|N||Preferred Brand|1595462-amylase42000UNT/lipase10000UNT/protease32000UNTDelayedReleaseOralCapsule[Zenpep]|ADULT 2020 632|1001|N|N|N||Preferred Generic|749780-{3(Azithromycin500MGOralTablet)}Pack|ADULT 2020 632|1001|N|N|N||Preferred Generic|103401-Hydrocortisone0.025MG/MGTopicalOintment|ADULT 2020 632|1001|N|N|N||Preferred Generic|1191315-FluocinoloneAcetonide0.25MG/MLTopicalCream|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2170613-1MLgalcanezumab-gnlm100MG/MLPrefilledSyringe[Emgality]|ADULT 2020 632|1001|N|N|N||Preferred Generic|833528-Amiodaronehydrochloride200MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1665906-1MLevolocumab140MG/MLPrefilledSyringe[Repatha]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1734642-elbasvir50MG/grazoprevir100MGOralTablet[Zepatier]|ADULT 2020 632|1001|N|N|N||Preferred Generic|204844-Azithromycin600MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|313761-zaleplon10MGOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1655934-ivacaftor125MG/lumacaftor200MGOralTablet[ORKAMBI]|ADULT 2020 632|1001|N|N|N||Preferred Brand|1250090-Nonoxynol-90.03MG/MGVaginalGel[GynolII]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|238004-168HREstradiol0.00417MG/HRTransdermalSystem|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1242615-Isotretinoin40MGOralCapsule[Myorisan]|ADULT 2020 632|1001|Y|N|Y||Preferred Generic|310140-eprosartan600MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1191128-EdrophoniumChloride10MG/MLInjectableSolution[Enlon]|ADULT 2020 632|1001|N|N|N||Preferred Generic|859040-Pramipexoledihydrochloride0.25MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|866144-Cyproheptadinehydrochloride4MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|313850-Amoxicillin40MG/MLOralSuspension|ADULT 2020 632|1001|Y|N|N||Preferred Brand|727714-0.67MLanakinra149MG/MLPrefilledSyringe[Kineret]|ADULT 2020 632|1001|N|N|N||Preferred Generic|855906-DiclofenacSodium50MGDelayedReleaseOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Brand|1658157-1MLHepatitisBSurfaceAntigenVaccine0.02MG/MLInjection[Engerix-B]|ADULT 2020 632|1001|N|N|N||Preferred Brand|991233-bexarotene0.01MG/MGTopicalGel[Targretin]|ADULT 2020 632|1001|N|N|N||Preferred Generic|198012-Naproxen375MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|562508-Amoxicillin875MG/Clavulanate125MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|240029-Cholecalciferol0.125MGOralCapsule|ADULT 2020 632|1001|N|N|Y||Preferred Generic|349195-Clonazepam0.25MGDisintegratingOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1650004-0.5MLInterferonbeta-1a0.088MG/MLAuto-Injector[Rebif]|ADULT 2020 632|1001|N|N|N||Preferred Generic|197499-Chlorthalidone25MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|759473-20ACTUATZanamivir5MG/ACTUATDryPowderInhaler[Relenza]|ADULT 2020 632|1001|Y|N|N||Preferred Generic|727339-0.5MLSumatriptan12MG/MLPrefilledSyringe|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1544402-0.6MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|ADULT 2020 632|1001|N|N|N||Preferred Generic|863669-Tamsulosinhydrochloride0.4MGOralCapsule|ADULT 2020 632|1001|N|N|Y||Preferred Generic|541363-Amphetamineaspartate7.5MG/AmphetamineSulfate7.5MG/Dextroamphetaminesaccharate7.5MG/DextroamphetamineSulfate7.5MGOralTa|ADULT 2020 632|1001|N|N|N||Preferred Generic|1000064-DoxepinHydrochloride150MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|309113-Cephalexin50MG/MLOralSuspension|ADULT 2020 632|1001|N|N|N||Preferred Generic|617312-atorvastatin10MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|577776-candesartancilexetil16MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|1923809-thyroid(USP)120MGOralTablet[NPThyroid]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|1806193-30/70Release24HRMethylphenidateHydrochloride50MGExtendedReleaseOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Brand|404492-5MLLaronidase0.58MG/MLInjection[Aldurazyme]|ADULT 2020 632|1001|N|N|N||Preferred Brand|1293864-ErgotamineTartrate2MGSublingualTablet[Ergomar]|ADULT 2020 632|1001|Y|N|N||Preferred Generic|728231-12HRranolazine1000MGExtendedReleaseOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|312440-pioglitazone30MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|862006-24HRGuanfacine1MGExtendedReleaseOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2256947-lasmiditan50MGOralTablet[Reyvow]|ADULT 2020 632|1001|N|N|N||Preferred Generic|1049630-DiphenhydramineHydrochloride25MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1806942-carfilzomib60MGInjection[Kyprolis]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|200224-montelukast10MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|208949-Estrogens,Conjugated(USP)0.9MGOralTablet[Premarin]|ADULT 2020 632|1001|N|N|N||Preferred Generic|966222-LevothyroxineSodium0.075MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|309955-Dipyridamole75MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|854836-lisdexamfetaminedimesylate30MGOralCapsule[Vyvanse]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2262713-MicronizedIsotretinoin16MGOralCapsule[Absorica]|ADULT 2020 632|1001|N|N|N||Preferred Generic|1648755-NITROFURANTOIN,MACROCRYSTALS25MG/Nitrofurantoin,Monohydrate75MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|686924-carvedilol3.125MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|1988977-24HRpregabalin330MGExtendedReleaseOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|307719-Acetylcysteine200MG/MLInhalationSolution|ADULT 2020 632|1001|N|N|N||Preferred Generic|1376336-prednisoloneacetate10MG/MLOphthalmicSuspension|ADULT 2020 632|1001|N|N|N||Preferred Generic|861132-24HRAlfuzosinhydrochloride10MGExtendedReleaseOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1544398-0.5MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|ADULT 2020 632|1001|N|N|N||Preferred Generic|317136-Nortriptyline25MGOralCapsule|ADULT 2020 632|1001|N|N|Y||Preferred Generic|866042-NeomycinSulfate500MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1649495-ivabradine7.5MGOralTablet[Corlanor]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|603978-nepafenac1MG/MLOphthalmicSuspension[Nevanac]|ADULT 2020 632|1001|N|N|N||Preferred Generic|308979-Carbamazepine200MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|198238-Sulindac150MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|724863-armodafinil50MGOralTablet|ADULT 2020 632|1001|N|Y|Y||Preferred Generic|244374-BenzoylPeroxide0.05MG/MG/Erythromycin0.03MG/MGTopicalGel|ADULT 2020 632|1001|N|N|Y||Preferred Generic|198051-Omeprazole20MGDelayedReleaseOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Brand|212373-Estrogens,Esterified(USP)1.25MGOralTablet[Menest]|ADULT 2020 632|1001|N|N|N||Preferred Generic|315183-PotassiumChloride8MEQExtendedReleaseOralCapsule|ADULT 2020 632|1001|N|N|Y||Preferred Generic|2047882-1MLtestosteronecypionate200MG/MLInjection|ADULT 2020 632|1001|N|N|N||Preferred Generic|197575-Desoximetasone0.0025MG/MGTopicalOintment|ADULT 2020 632|1001|Y|N|N||Preferred Brand|753437-9HRMethylphenidate1.11MG/HRTransdermalSystem[Daytrana]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|861225-24HRAmphetamineaspartate5MG/AmphetamineSulfate5MG/Dextroamphetaminesaccharate5MG/DextroamphetamineSulfate5MGExtendedRe|ADULT 2020 632|1001|Y|N|N||Preferred Generic|1734399-1MLGranisetron1MG/MLInjection|ADULT 2020 632|1001|N|N|N||Preferred Generic|198152-Probenecid500MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|861223-24HRAmphetamineaspartate3.75MG/AmphetamineSulfate3.75MG/Dextroamphetaminesaccharate3.75MG/DextroamphetamineSulfate3.75|ADULT 2020 632|1001|Y|N|N||Preferred Generic|903857-PyridostigmineBromide60MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|992454-PromethazineHydrochloride25MGRectalSuppository|ADULT 2020 632|1001|N|N|Y||Preferred Generic|894780-MorphineSulfate4MG/MLOralSolution|ADULT 2020 632|1001|N|N|N||Preferred Generic|617311-atorvastatin40MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|199352-trandolapril4MGOralTablet|ADULT 2020 632|1001|N|Y|Y||Preferred Brand|2200650-semaglutide14MGOralTablet[Rybelsus]|ADULT 2020 632|1001|N|N|N||Preferred Generic|310489-24HRGlipizide2.5MGExtendedReleaseOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1728095-romiplostim0.25MGInjection[Nplate]|ADULT 2020 632|1001|N|N|Y||Preferred Brand|2053927-sodiumzirconiumcyclosilicate10000MGPowderforOralSuspension[Lokelma]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|892625-MorphineSulfate20MG/MLOralSolution|ADULT 2020 632|1001|N|N|N||Preferred Brand|753543-Reclipsen28DayPack|ADULT 2020 632|1001|N|Y|Y||Preferred Generic|284201-zolmitriptan2.5MGDisintegratingOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|313190-Tacrolimus0.5MGOralCapsule|ADULT 2020 632|1001|N|Y|Y||Preferred Generic|309333-Clindamycin10MG/MLTopicalSolution|ADULT 2020 632|1001|Y|N|N||Preferred Brand|207059-interferonbeta-1b0.3MGInjection[Betaseron]|ADULT 2020 632|1001|N|N|N||Preferred Generic|992153-methenaminemandelate1000MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1235150-azilsartanmedoxomil40MG/Chlorthalidone12.5MGOralTablet[Edarbyclor]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|854852-lisdexamfetaminedimesylate50MGOralCapsule[Vyvanse]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|847913-60ACTUATexenatide0.01MG/ACTUATPenInjector[Byetta]|ADULT 2020 632|1001|N|N|N||Preferred Generic|312529-PotassiumChloride8MEQExtendedReleaseOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2262727-MicronizedIsotretinoin32MGOralCapsule[Absorica]|ADULT 2020 632|1001|N|N|N||Preferred Generic|831054-DiltiazemHydrochloride120MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|997229-Donepezilhydrochloride5MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|897612-24HRVerapamilhydrochloride120MGExtendedReleaseOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|1923432-dorzolamide20MG/ML/Timolol5MG/MLOphthalmicSolution|ADULT 2020 632|1001|N|N|N||Preferred Generic|1098134-24HRNiacin1000MGExtendedReleaseOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|1014676-cetirizinehydrochloride5MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|313566-valganciclovir450MGOralTablet|ADULT 2020 632|1001|N|Y|Y||Preferred Generic|314227-Sumatriptan20MG/ACTUATNasalSpray|ADULT 2020 632|1001|Y|N|N||Preferred Brand|582595-Iloprost0.01MG/MLInhalationSolution[Ventavis]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|857366-EconazoleNitrate10MG/MLTopicalCream|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1232200-Zolpidemtartrate1.75MGSublingualTablet[Intermezzo]|ADULT 2020 632|1001|N|N|N||Preferred Generic|197860-Leucovorin10MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|860975-24HRMetforminhydrochloride500MGExtendedReleaseOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2262719-MicronizedIsotretinoin24MGOralCapsule[Absorica]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|857002-Acetaminophen325MG/HydrocodoneBitartrate5MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1544386-0.25MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|313570-Vancomycin125MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|895987-Fluticasonepropionate0.5MG/MLTopicalCream|ADULT 2020 632|1001|N|N|N||Preferred Generic|197658-Estradiol1MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1871463-lisdexamfetaminedimesylate20MGChewableTablet[Vyvanse]|ADULT 2020 632|1001|N|N|Y||Preferred Brand|804186-0.5MLMeaslesVirusVaccineLive,Enders'attenuatedEdmonstonstrain2000UNT/ML/MumpsVirusVaccineLive,JerylLynnStrain25000UNT/|ADULT 2020 632|1001|N|N|N||Preferred Generic|197581-Dexamethasone2MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|313195-Tamoxifen20MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|197700-Fluconazole200MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|597768-deferasirox125MGTabletforOralSuspension|ADULT 2020 632|1001|N|N|N||Preferred Generic|855926-DiclofenacSodium75MGDelayedReleaseOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1149617-COLLAGENASE0.25UNT/MGTopicalOintment[Santyl]|ADULT 2020 632|1001|N|N|N||Preferred Generic|979471-Hydrochlorothiazide25MG/LosartanPotassium100MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Brand|1596445-7ACTUATumeclidinium0.0625MG/ACTUATDryPowderInhaler[Incruse]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|854844-lisdexamfetaminedimesylate70MGOralCapsule[Vyvanse]|ADULT 2020 632|1001|N|N|N||Preferred Generic|197311-Acyclovir400MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|199206-Riluzole50MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|831102-DiltiazemHydrochloride90MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|543546-Nystatin100000UNT/MLTopicalCream|ADULT 2020 632|1001|N|N|N||Preferred Brand|905379-HydralazineHydrochloride37.5MG/IsosorbideDinitrate20MGOralTablet[Bidil]|ADULT 2020 632|1001|N|N|N||Preferred Generic|896762-Labetalolhydrochloride200MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|577040-CalciumCarbonate648MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1541928-sunitinib37.5MGOralCapsule[Sutent]|ADULT 2020 632|1001|N|N|N||Preferred Generic|312615-Prednisone20MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|824301-rufinamide400MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Brand|1992169-InsulinLispro100UNT/MLInjectableSolution[Admelog]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|854235-0.4MLEnoxaparinsodium100MG/MLPrefilledSyringe|ADULT 2020 632|1001|N|N|N||Preferred Generic|1049909-DiphenhydramineHydrochloride25MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|198332-Trimethoprim100MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|892255-LevothyroxineSodium0.3MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|700883-temozolomide140MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|1362712-MexiletineHydrochloride200MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Brand|863841-amylase60000UNT/lipase12000UNT/protease38000UNTDelayedReleaseOralCapsule[Creon]|ADULT 2020 632|1001|N|N|N||Preferred Generic|857183-FosinoprilSodium20MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|486131-BenzoylPeroxide0.1MG/MGTopicalGel|ADULT 2020 632|1001|N|N|Y||Preferred Generic|904405-Alendronicacid40MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|312020-Nitroglycerin9MGExtendedReleaseOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Brand|209002-prednisolone1.2MG/MLOphthalmicSuspension[PredMild]|ADULT 2020 632|1001|N|N|N||Preferred Generic|856519-PropranololHydrochloride40MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|313226-terconazole4MG/MLVaginalCream|ADULT 2020 632|1001|N|N|N||Preferred Generic|313797-Amoxicillin25MG/MLOralSuspension|ADULT 2020 632|1001|N|N|N||Preferred Generic|1665188-1MLLorazepam2MG/MLInjection|ADULT 2020 632|1001|N|Y|N||Preferred Generic|349556-ezetimibe10MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|312961-Simvastatin20MGOralTablet|ADULT 2020 632|1001|N|Y|N||Preferred Generic|197506-Cimetidine300MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|310169-Estradiol0.1MG/MLVaginalCream|ADULT 2020 632|1001|N|N|N||Preferred Generic|598006-Erythromycin250MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1115259-1.5MLLeuprolideAcetate30MG/MLPrefilledSyringe[Lupron]|ADULT 2020 632|1001|N|N|N||Preferred Brand|152854-Itraconazole10MG/MLOralSolution[Sporanox]|ADULT 2020 632|1001|N|N|Y||Preferred Brand|1736863-3MLInsulinGlargine100UNT/MLPenInjector[Basaglar]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|903855-2MLPyridostigmineBromide5MG/MLInjection[Regonol]|ADULT 2020 632|1001|N|N|N||Preferred Generic|312036-Nortriptyline2MG/MLOralSolution|ADULT 2020 632|1001|Y|N|N||Preferred Generic|1607784-deferasirox180MGOralTablet|ADULT 2020 632|1001|N|Y|Y||Preferred Generic|483446-pregabalin200MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|686405-ErythromycinEthylsuccinate400MGOralTablet|ADULT 2020 632|1001|N|Y|N||Preferred Brand|996633-NamendaXR28DayTitrationPack|ADULT 2020 632|1001|N|N|Y||Preferred Generic|905495-ChlordiazepoxideHydrochloride25MGOralCapsule|ADULT 2020 632|1001|N|Y|N||Preferred Generic|313921-calcipotriene0.05MG/MLTopicalCream|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1488671-12HRTreprostinil0.25MGExtendedReleaseOralTablet[Orenitram]|ADULT 2020 632|1001|N|N|N||Preferred Generic|205326-Lisinopril30MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|197310-Acyclovir200MGOralCapsule|ADULT 2020 632|1001|N|N|Y||Preferred Generic|197900-Lorazepam0.5MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1300797-24HRmirabegron25MGExtendedReleaseOralTablet[Myrbetriq]|ADULT 2020 632|1001|N|N|Y||Preferred Brand|1547664-14ACTUATfluticasonefuroate0.1MG/ACTUATDryPowderInhaler[Arnuity]|ADULT 2020 632|1001|N|N|N||Preferred Brand|1000499-Prempro0.625/2.528DayPack|ADULT 2020 632|1001|N|N|N||Preferred Generic|105585-Methotrexate2.5MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|260409-prednisolone1MG/MLOralSolution[Pediapred]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|995868-CodeinePhosphate2MG/ML/Guaifenesin20MG/MLOralSolution|ADULT 2020 632|1001|N|N|N||Preferred Brand|1233850-Vestura28DayPack|ADULT 2020 632|1001|Y|N|N||Preferred Generic|897021-12HRdalfampridine10MGExtendedReleaseOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|830837-24HRDiltiazemHydrochloride240MGExtendedReleaseOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Brand|758027-0.5MLInterferonbeta-1a0.088MG/MLPrefilledSyringe[Rebif]|ADULT 2020 632|1001|Y|N|N||Preferred Generic|833234-mesalamine800MGDelayedReleaseOralTablet|ADULT 2020 632|1001|N|Y|Y||Preferred Brand|2200658-semaglutide7MGOralTablet[Rybelsus]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|862025-24HRGuanfacine4MGExtendedReleaseOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|198033-Nifedipine20MGOralCapsule|ADULT 2020 632|1001|N|N|Y||Preferred Generic|854238-0.6MLEnoxaparinsodium100MG/MLPrefilledSyringe|ADULT 2020 632|1001|N|Y|Y||Preferred Generic|1806195-50/50Release24HRMethylphenidateHydrochloride10MGExtendedReleaseOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Generic|1373503-{7(EthinylEstradiol0.01MGOralTablet)/42(EthinylEstradiol0.02MG/Levonorgestrel0.15MGOralTablet)/21(EthinylEstradiol0.0|ADULT 2020 632|1001|N|N|N||Preferred Generic|1801298-MicroencapsulatedPotassiumChloride10MEQExtendedReleaseOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|999613-SulfacetamideSodium100MG/ML/Sulfur50MG/MLMedicatedLiquidSoap|ADULT 2020 632|1001|N|N|N||Preferred Generic|1085686-TriamcinoloneAcetonide5MG/MLTopicalCream|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1746898-10MLreslizumab10MG/MLInjection[Cinqair]|ADULT 2020 632|1001|N|N|N||Preferred Generic|856578-PropranololHydrochloride80MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|855861-Phenytoinsodium200MGExtendedReleaseOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|311994-NITROFURANTOIN,MACROCRYSTALS25MGOralCapsule|ADULT 2020 632|1001|N|N|Y||Preferred Generic|993462-midodrinehydrochloride10MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1921010-0.1MLadalimumab100MG/MLPrefilledSyringe[Humira]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|312840-rizatriptan5MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2273115-24HRtofacitinib22MGExtendedReleaseOralTablet[Xeljanz]|ADULT 2020 632|1001|Y|N|N||Preferred Generic|1373497-{14(dimethylfumarate120MGDelayedReleaseOralCapsule)/46(dimethylfumarate240MGDelayedReleaseOralCapsule)}Pack|ADULT 2020 632|1001|Y|N|N||Preferred Generic|198071-Penicillamine250MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Brand|847189-3MLinsulinisophane,human70UNT/ML/insulin,regular,human30UNT/MLPenInjector[Humulin]|ADULT 2020 632|1001|N|N|N||Preferred Generic|597852-anagrelide1MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|311296-Levofloxacin750MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|312847-ropinirole2MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|979468-Hydrochlorothiazide12.5MG/LosartanPotassium50MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|197686-Etodolac400MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1747181-0.4MLMethotrexate31.3MG/MLAuto-Injector[Otrexup]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2106362-rifamycinSV194MGDelayedReleaseOralTablet[Aemcolo]|ADULT 2020 632|1001|N|N|N||Preferred Brand|213621-Bacitracin0.5UNT/MG/PolymyxinB10UNT/MGOphthalmicOintment[Polycin]|ADULT 2020 632|1001|N|N|N||Preferred Generic|857683-TerbutalineSulfate5MGOralTablet|ADULT 2020 632|1001|N|Y|N||Preferred Brand|835721-Ethionamide250MGOralTablet[Trecator]|ADULT 2020 632|1001|N|N|N||Preferred Generic|1099288-DesipramineHydrochloride10MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|904481-PravastatinSodium80MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|864978-MethadoneHydrochloride40MGTabletforOralSuspension|ADULT 2020 632|1001|N|N|N||Preferred Generic|1797907-Fluticasonepropionate0.05MG/ACTUATMeteredDoseNasalSpray|ADULT 2020 632|1001|N|N|N||Preferred Generic|312846-ropinirole0.5MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|1657173-0.5MLSumatriptan8MG/MLCartridge|ADULT 2020 632|1001|N|N|N||Preferred Generic|200032-carvedilol12.5MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|1946772-Methotrexate25MG/MLInjectableSolution|ADULT 2020 632|1001|N|N|N||Preferred Generic|905225-HydralazineHydrochloride25MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|197443-Carbidopa10MG/Levodopa100MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|966270-LevothyroxineSodium0.137MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|835593-ImipramineHydrochloride10MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|197856-Ketoprofen75MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Brand|1595457-amylase24000UNT/lipase5000UNT/protease17000UNTDelayedReleaseOralCapsule[Zenpep]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|596930-duloxetine30MGDelayedReleaseOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1871461-lisdexamfetaminedimesylate30MGChewableTablet[Vyvanse]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1488679-12HRTreprostinil2.5MGExtendedReleaseOralTablet[Orenitram]|ADULT 2020 632|1001|N|N|N||Preferred Brand|1114135-amylase16000UNT/lipase3000UNT/protease10000UNTDelayedReleaseOralCapsule[Zenpep]|ADULT 2020 632|1001|N|Y|N||Preferred Brand|1551306-0.5MLdulaglutide3MG/MLAuto-Injector[Trulicity]|ADULT 2020 632|1001|Y|N|N||Preferred Generic|205315-topiramate25MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|198141-Prazosin5MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|403967-zonisamide50MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|996561-Memantinehydrochloride10MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|1860127-Abuse-Deterrent12HROxycodoneHydrochloride60MGExtendedReleaseOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|688242-Estrogens,Conjugated(USP)0.625MG/MLVaginalCream[Premarin]|ADULT 2020 632|1001|N|N|N||Preferred Brand|1114041-DextromethorphanHydrobromide1MG/MLOralSolution[DayQuilCough]|ADULT 2020 632|1001|N|N|N||Preferred Generic|197624-Disulfiram500MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|310015-dorzolamide20MG/MLOphthalmicSolution|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2282414-bempedoicacid180MGOralTablet[Nexletol]|ADULT 2020 632|1001|N|N|N||Preferred Brand|1426881-Levonorgestrel1.5MGOralTablet[MyWay]|ADULT 2020 632|1001|Y|N|N||Preferred Generic|1299911-Tiagabinehydrochloride2MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|310379-Fluorouracil20MG/MLTopicalSolution|ADULT 2020 632|1001|N|N|Y||Preferred Generic|835829-testosteronecypionate100MG/MLInjectableSolution|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1115449-1MLLeuprolideAcetate11.25MG/MLPrefilledSyringe[Lupron]|ADULT 2020 632|1001|N|N|N||Preferred Generic|859044-Pramipexoledihydrochloride0.5MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|351172-Dutasteride0.5MGOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1921017-0.2MLadalimumab100MG/MLPrefilledSyringe[Humira]|ADULT 2020 632|1001|N|Y|N||Preferred Generic|242754-Levalbuterol0.417MG/MLInhalationSolution|ADULT 2020 632|1001|N|N|N||Preferred Generic|310434-gabapentin800MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|310433-gabapentin600MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|835603-tramadolhydrochloride50MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1100706-Linagliptin5MGOralTablet[Tradjenta]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|104894-Ondansetron4MGDisintegratingOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1115464-1MLLeuprolideAcetate7.5MG/MLPrefilledSyringe[Lupron]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|310288-Fenofibrate134MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|197313-Acyclovir800MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|312055-Nystatin100000UNT/MLOralSuspension|ADULT 2020 632|1001|N|N|Y||Preferred Generic|854876-Zolpidemtartrate5MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1873765-plecanatide3MGOralTablet[Trulance]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|352045-1MLdarbepoetinalfa0.04MG/MLInjection[Aranesp]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|904419-Alendronicacid10MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|309045-Cefaclor250MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|199390-Etodolac500MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|105553-Chlorambucil2MGOralTablet[Leukeran]|ADULT 2020 632|1001|N|N|Y||Preferred Brand|864650-Ganciclovir0.0015MG/MGOphthalmicGel[Zirgan]|ADULT 2020 632|1001|N|N|N||Preferred Brand|1000497-Prempro0.45/1.528DayPack|ADULT 2020 632|1001|N|N|Y||Preferred Generic|312086-Ondansetron8MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|313585-24HRvenlafaxine75MGExtendedReleaseOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Generic|848140-Amlodipine5MG/Hydrochlorothiazide12.5MG/valsartan160MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|310534-Glyburide2.5MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|749783-{6(Azithromycin250MGOralTablet)}Pack|ADULT 2020 632|1001|N|N|N||Preferred Generic|353538-24HRIsosorbideMononitrate60MGExtendedReleaseOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|686379-celecoxib50MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|310410-FolicAcid1MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|312641-Progesterone200MGOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Brand|404065-Isotretinoin40MGOralCapsule[Claravis]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|836645-Zolpidemtartrate10MGSublingualTablet[Edluar]|ADULT 2020 632|1001|N|N|N||Preferred Generic|1000647-PilocarpineHydrochloride10MG/MLOphthalmicSolution|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1116639-Ticagrelor90MGOralTablet[Brilinta]|ADULT 2020 632|1001|N|N|N||Preferred Generic|199890-topiramate200MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1596778-14ACTUATBudesonide2MG/ACTUATRectalFoam[Uceris]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1653243-1MLsecukinumab150MG/MLAuto-Injector[Cosentyx]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|856940-Acetaminophen21.7MG/ML/HydrocodoneBitartrate0.5MG/MLOralSolution|ADULT 2020 632|1001|N|N|N||Preferred Generic|351136-Albuterol0.417MG/MLInhalationSolution|ADULT 2020 632|1001|Y|N|N||Preferred Brand|731235-0.4MLdarbepoetinalfa0.5MG/MLPrefilledSyringe[Aranesp]|ADULT 2020 632|1001|N|N|N||Preferred Generic|486148-24HRNitroglycerin0.2MG/HRTransdermalSystem|ADULT 2020 632|1001|N|N|Y||Preferred Brand|901644-0.5MLStreptococcuspneumoniaeserotype1capsularantigendiphtheriaCRM197proteinconjugatevaccine0.0044MG/ML/Streptococcuspn|ADULT 2020 632|1001|N|N|N||Preferred Generic|242590-ferrousgluconate240MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|1299909-Tiagabinehydrochloride16MGOralTablet|ADULT 2020 632|1001|N|Y|Y||Preferred Generic|998679-168HRClonidine0.0125MG/HRTransdermalSystem|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1801519-Methylnaltrexonebromide150MGOralTablet[Relistor]|ADULT 2020 632|1001|N|N|N||Preferred Generic|197853-Ketoconazole200MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|349595-atomoxetine60MGOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1112687-Amethia91DayPack|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1921468-HumiraPen80MG/0.8MLand40MG/0.4ML-Psoriasis/UveitisStarterPackage(3count)|ADULT 2020 632|1001|N|N|N||Preferred Brand|207373-Mitotane500MGOralTablet[Lysodren]|ADULT 2020 632|1001|N|N|N||Preferred Generic|197797-hydroxyurea500MGOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1796096-24HRLinagliptin5MG/Metforminhydrochloride1000MGExtendedReleaseOralTablet[Jentadueto]|ADULT 2020 632|1001|Y|N|N||Preferred Generic|754508-{1(aprepitant125MGOralCapsule)/2(aprepitant80MGOralCapsule)}Pack|ADULT 2020 632|1001|N|N|N||Preferred Generic|992438-PromethazineHydrochloride12.5MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1729013-selexipag1MGOralTablet[Uptravi]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|404450-Thalidomide200MGOralCapsule[Thalomid]|ADULT 2020 632|1001|N|N|N||Preferred Generic|314238-Tropicamide10MG/MLOphthalmicSolution|ADULT 2020 632|1001|N|N|N||Preferred Generic|313477-Trifluridine10MG/MLOphthalmicSolution|ADULT 2020 632|1001|N|N|N||Preferred Generic|197626-Doxazosin2MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|860901-galantaminehydrobromide4MG/MLOralSolution|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2106075-0.9MLtocilizumab180MG/MLAuto-Injector[Actemra]|ADULT 2020 632|1001|N|Y|N||Preferred Brand|1992703-ertugliflozin7.5MG/Metforminhydrochloride500MGOralTablet[Segluromet]|ADULT 2020 632|1001|N|N|N||Preferred Generic|749860-{21(EthinylEstradiol0.035MG/norgestimate0.25MGOralTablet)/7(InertIngredients1MGOralTablet)}Pack|ADULT 2020 632|1001|N|N|N||Preferred Generic|199425-Melatonin1MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|313565-valacyclovir500MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|199378-12HRCarbamazepine100MGExtendedReleaseOralTablet|ADULT 2020 632|1001|Y|N|Y||Preferred Generic|835809-testosteroneenanthate200MG/MLInjectableSolution|ADULT 2020 632|1001|N|N|N||Preferred Generic|1053697-Nystatin100UNT/MG/TriamcinoloneAcetonide0.001MG/MGTopicalOintment|ADULT 2020 632|1001|N|N|Y||Preferred Generic|897640-Verapamilhydrochloride180MGExtendedReleaseOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|349199-valsartan80MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|863628-24HROxybutyninchloride15MGExtendedReleaseOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|310346-Finasteride5MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1441413-0.4MLMethotrexate37.5MG/MLAuto-Injector[Otrexup]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1441530-0.9MLtocilizumab180MG/MLPrefilledSyringe[Actemra]|ADULT 2020 632|1001|N|N|N||Preferred Generic|308177-Amoxicillin125MGChewableTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|252559-Budesonide0.5MG/MLInhalationSuspension|ADULT 2020 632|1001|N|N|N||Preferred Generic|317128-Misoprostol0.2MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|349405-Olmesartanmedoxomil40MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|198034-24HRNifedipine30MGExtendedReleaseOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1592285-pirfenidone267MGOralCapsule[Esbriet]|ADULT 2020 632|1001|N|Y|N||Preferred Brand|212381-aminosalicylicacid4000MGOralGranules[PaserD/R]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2196592-120ACTUATformoterolfumarate0.005MG/ACTUAT/mometasonefuroate0.05MG/ACTUATMeteredDoseInhaler[Dulera]|ADULT 2020 632|1001|Y|N|N||Preferred Generic|578330-candesartancilexetil32MG/Hydrochlorothiazide12.5MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|856467-Tri-Lo-Sprintec28DayPack|ADULT 2020 632|1001|N|N|N||Preferred Generic|897584-24HRVerapamilhydrochloride100MGExtendedReleaseOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|1665050-Cefazolin1000MGInjection|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1871465-lisdexamfetaminedimesylate10MGChewableTablet[Vyvanse]|ADULT 2020 632|1001|N|N|N||Preferred Generic|861171-12HRPropafenoneHydrochloride425MGExtendedReleaseOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2201540-romiplostim0.125MGInjection[Nplate]|ADULT 2020 632|1001|N|N|N||Preferred Generic|897590-24HRVerapamilhydrochloride200MGExtendedReleaseOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Generic|848145-Amlodipine5MG/Hydrochlorothiazide25MG/valsartan160MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1596023-ferriccitrate1000MGOralTablet[Auryxia]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|1091150-MethylphenidateHydrochloride10MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|261105-Etanercept25MG/MLInjectableSolution[Enbrel]|ADULT 2020 632|1001|N|N|N||Preferred Generic|855818-prasugrel5MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|762007-Nortrel7/7/728DayPack|ADULT 2020 632|1001|N|N|Y||Preferred Generic|807832-24HRLevetiracetam500MGExtendedReleaseOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1484296-sucroferricoxyhydroxide500MGChewableTablet[Velphoro]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1375922-bromfenac0.7MG/MLOphthalmicSolution[Prolensa]|ADULT 2020 632|1001|N|N|N||Preferred Generic|315187-Prednisone1MG/MLOralSolution|ADULT 2020 632|1001|N|N|N||Preferred Generic|313134-Sulfamethoxazole40MG/ML/Trimethoprim8MG/MLOralSuspension|ADULT 2020 632|1001|Y|N|N||Preferred Brand|616018-abatacept250MGInjection[Orencia]|ADULT 2020 632|1001|N|N|N||Preferred Generic|197943-Methocarbamol500MGOralTablet|ADULT 2020 632|1001|N|Y|N||Preferred Generic|311347-linezolid600MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|197839-IsosorbideDinitrate30MGOralTablet|ADULT 2020 632|1001|Y|N|Y||Preferred Generic|577033-sildenafil20MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1544396-0.45MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2203893-sofosbuvir200MGOralTablet[Sovaldi]|ADULT 2020 632|1001|N|N|N||Preferred Generic|1099300-DesipramineHydrochloride25MGOralTablet|ADULT 2020 632|1001|N|Y|Y||Preferred Generic|313189-Tacrolimus0.0003MG/MGTopicalOintment|ADULT 2020 632|1001|N|N|N||Preferred Generic|142034-BenzoylPeroxide100MG/MLMedicatedLiquidSoap|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1657976-4MLtocilizumab20MG/MLInjection[Actemra]|ADULT 2020 632|1001|N|N|N||Preferred Brand|1422081-Enskyce28DayPack|ADULT 2020 632|1001|N|N|Y||Preferred Generic|892589-MorphineSulfate2MG/MLOralSolution|ADULT 2020 632|1001|N|N|N||Preferred Generic|197628-Doxazosin8MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1441407-0.4MLMethotrexate25MG/MLAuto-Injector[Otrexup]|ADULT 2020 632|1001|N|N|N||Preferred Generic|1099296-DesipramineHydrochloride150MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|705824-100MLzoledronicacid0.05MG/MLInjection|ADULT 2020 632|1001|N|N|N||Preferred Generic|866083-buspironehydrochloride10MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Brand|2059017-rivaroxaban2.5MGOralTablet[Xarelto]|ADULT 2020 632|1001|N|N|N||Preferred Generic|308212-Ampicillin500MGOralCapsule|ADULT 2020 632|1001|N|N|Y||Preferred Generic|892582-MorphineSulfate15MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|966221-LevothyroxineSodium0.05MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Brand|1597103-0.5MLL1protein,Humanpapillomavirustype11Vaccine0.08MG/ML/L1protein,Humanpapillomavirustype16Vaccine0.12MG/ML/L1protei|ADULT 2020 632|1001|N|N|N||Preferred Generic|308416-Aspirin81MGDelayedReleaseOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|861416-Azithromycin1000MGPowderforOralSuspension|ADULT 2020 632|1001|N|N|N||Preferred Brand|213291-ParoxetineHydrochloride2MG/MLOralSuspension[Paxil]|ADULT 2020 632|1001|N|N|N||Preferred Generic|1806187-30/70Release24HRMethylphenidateHydrochloride20MGExtendedReleaseOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Brand|1797880-Nafarelin0.2MG/ACTUATMeteredDoseNasalSpray[Synarel]|ADULT 2020 632|1001|N|Y|Y||Preferred Generic|309332-Clindamycin0.01MG/MGTopicalGel|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2265689-Voxelotor500MGOralTablet[Oxbryta]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2550713-0.5MLsecukinumab150MG/MLPrefilledSyringe[Cosentyx]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|884385-DextroamphetamineSulfate10MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|1005856-SulfacetamideSodium100MG/ML/Sulfur50MG/MLTopicalLotion|ADULT 2020 632|1001|N|N|N||Preferred Generic|834102-PenicillinVPotassium500MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|1146690-24HRlamotrigine250MGExtendedReleaseOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Brand|2000136-Vancomycin50MG/MLOralSolution[Firvanq]|ADULT 2020 632|1001|N|N|N||Preferred Brand|751871-Nortrel1/3521DayPack|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1654630-1MLglatirameracetate20MG/MLPrefilledSyringe[Glatopa]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|198036-24HRNifedipine90MGExtendedReleaseOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|801054-POLYETHYLENEGLYCOL3350420000MG/PotassiumChloride1480MG/SodiumBicarbonate5720MG/SodiumChloride11200MGPowderforOralSolut|ADULT 2020 632|1001|N|N|N||Preferred Generic|245314-Albuterol5MG/MLInhalationSolution|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1551923-naloxegol12.5MGOralTablet[Movantik]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1925257-0.7MLabatacept125MG/MLPrefilledSyringe[Orencia]|ADULT 2020 632|1001|N|N|N||Preferred Generic|1000070-DoxepinHydrochloride25MGOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1923338-1.14MLsarilumab132MG/MLPrefilledSyringe[Kevzara]|ADULT 2020 632|1001|N|N|N||Preferred Generic|311289-Levetiracetam500MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|310594-Gramicidin0.025MG/ML/Neomycin1.75MG/ML/PolymyxinB10000UNT/MLOphthalmicSolution|ADULT 2020 632|1001|N|N|N||Preferred Generic|283433-Melatonin10MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|311681-Metronidazole500MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|854840-lisdexamfetaminedimesylate40MGOralCapsule[Vyvanse]|ADULT 2020 632|1001|N|N|N||Preferred Generic|866511-MetoprololTartrate100MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|617316-Amoxicillin400MG/Clavulanate57MGChewableTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2557216-trikafta50MG/37.5MG/25MGand75MGPack|ADULT 2020 632|1001|N|N|N||Preferred Generic|892246-LevothyroxineSodium0.1MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|198024-Niacin500MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|1191013-Proparacainehydrochloride5MG/MLOphthalmicSolution|ADULT 2020 632|1001|N|N|N||Preferred Generic|313582-venlafaxine25MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|260376-Terazosin10MGOralCapsule|ADULT 2020 632|1001|N|Y|Y||Preferred Generic|197978-Metolazone10MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|313096-Spironolactone25MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|198342-Urea400MG/MLTopicalCream|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2536758-24HRviloxazine200MGExtendedReleaseOralCapsule[Qelbree]|ADULT 2020 632|1001|Y|N|N||Preferred Generic|722122-ambrisentan5MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Brand|2000133-Vancomycin25MG/MLOralSolution[Firvanq]|ADULT 2020 632|1001|Y|N|N||Preferred Generic|725021-24HRrivastigmine0.192MG/HRTransdermalSystem|ADULT 2020 632|1001|N|N|Y||Preferred Brand|211609-hypromellose5MG/MLOphthalmicSolution[IsoptoAlkaline]|ADULT 2020 632|1001|N|N|N||Preferred Generic|315090-Erythromycin333MGDelayedReleaseOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1091654-azilsartanmedoxomil80MGOralTablet[Edarbi]|ADULT 2020 632|1001|N|N|N||Preferred Generic|393245-Digoxin0.05MG/MLOralSolution|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1720606-mepolizumab100MGInjection[Nucala]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1870950-deflazacort6MGOralTablet[Emflaza]|ADULT 2020 632|1001|N|N|N||Preferred Generic|835894-cyclosporine,modified25MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|903891-FluvoxamineMaleate50MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|850091-24HRlamotrigine50MGExtendedReleaseOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1870952-deflazacort30MGOralTablet[Emflaza]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2058906-cannabidiol100MG/MLOralSolution[Epidiolex]|ADULT 2020 632|1001|N|N|N||Preferred Generic|200060-mycophenolatemofetil500MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|545835-LeuprolideAcetate5MG/MLInjectableSolution|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1729033-selexipag1.4MGOralTablet[Uptravi]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1649605-PlegridyPenStarterPack|ADULT 2020 632|1001|N|N|N||Preferred Generic|835913-MefloquineHydrochloride250MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|1737459-PamidronateDisodium30MGInjection|ADULT 2020 632|1001|Y|N|N||Preferred Generic|861375-sevelamercarbonate800MGPowderforOralSuspension|ADULT 2020 632|1001|N|N|Y||Preferred Generic|309309-Ciprofloxacin500MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|282755-telmisartan20MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2119391-Spravato56MGDoseKit|ADULT 2020 632|1001|Y|N|N||Preferred Generic|245134-72HRFentanyl0.025MG/HRTransdermalSystem|ADULT 2020 632|1001|N|N|Y||Preferred Generic|801966-4MLDiazepam5MG/MLRectalGel|ADULT 2020 632|1001|Y|N|N||Preferred Brand|205922-1MLEpoetinAlfa3000UNT/MLInjection[Procrit]|ADULT 2020 632|1001|N|N|N||Preferred Generic|309054-cefdinir25MG/MLOralSuspension|ADULT 2020 632|1001|N|N|Y||Preferred Brand|1190916-0.5MLdiphtheriatoxoidvaccine,inactivated4UNT/ML/tetanustoxoidvaccine,inactivated10UNT/MLInjection[Tenivac]|ADULT 2020 632|1001|N|N|N||Preferred Generic|308189-Amoxicillin80MG/MLOralSuspension|ADULT 2020 632|1001|N|N|N||Preferred Brand|644304-Tamoxifen2MG/MLOralSolution[Soltamox]|ADULT 2020 632|1001|N|N|N||Preferred Brand|896006-120ACTUATFluticasonepropionate0.22MG/ACTUATMeteredDoseInhaler[Flovent]|ADULT 2020 632|1001|N|Y|N||Preferred Generic|311345-linezolid20MG/MLOralSuspension|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1593858-lisdexamfetaminedimesylate10MGOralCapsule[Vyvanse]|ADULT 2020 632|1001|N|N|N||Preferred Generic|876193-POLYETHYLENEGLYCOL335017000MGPowderforOralSolution|ADULT 2020 632|1001|N|N|N||Preferred Brand|210000-AluminumHydroxide80MG/ML/MagnesiumHydroxide80MG/ML/Simethicone8MG/MLOralSuspension[Almacone]|ADULT 2020 632|1001|Y|N|N||Preferred Generic|886634-ButorphanolTartrate1MG/ACTUATMeteredDoseNasalSpray|ADULT 2020 632|1001|N|N|Y||Preferred Generic|248478-84HREstradiol0.00104MG/HRTransdermalSystem|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1593775-24HRdapagliflozin10MG/Metforminhydrochloride1000MGExtendedReleaseOralTablet[Xigduo]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|897749-HydromorphoneHydrochloride3MGRectalSuppository|ADULT 2020 632|1001|N|N|N||Preferred Generic|1014314-TriamcinoloneAcetonide1MG/MLTopicalCream|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2262731-MicronizedIsotretinoin8MGOralCapsule[Absorica]|ADULT 2020 632|1001|N|N|N||Preferred Generic|197361-Amlodipine5MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1243026-Linagliptin2.5MG/Metforminhydrochloride1000MGOralTablet[Jentadueto]|ADULT 2020 632|1001|Y|N|N||Preferred Generic|855626-Twice-Dailydiclofenacepolamine0.013MG/MGMedicatedPatch|ADULT 2020 632|1001|Y|N|N||Preferred Generic|700885-temozolomide180MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|476809-Mirtazapine7.5MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|762675-{21(Methylprednisolone4MGOralTablet)}Pack|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1364477-teduglutide5MGInjection[Gattex]|ADULT 2020 632|1001|N|N|N||Preferred Generic|904396-Alendronicacid35MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|646333-Capsaicin1MG/MLTopicalCream|ADULT 2020 632|1001|N|N|N||Preferred Generic|904170-PrimaquinePhosphate26.3MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|828696-Zolpidemtartrate5MG/ACTUATOralSpray[Zolpimist]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1665900-1MLevolocumab140MG/MLAuto-Injector[Repatha]|ADULT 2020 632|1001|Y|N|N||Preferred Generic|864675-Atovaquone250MG/proguanilhydrochloride100MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|314285-zonisamide100MGOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Generic|317160-temozolomide100MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|198369-torsemide10MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Brand|311027-insulinisophane,human100UNT/MLInjectableSuspension[NovolinN]|ADULT 2020 632|1001|Y|N|N||Preferred Generic|900156-24HRlamotrigine200MGExtendedReleaseOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|758032-0.5MLInterferonbeta-1a0.044MG/MLPrefilledSyringe[Rebif]|ADULT 2020 632|1001|Y|N|Y||Preferred Generic|106302-Tretinoin0.25MG/MLTopicalCream|ADULT 2020 632|1001|N|N|N||Preferred Generic|198335-Sulfamethoxazole800MG/Trimethoprim160MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|205669-Dexamethasone1MG/MLOphthalmicSuspension[Maxidex]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1921081-1.56MLabaloparatide2MG/MLPenInjector[Tymlos]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|1918209-60ACTUATfluticasonepropionate0.055MG/ACTUAT/salmeterol0.014MG/ACTUATDryPowderInhaler|ADULT 2020 632|1001|N|N|N||Preferred Generic|898342-Amlodipine10MG/Benazeprilhydrochloride20MGOralCapsule|ADULT 2020 632|1001|N|N|Y||Preferred Generic|313413-tizanidine4MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1594358-HumiraPediatricCrohn'sDiseaseStarterPackage(3count)|ADULT 2020 632|1001|N|N|N||Preferred Generic|2532159-PMDDfluoxetine10MGOralTablet|ADULT 2020 632|1001|N|Y|N||Preferred Generic|197984-Minocycline100MGOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Generic|578325-candesartancilexetil16MG/Hydrochlorothiazide12.5MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|1010878-LidocaineHydrochloride40MG/MLMucousMembraneTopicalSolution|ADULT 2020 632|1001|Y|N|N||Preferred Brand|748740-Topotecan1MGOralCapsule[Hycamtin]|ADULT 2020 632|1001|N|N|N||Preferred Generic|200132-Acarbose25MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|197316-Albuterol2MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|1597123-2500MGTestosterone0.01MG/MGTopicalGel|ADULT 2020 632|1001|N|N|N||Preferred Brand|830470-1MLrabiesvirusvaccinewistarstrainPM-1503-3M(Human),Inactivated2.5UNT/MLInjection[Imovax]|ADULT 2020 632|1001|N|N|N||Preferred Generic|858616-Nicardipinehydrochloride30MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|311668-Metoclopramide5MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|1806197-30/70Release24HRMethylphenidateHydrochloride60MGExtendedReleaseOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Brand|212039-Estrogens,Esterified(USP)0.3MGOralTablet[Menest]|ADULT 2020 632|1001|N|N|N||Preferred Generic|859424-Rosuvastatincalcium5MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|858040-saxagliptin5MGOralTablet[Onglyza]|ADULT 2020 632|1001|N|N|N||Preferred Generic|828348-Cyclobenzaprinehydrochloride10MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|204423-Hydrocortisone10MG/ML/Neomycin3.5MG/ML/PolymyxinB10000UNT/MLOticSolution|ADULT 2020 632|1001|N|N|N||Preferred Generic|993518-12HRBupropionHydrochloride150MGExtendedReleaseOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|855318-WarfarinSodium3MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|541892-Amphetamineaspartate2.5MG/AmphetamineSulfate2.5MG/Dextroamphetaminesaccharate2.5MG/DextroamphetamineSulfate2.5MGOralTa|ADULT 2020 632|1001|N|N|Y||Preferred Brand|211947-Atovaquone150MG/MLOralSuspension[Mepron]|ADULT 2020 632|1001|N|N|N||Preferred Generic|859419-Rosuvastatincalcium40MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|856840-AmitriptylineHydrochloride50MG/Perphenazine4MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|313161-Sumatriptan50MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|198760-Niacin50MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|996571-Memantinehydrochloride5MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|1190655-AtropineSulfate10MG/MLOphthalmicSolution|ADULT 2020 632|1001|N|N|Y||Preferred Brand|311033-insulin,regular,human100UNT/MLInjectableSolution[NovolinR]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|861045-1.5MLpramlintideacetate1MG/MLPenInjector[Symlin]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|198035-24HRNifedipine60MGExtendedReleaseOralTablet|ADULT 2020 632|1001|N|Y|N||Preferred Generic|197417-Bumetanide0.5MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|314000-Glyburide1.5MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|199149-Acarbose50MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Brand|1656351-sacubitril49MG/valsartan51MGOralTablet[Entresto]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1373337-Isotretinoin40MGOralCapsule[Zenatane]|ADULT 2020 632|1001|Y|N|N||Preferred Generic|864769-MethadoneHydrochloride2MG/MLOralSolution|ADULT 2020 632|1001|N|Y|N||Preferred Brand|1356673-BenzylAlcohol0.05ML/MLTopicalLotion[Ulesfia]|ADULT 2020 632|1001|N|N|N||Preferred Generic|198104-Pindolol10MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|995607-EthambutolHydrochloride400MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2107355-prucalopride2MGOralTablet[Motegrity]|ADULT 2020 632|1001|N|N|N||Preferred Generic|861743-Glyburide1.25MG/Metforminhydrochloride250MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2045961-Doptelet60MGDailyDoseCartonPack|ADULT 2020 632|1001|N|N|N||Preferred Generic|197518-Clindamycin150MGOralCapsule|ADULT 2020 632|1001|N|N|Y||Preferred Generic|200095-irbesartan150MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|1812015-Osmotic24HRNifedipine90MGExtendedReleaseOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|153473-Altretamine50MGOralCapsule[Hexalen]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|241946-84HREstradiol0.00156MG/HRTransdermalSystem|ADULT 2020 632|1001|N|N|Y||Preferred Brand|707566-PolyethyleneGlycol4004MG/ML/Propyleneglycol3MG/MLOphthalmicSolution[Systane]|ADULT 2020 632|1001|Y|N|N||Preferred Generic|898715-pregabalin20MG/MLOralSolution|ADULT 2020 632|1001|N|N|N||Preferred Generic|1012021-Prednisolonesodiumphosphate2.5MG/ML/SulfacetamideSodium100MG/MLOphthalmicSolution|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1244062-0.6MLMethylnaltrexonebromide20MG/MLPrefilledSyringe[Relistor]|ADULT 2020 632|1001|N|N|N||Preferred Generic|311486-meloxicam7.5MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|1923828-deferasirox180MGOralGranules|ADULT 2020 632|1001|N|N|N||Preferred Generic|152695-meloxicam15MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Brand|895756-PolyethyleneGlycol4000.004MG/MG/Propyleneglycol0.003MG/MGOphthalmicGel[Systane]|ADULT 2020 632|1001|N|Y|N||Preferred Generic|730988-Carbidopa50MG/entacapone200MG/Levodopa200MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|992432-PromethazineHydrochloride1.25MG/MLOralSolution|ADULT 2020 632|1001|N|N|N||Preferred Generic|197449-Cefaclor500MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|702519-Phenobarbital4MG/MLOralSolution|ADULT 2020 632|1001|N|Y|N||Preferred Generic|855189-24HRtolterodinetartrate4MGExtendedReleaseOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Generic|998189-everolimus2.5MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|309314-Citalopram40MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|858613-Nicardipinehydrochloride20MGOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Generic|349409-Treprostinil2.5MG/MLInjectableSolution|ADULT 2020 632|1001|Y|N|N||Preferred Generic|857224-Sevelamerhydrochloride800MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|1989117-0.3MLEpinephrine1MG/MLPrefilledSyringe[Symjepi]|ADULT 2020 632|1001|N|N|N||Preferred Generic|1245919-Marlissa28DayPack|ADULT 2020 632|1001|N|N|N||Preferred Generic|1053753-Nystatin100000UNT/ML/TriamcinoloneAcetonide1MG/MLTopicalCream|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1657980-10MLtocilizumab20MG/MLInjection[Actemra]|ADULT 2020 632|1001|N|N|N||Preferred Generic|197433-calciumacetate667MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|996572-{21(Memantinehydrochloride10MGOralTablet)/28(Memantinehydrochloride5MGOralTablet)}Pack|ADULT 2020 632|1001|N|N|N||Preferred Generic|197699-Fluconazole150MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|199143-Niacin250MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|898350-Amlodipine2.5MG/Benazeprilhydrochloride10MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|311196-24HRIsosorbideMononitrate120MGExtendedReleaseOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|432401-cinacalcet60MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1364362-ponatinib45MGOralTablet[Iclusig]|ADULT 2020 632|1001|N|N|N||Preferred Generic|898346-Amlodipine10MG/Benazeprilhydrochloride40MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|991086-DicyclomineHydrochloride20MGOralTablet|ADULT 2020 632|1001|N|Y|N||Preferred Generic|855182-24HRtolterodinetartrate2MGExtendedReleaseOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Brand|799830-dasatinib100MGOralTablet[Sprycel]|ADULT 2020 632|1001|N|N|N||Preferred Generic|1366116-bacitracinzinc0.5UNT/MGTopicalOintment|ADULT 2020 632|1001|N|N|N||Preferred Generic|860981-24HRMetforminhydrochloride750MGExtendedReleaseOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|858810-EnalaprilMaleate20MGOralTablet|ADULT 2020 632|1001|Y|N|Y||Preferred Brand|1292435-0.65MLVaricella-ZosterVirusVaccineLive(Oka-Merck)strain29800UNT/MLInjection[Zostavax]|ADULT 2020 632|1001|N|Y|N||Preferred Generic|311787-moxifloxacin400MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|153822-candesartancilexetil4MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|857321-BethanecholChloride10MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Brand|830263-1MLHepatitisBSurfaceAntigenVaccine0.04MG/MLInjection[Recombivax]|ADULT 2020 632|1001|N|N|N||Preferred Generic|310982-imiquimod50MG/MLTopicalCream|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2001321-Roflumilast0.25MGOralTablet[Daliresp]|ADULT 2020 632|1001|N|N|N||Preferred Generic|198857-Simethicone66.7MG/MLOralSuspension|ADULT 2020 632|1001|N|N|Y||Preferred Generic|242462-cilostazol50MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Brand|2166204-10ACTUATtiotropium0.0025MG/ACTUATInhalationSpray[Spiriva]|ADULT 2020 632|1001|N|N|N||Preferred Generic|309115-Cephalexin250MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|892349-24HRMorphineSulfate60MGExtendedReleaseOralCapsule|ADULT 2020 632|1001|N|N|Y||Preferred Generic|485484-tizanidine6MGOralCapsule|ADULT 2020 632|1001|N|N|Y||Preferred Brand|106892-insulinisophane,human70UNT/ML/insulin,regular,human30UNT/MLInjectableSuspension[Humulin]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2057216-0.8MLfilgrastim-aafi0.6MG/MLPrefilledSyringe[Nivestym]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2000013-1.1MLhydroxyprogesteronecaproate(USP)250MG/MLAuto-Injector[Makena]|ADULT 2020 632|1001|Y|N|N||Preferred Generic|402505-12HRCarbamazepine200MGExtendedReleaseOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|731227-0.4MLdarbepoetinalfa0.1MG/MLPrefilledSyringe[Aranesp]|ADULT 2020 632|1001|Y|N|Y||Preferred Generic|891893-MorphineSulfate60MGExtendedReleaseOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|856825-AmitriptylineHydrochloride25MG/Perphenazine4MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|313210-temozolomide250MGOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2048568-tofacitinib10MGOralTablet[Xeljanz]|ADULT 2020 632|1001|N|N|N||Preferred Generic|1724437-thyroid(USP)90MGOralTablet[NPThyroid]|ADULT 2020 632|1001|N|N|N||Preferred Generic|343033-Dexamethasone0.75MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|897126-3MLliraglutide6MG/MLPenInjector[Victoza]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|310149-Erythromycin0.005MG/MGOphthalmicOintment|ADULT 2020 632|1001|Y|N|N||Preferred Brand|809998-lacosamide200MGOralTablet[Vimpat]|ADULT 2020 632|1001|Y|N|N||Preferred Generic|477130-Hydrochlorothiazide25MG/telmisartan80MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|836358-IpratropiumBromide0.2MG/MLInhalationSolution|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1868020-pirfenidone801MGOralTablet[Esbriet]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|197590-Diazepam2MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|886662-FlecainideAcetate50MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1011752-aliskiren300MG/Hydrochlorothiazide12.5MGOralTablet[TekturnaHCT]|ADULT 2020 632|1001|N|N|N||Preferred Generic|898687-Benazeprilhydrochloride10MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|242446-Ofloxacin3MG/MLOticSolution|ADULT 2020 632|1001|N|N|N||Preferred Generic|106387-Permethrin50MG/MLTopicalCream|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1000089-alcaftadine2.5MG/MLOphthalmicSolution[Lastacaft]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|1298091-FlurazepamHydrochloride30MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|1234571-PhenylephrineHydrochloride100MG/MLOphthalmicSolution|ADULT 2020 632|1001|Y|N|N||Preferred Generic|477347-lanthanumcarbonate500MGChewableTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|876514-Amlodipine10MG/telmisartan40MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|642452-lanthanumcarbonate750MGChewableTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|2101899-Sodiumpolystyrenesulfonate15000MGPowderforOralSuspension|ADULT 2020 632|1001|Y|N|N||Preferred Generic|904952-3MLibandronicacid1MG/MLPrefilledSyringe|ADULT 2020 632|1001|N|N|Y||Preferred Brand|1992171-3MLInsulinLispro100UNT/MLPenInjector[Admelog]|ADULT 2020 632|1001|N|N|N||Preferred Generic|197698-Fluconazole100MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|848176-AugmentedBetamethasone0.5MG/MLTopicalCream|ADULT 2020 632|1001|N|N|N||Preferred Generic|854901-BisoprololFumarate10MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1741049-24HRtofacitinib11MGExtendedReleaseOralTablet[Xeljanz]|ADULT 2020 632|1001|N|N|Y||Preferred Brand|1992428-Eliquis30-DayStarterPack|ADULT 2020 632|1001|N|N|N||Preferred Generic|859193-selegilinehydrochloride5MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|251872-pantoprazole20MGDelayedReleaseOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|310599-Granisetron1MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|212232-Estrogens,Esterified(USP)0.625MGOralTablet[Menest]|ADULT 2020 632|1001|N|N|N||Preferred Generic|311192-IsosorbideMononitrate10MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2475856-vericiguat2.5MGOralTablet[Verquvo]|ADULT 2020 632|1001|N|N|N||Preferred Generic|311726-Mirtazapine45MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|351297-insulinaspartprotamine,human70UNT/ML/insulinaspart,human30UNT/MLInjectableSuspension|ADULT 2020 632|1001|N|N|N||Preferred Generic|849515-DesmopressinAcetate0.1MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|897649-Verapamilhydrochloride240MGExtendedReleaseOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1989109-1MLbenralizumab30MG/MLPrefilledSyringe[Fasenra]|ADULT 2020 632|1001|N|N|N||Preferred Brand|351901-Sirolimus1MG/MLOralSolution[Rapamune]|ADULT 2020 632|1001|N|N|N||Preferred Generic|198153-Colchicine0.5MG/Probenecid500MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Brand|404448-84HRoxybutynin0.162MG/HRTransdermalSystem[Oxytrol]|ADULT 2020 632|1001|N|N|N||Preferred Generic|898353-Amlodipine5MG/Benazeprilhydrochloride10MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|198146-Prednisone2.5MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|348719-Tobramycin60MG/MLInhalationSolution|ADULT 2020 632|1001|Y|N|N||Preferred Generic|403879-imatinib400MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|314209-rizatriptan10MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1310531-teriflunomide14MGOralTablet[Aubagio]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|311918-naratriptan1MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|852877-QuinidineSulfate200MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1245003-eltrombopag12.5MGOralTablet[Promacta]|ADULT 2020 632|1001|Y|N|N||Preferred Generic|403818-moxifloxacin5MG/MLOphthalmicSolution|ADULT 2020 632|1001|N|N|N||Preferred Generic|997501-Fexofenadinehydrochloride60MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|197517-Clarithromycin500MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|349408-Treprostinil10MG/MLInjectableSolution|ADULT 2020 632|1001|N|N|Y||Preferred Generic|310467-Gentamicin3MG/MLOphthalmicSolution|ADULT 2020 632|1001|Y|N|Y||Preferred Brand|665036-sitagliptin100MGOralTablet[Januvia]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|200096-irbesartan300MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Brand|798479-1MLHepatitisAVaccine(Inactivated)StrainHM1751440UNT/MLPrefilledSyringe[Havrix]|ADULT 2020 632|1001|N|N|N||Preferred Generic|833008-DesmopressinAcetate0.2MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|1115698-Oseltamivir6MG/MLOralSuspension|ADULT 2020 632|1001|N|N|N||Preferred Generic|1115005-DocusateSodium100MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|309273-cholinesalicylate58.6MG/ML/MagnesiumSalicylate72.4MG/MLOralSolution|ADULT 2020 632|1001|N|N|N||Preferred Generic|197886-Hydrochlorothiazide12.5MG/Lisinopril20MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Brand|2360588-0.5MLNeisseriameningitidisserogroupAcapsularpolysaccharidetetanustoxoidproteinconjugatevaccine0.02MG/ML/Neisseriameni|ADULT 2020 632|1001|Y|N|N||Preferred Generic|1011739-aliskiren300MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1855527-HumiraPediatricCrohn'sDiseaseStarterPackage(2count)|ADULT 2020 632|1001|N|N|Y||Preferred Generic|477560-Fenofibrate145MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|1149632-84HREstradiol0.00313MG/HRTransdermalSystem|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1302833-24HRPhentermine7.5MG/topiramate46MGExtendedReleaseOralCapsule[Qsymia]|ADULT 2020 632|1001|N|N|N||Preferred Brand|863829-amylase120000UNT/lipase24000UNT/protease76000UNTDelayedReleaseOralCapsule[Creon]|ADULT 2020 632|1001|Y|N|N||Preferred Generic|876529-Amlodipine5MG/telmisartan80MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|200131-12HRCarbamazepine300MGExtendedReleaseOralCapsule|ADULT 2020 632|1001|N|Y|N||Preferred Generic|810090-Carbidopa18.75MG/entacapone200MG/Levodopa75MGOralTablet|ADULT 2020 632|1001|N|Y|Y||Preferred Generic|998671-168HRClonidine0.00417MG/HRTransdermalSystem|ADULT 2020 632|1001|N|N|N||Preferred Generic|861657-24HRNitroglycerin0.1MG/HRTransdermalSystem|ADULT 2020 632|1001|N|N|N||Preferred Generic|308962-Captopril100MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|892342-24HRMorphineSulfate30MGExtendedReleaseOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|259255-atorvastatin80MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|900038-PhentermineHydrochloride30MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|429503-Hydrochlorothiazide12.5MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|308963-Captopril12.5MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2056670-AimovigAutoinjector2-Pack(140MGDose)|ADULT 2020 632|1001|N|N|N||Preferred Generic|310539-Glyburide6MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1732157-incobotulinumtoxinA50UNTInjection[Xeomin]|ADULT 2020 632|1001|N|N|N||Preferred Generic|328161-Methylprednisolone16MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|830463-1MLrabiesvirusvaccineflury-lepstrain2.5UNT/MLInjection[RabAvert]|ADULT 2020 632|1001|N|N|N||Preferred Generic|852913-QuinidineSulfate300MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|1242787-Alyacen7/7/7Kit|ADULT 2020 632|1001|N|N|N||Preferred Generic|198759-Niacin100MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|896758-Labetalolhydrochloride100MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|198211-Simvastatin40MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1011755-aliskiren300MG/Hydrochlorothiazide25MGOralTablet[TekturnaHCT]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2047602-1MLepoetinalfa-epbx2000UNT/MLInjection[Retacrit]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|313415-Tobramycin3MG/MLOphthalmicSolution|ADULT 2020 632|1001|Y|N|N||Preferred Brand|825425-eltrombopag25MGOralTablet[Promacta]|ADULT 2020 632|1001|Y|N|N||Preferred Generic|465355-voriconazole40MG/MLOralSuspension|ADULT 2020 632|1001|Y|N|N||Preferred Generic|1591943-ledipasvir90MG/sofosbuvir400MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|858747-Ursodiol300MGOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2047608-1MLepoetinalfa-epbx3000UNT/MLInjection[Retacrit]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|315223-Sumatriptan25MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|2110516-60ACTUATFluticasonepropionate0.5MG/ACTUAT/salmeterol0.05MG/ACTUATDryPowderInhaler[Wixela]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|1596780-60ACTUATTestosterone12.5MG/ACTUATTopicalGel|ADULT 2020 632|1001|N|Y|N||Preferred Generic|197508-Cimetidine800MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|199353-trandolapril1MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|1550940-Colchicine0.6MGOralCapsule|ADULT 2020 632|1001|N|N|Y||Preferred Generic|1649990-DoxycyclineMonohydrate100MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Brand|208547-thyroid(USP)180MGOralTablet[ArmourThyroid]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2056700-1.5MLfremanezumab-vfrm150MG/MLPrefilledSyringe[Ajovy]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1300803-24HRmirabegron50MGExtendedReleaseOralTablet[Myrbetriq]|ADULT 2020 632|1001|N|N|N||Preferred Generic|1099678-DivalproexSodium250MGDelayedReleaseOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|103403-Hydrocortisone10MG/MLTopicalLotion|ADULT 2020 632|1001|Y|N|N||Preferred Brand|853354-0.5MLustekinumab90MG/MLPrefilledSyringe[Stelara]|ADULT 2020 632|1001|Y|N|N||Preferred Generic|1098608-24HRlamotrigine300MGExtendedReleaseOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|1599949-60ACTUATTestosterone30MG/ACTUATTopicalSolution|ADULT 2020 632|1001|N|N|N||Preferred Generic|978006-LoperamideHydrochloride2MGOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2057205-0.5MLfilgrastim-aafi0.6MG/MLPrefilledSyringe[Nivestym]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1729076-UptraviTitrationPack|ADULT 2020 632|1001|N|N|N||Preferred Brand|1359135-Tri-LegestFe28DayPack|ADULT 2020 632|1001|N|N|N||Preferred Generic|198049-Ofloxacin300MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|1190568-AtropineSulfate0.005MG/ML/DiphenoxylateHydrochloride0.5MG/MLOralSolution|ADULT 2020 632|1001|N|Y|N||Preferred Generic|311286-Levalbuterol0.21MG/MLInhalationSolution|ADULT 2020 632|1001|N|N|N||Preferred Generic|310429-Furosemide20MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|1918042-abirateroneacetate500MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|311194-IsosorbideDinitrate40MGExtendedReleaseOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|616292-sunitinib50MGOralCapsule[Sutent]|ADULT 2020 632|1001|Y|N|N||Preferred Generic|1607792-deferasirox360MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Brand|1656356-sacubitril97MG/valsartan103MGOralTablet[Entresto]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|809994-lacosamide150MGOralTablet[Vimpat]|ADULT 2020 632|1001|N|N|N||Preferred Generic|197409-Betamethasone0.001MG/MGTopicalOintment|ADULT 2020 632|1001|N|N|N||Preferred Generic|313979-fludrocortisoneacetate0.1MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|205532-DornaseAlfa1MG/MLInhalationSolution[Pulmozyme]|ADULT 2020 632|1001|Y|N|N||Preferred Generic|349410-Treprostinil5MG/MLInjectableSolution|ADULT 2020 632|1001|Y|N|N||Preferred Generic|1607617-24HRdesvenlafaxinesuccinate25MGExtendedReleaseOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|1367436-21DAYEthinylEstradiol0.000625MG/HR/Etonogestrel0.005MG/HRVaginalSystem|ADULT 2020 632|1001|Y|N|N||Preferred Brand|727816-0.5MLInterferonbeta-1a0.06MG/MLPrefilledSyringe[Avonex]|ADULT 2020 632|1001|N|N|N||Preferred Generic|252732-Melatonin5MGOralTablet|ADULT 2020 632|1001|N|Y|N||Preferred Generic|606730-Esomeprazole40MGDelayedReleaseOralCapsule|ADULT 2020 632|1001|N|N|Y||Preferred Generic|1049221-Acetaminophen325MG/OxycodoneHydrochloride5MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1593835-24HRdapagliflozin10MG/Metforminhydrochloride500MGExtendedReleaseOralTablet[Xigduo]|ADULT 2020 632|1001|N|N|N||Preferred Generic|198428-lamotrigine150MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|577208-Omega-3AcidEthylEsters(USP)1000MGOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Brand|795749-RebifTitrationPack|ADULT 2020 632|1001|N|N|N||Preferred Generic|828320-Cyclobenzaprinehydrochloride5MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|643175-dasatinib50MGOralTablet[Sprycel]|ADULT 2020 632|1001|Y|N|N||Preferred Generic|240912-Granisetron1MG/MLInjectableSolution|ADULT 2020 632|1001|N|N|N||Preferred Generic|1000048-DoxepinHydrochloride10MGOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Brand|205924-1MLEpoetinAlfa4000UNT/MLInjection[Procrit]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1037185-LoLoestrinFe28DayPack|ADULT 2020 632|1001|N|N|N||Preferred Generic|722126-Amlodipine10MG/valsartan160MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|403811-aprepitant125MGOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Brand|809159-0.5MLEtanercept50MG/MLPrefilledSyringe[Enbrel]|ADULT 2020 632|1001|N|N|N||Preferred Brand|854910-BisoprololFumarate10MG/Hydrochlorothiazide6.25MGOralTablet[Ziac]|ADULT 2020 632|1001|N|N|N||Preferred Generic|310353-Fluconazole40MG/MLOralSuspension|ADULT 2020 632|1001|N|N|N||Preferred Generic|308136-Amlodipine2.5MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|643714-lenalidomide15MGOralCapsule[Revlimid]|ADULT 2020 632|1001|N|Y|N||Preferred Generic|810083-Carbidopa31.25MG/entacapone200MG/Levodopa125MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|197885-Hydrochlorothiazide12.5MG/Lisinopril10MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|1000500-Prempro0.625/528DayPack|ADULT 2020 632|1001|Y|N|N||Preferred Brand|828703-1.2MLPlerixafor20MG/MLInjection[Mozobil]|ADULT 2020 632|1001|N|N|N||Preferred Generic|1085745-TriamcinoloneAcetonide1MG/MLTopicalLotion|ADULT 2020 632|1001|N|N|N||Preferred Brand|864010-ammoniumlactate120MG/MLTopicalLotion[Geri-Hydrolac]|ADULT 2020 632|1001|N|Y|N||Preferred Generic|197419-Bumetanide2MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Brand|637188-varenicline0.5MGOralTablet[Chantix]|ADULT 2020 632|1001|Y|N|N||Preferred Generic|857700-DiclofenacSodium15MG/MLTopicalSolution|ADULT 2020 632|1001|N|N|N||Preferred Brand|759469-Quasense91DayPack|ADULT 2020 632|1001|N|N|Y||Preferred Brand|1300206-0.5MLBordetellapertussisfilamentoushemagglutininvaccine,inactivated0.01MG/ML/Bordetellapertussisfimbriae2/3vaccine,in|ADULT 2020 632|1001|Y|N|N||Preferred Generic|1597129-5000MGTestosterone0.01MG/MGTopicalGel|ADULT 2020 632|1001|N|N|N||Preferred Generic|197817-Indomethacin25MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|311277-lansoprazole30MGDelayedReleaseOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|308508-Bacitracin0.5UNT/MGOphthalmicOintment|ADULT 2020 632|1001|N|N|N||Preferred Generic|722134-Amlodipine5MG/valsartan160MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Brand|261315-Oseltamivir75MGOralCapsule[Tamiflu]|ADULT 2020 632|1001|N|N|N||Preferred Generic|866427-24HRmetoprololsuccinate25MGExtendedReleaseOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|197318-Albuterol4MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|810002-lacosamide50MGOralTablet[Vimpat]|ADULT 2020 632|1001|N|N|N||Preferred Generic|643102-Ibuprofen200MGOralTablet[Wal-Profen]|ADULT 2020 632|1001|N|Y|N||Preferred Brand|1801840-lifitegrast50MG/MLOphthalmicSolution[Xiidra]|ADULT 2020 632|1001|N|N|N||Preferred Generic|866514-MetoprololTartrate50MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1011712-aliskiren150MG/Hydrochlorothiazide12.5MGOralTablet[TekturnaHCT]|ADULT 2020 632|1001|N|N|N||Preferred Generic|198370-torsemide100MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|728109-Oseltamivir30MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Brand|1048452-ColestipolHydrochloride5000MGGranulesforOralSuspension[Colestid]|ADULT 2020 632|1001|N|N|N||Preferred Generic|198175-Propylthiouracil50MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|2110513-60ACTUATFluticasonepropionate0.25MG/ACTUAT/salmeterol0.05MG/ACTUATDryPowderInhaler[Wixela]|ADULT 2020 632|1001|N|N|N||Preferred Generic|979464-Hydrochlorothiazide12.5MG/LosartanPotassium100MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|848943-CholestyramineResin4000MGPowderforOralSuspension|ADULT 2020 632|1001|N|N|N||Preferred Generic|1094107-Phenazopyridinehydrochloride100MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|864706-MethadoneHydrochloride10MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|1358775-MicrogestinFe1/2028DayPack|ADULT 2020 632|1001|N|N|N||Preferred Generic|197516-Clarithromycin250MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|898378-Benazeprilhydrochloride5MG/Hydrochlorothiazide6.25MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|864761-MethadoneHydrochloride1MG/MLOralSolution|ADULT 2020 632|1001|N|N|N||Preferred Brand|2564038-influenzaAvirusA/Cambodia/e0826360/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.03MG/|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2058877-1MLgalcanezumab-gnlm120MG/MLAuto-Injector[Emgality]|ADULT 2020 632|1001|N|N|N||Preferred Generic|312997-SodiumChloride9MG/MLInhalationSolution|ADULT 2020 632|1001|Y|N|N||Preferred Generic|205324-modafinil200MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|313521-Tropicamide5MG/MLOphthalmicSolution|ADULT 2020 632|1001|N|N|Y||Preferred Generic|197739-Glycopyrrolate2MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|310377-Fluorometholone1MG/MLOphthalmicSuspension|ADULT 2020 632|1001|N|Y|N||Preferred Brand|2398842-3MLsemaglutide1.34MG/MLPenInjector[Ozempic]|ADULT 2020 632|1001|N|N|N||Preferred Brand|1595478-amylase84000UNT/lipase20000UNT/protease63000UNTDelayedReleaseOralCapsule[Zenpep]|ADULT 2020 632|1001|N|N|N||Preferred Generic|763185-{21(Prednisone10MGOralTablet)}Pack|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1313061-24HRPhentermine11.25MG/topiramate69MGExtendedReleaseOralCapsule[Qsymia]|ADULT 2020 632|1001|N|Y|N||Preferred Generic|310600-Griseofulvin500MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|1039273-Hydrocortisone10MG/MLTopicalSolution[ScalpicinItchRelief]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1291092-hydrocortisoneacetate30MGRectalSuppository[Proctocort]|ADULT 2020 632|1001|Y|N|N||Preferred Generic|1299903-Tiagabinehydrochloride12MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1871469-lisdexamfetaminedimesylate50MGChewableTablet[Vyvanse]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|349201-valsartan160MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2359353-24HRempagliflozin25MG/linagliptin5MG/metforminhydrochloride1000MGExtendedReleaseOralTablet[Trijardy]|ADULT 2020 632|1001|N|N|N||Preferred Generic|1099687-ValproicAcid50MG/MLOralSolution|ADULT 2020 632|1001|N|N|N||Preferred Generic|1000673-SulfacetamideSodium0.1MG/MGOphthalmicOintment|ADULT 2020 632|1001|N|N|N||Preferred Generic|833217-DiltiazemHydrochloride30MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|197903-Lovastatin10MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|307675-Acetaminophen32MG/MLOralSolution|ADULT 2020 632|1001|N|N|N||Preferred Generic|898367-Benazeprilhydrochloride20MG/Hydrochlorothiazide12.5MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|308696-BenzoylPeroxide50MG/MLMedicatedLiquidSoap|ADULT 2020 632|1001|Y|N|N||Preferred Generic|1657160-0.5MLSumatriptan12MG/MLCartridge|ADULT 2020 632|1001|N|N|N||Preferred Brand|854921-BisoprololFumarate5MG/Hydrochlorothiazide6.25MGOralTablet[Ziac]|ADULT 2020 632|1001|N|N|N||Preferred Generic|979444-MetaproterenolSulfate2MG/MLOralSolution|ADULT 2020 632|1001|N|N|N||Preferred Generic|886671-FlecainideAcetate150MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|897624-24HRVerapamilhydrochloride240MGExtendedReleaseOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|313123-Sucralfate100MG/MLOralSuspension|ADULT 2020 632|1001|N|N|N||Preferred Generic|898359-Amlodipine5MG/Benazeprilhydrochloride40MGOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Brand|643177-dasatinib70MGOralTablet[Sprycel]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2047596-1MLepoetinalfa-epbx10000UNT/MLInjection[Retacrit]|ADULT 2020 632|1001|N|N|N||Preferred Generic|855312-WarfarinSodium2.5MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|1359858-Fluticasonepropionate0.5MG/ACTUAT/salmeterol0.05MG/ACTUATDryPowderInhaler|ADULT 2020 632|1001|N|Y|N||Preferred Brand|1992816-ertugliflozin5MGOralTablet[Steglatro]|ADULT 2020 632|1001|N|N|N||Preferred Generic|198047-Nortriptyline75MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|897683-Verapamilhydrochloride80MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|349208-Sirolimus1MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|485485-tizanidine4MGOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Generic|245136-72HRFentanyl0.1MG/HRTransdermalSystem|ADULT 2020 632|1001|N|N|N||Preferred Generic|1049906-DiphenhydramineHydrochloride2.5MG/MLOralSolution|ADULT 2020 632|1001|N|N|N||Preferred Generic|403854-Hydrochlorothiazide12.5MG/Olmesartanmedoxomil40MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1373333-Isotretinoin10MGOralCapsule[Zenatane]|ADULT 2020 632|1001|Y|N|N||Preferred Generic|485421-24HRdarifenacin15MGExtendedReleaseOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|1806181-30/70Release24HRMethylphenidateHydrochloride10MGExtendedReleaseOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|1362706-MexiletineHydrochloride150MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|311892-nabumetone500MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Brand|1658102-1MLhepatitisAvirusstrainCR326Fantigen,inactivated50UNT/MLInjection[Vaqta]|ADULT 2020 632|1001|N|N|N||Preferred Generic|308725-bexarotene75MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|639566-VitaminB650MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|313988-Furosemide40MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|1366550-24HRBudesonide9MGExtendedReleaseOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|992475-PromethazineHydrochloride50MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1989085-bosentan32MGTabletforOralSuspension[Tracleer]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|763565-0.4MLadalimumab50MG/MLPrefilledSyringe[Humira]|ADULT 2020 632|1001|N|N|Y||Preferred Brand|803371-1MLHepatitisAVaccine(Inactivated)StrainHM175720UNT/ML/HepatitisBSurfaceAntigenVaccine0.02MG/MLPrefilledSyringe[Twinrix|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1813112-Rajani28DayPack|ADULT 2020 632|1001|N|N|N||Preferred Generic|859186-selegilinehydrochloride5MGOralCapsule|ADULT 2020 632|1001|N|N|Y||Preferred Brand|2166928-10ACTUATolodaterol0.0025MG/ACTUAT/tiotropium0.0025MG/ACTUATInhalationSpray[Stiolto]|ADULT 2020 632|1001|N|N|N||Preferred Generic|197684-Etodolac200MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|312849-ropinirole5MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1650901-0.5MLInterferonbeta-1a0.06MG/MLAuto-Injector[Avonex]|ADULT 2020 632|1001|N|Y|Y||Preferred Generic|998675-168HRClonidine0.00833MG/HRTransdermalSystem|ADULT 2020 632|1001|N|N|N||Preferred Brand|616449-MycophenolicAcid360MGDelayedReleaseOralTablet[Myfortic]|ADULT 2020 632|1001|N|N|N||Preferred Generic|1094104-Phenazopyridinehydrochloride200MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2475860-vericiguat5MGOralTablet[Verquvo]|ADULT 2020 632|1001|N|N|N||Preferred Generic|308714-Betamethasone0.5MG/ML/Clotrimazole10MG/MLTopicalCream|ADULT 2020 632|1001|N|N|N||Preferred Generic|903884-FluvoxamineMaleate100MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|308345-apraclonidine5MG/MLOphthalmicSolution|ADULT 2020 632|1001|Y|N|N||Preferred Generic|603206-erlotinib150MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|205913-EpoetinAlfa10000UNT/MLInjectableSolution[Procrit]|ADULT 2020 632|1001|N|N|N||Preferred Generic|979480-LosartanPotassium100MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|876524-Amlodipine5MG/telmisartan40MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|351487-thyroid(USP)130MGOralTablet[Westhroid]|ADULT 2020 632|1001|Y|N|N||Preferred Generic|403878-imatinib100MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|866412-24HRmetoprololsuccinate100MGExtendedReleaseOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|827713-MineralOil0.03MG/MG/Petrolatum0.94MG/MGOphthalmicOintment[SystaneNighttime]|ADULT 2020 632|1001|N|Y|N||Preferred Generic|349590-Levalbuterol0.103MG/MLInhalationSolution|ADULT 2020 632|1001|N|N|N||Preferred Generic|197863-Leucovorin5MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2003767-1.14MLsarilumab175MG/MLAuto-Injector[Kevzara]|ADULT 2020 632|1001|N|N|N||Preferred Generic|979475-MetaproterenolSulfate20MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|1926331-0.5UNTDoses3MLInsulinLispro100UNT/MLPenInjector|ADULT 2020 632|1001|N|N|Y||Preferred Brand|731281-InsulinLispro50UNT/ML/insulinlisproprotamine,human50UNT/MLInjectableSuspension[HumalogMix]|ADULT 2020 632|1001|N|N|N||Preferred Generic|198365-Prochlorperazine10MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|847252-3MLInsulinLispro25UNT/ML/insulinlisproprotamine,human75UNT/MLPenInjector|ADULT 2020 632|1001|N|N|Y||Preferred Generic|1009145-Amphetamineaspartate1.875MG/AmphetamineSulfate1.875MG/Dextroamphetaminesaccharate1.875MG/DextroamphetamineSulfate1.87|ADULT 2020 632|1001|N|N|N||Preferred Brand|208513-Estrogens,Conjugated(USP)0.3MGOralTablet[Premarin]|ADULT 2020 632|1001|N|N|N||Preferred Generic|198429-lamotrigine200MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1243843-24HRMetforminhydrochloride1000MG/sitagliptin50MGExtendedReleaseOralTablet[Janumet]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|896245-120ACTUATFluticasonepropionate0.115MG/ACTUAT/salmeterol0.021MG/ACTUATMeteredDoseInhaler[Advair]|ADULT 2020 632|1001|N|N|N||Preferred Generic|402698-24HRFelodipine2.5MGExtendedReleaseOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|836649-Zolpidemtartrate5MGSublingualTablet[Edluar]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2123314-Mayzent0.25MGStarterPack|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1729065-selexipag0.8MGOralTablet[Uptravi]|ADULT 2020 632|1001|N|N|N||Preferred Generic|349332-Escitalopram10MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|849506-DesmopressinAcetate0.01MG/ACTUATNasalSpray|ADULT 2020 632|1001|Y|N|N||Preferred Brand|858366-KetorolacTromethamine4.5MG/MLOphthalmicSolution[Acuvail]|ADULT 2020 632|1001|Y|N|N||Preferred Generic|197730-Furosemide10MG/MLOralSolution|ADULT 2020 632|1001|N|N|N||Preferred Generic|898723-Benazeprilhydrochloride5MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1374574-TOBIPodhalerKit,224|ADULT 2020 632|1001|Y|N|N||Preferred Generic|485489-Temazepam22.5MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|309686-Dexamethasone0.1MG/MLOralSolution|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1663728-Isotretinoin30MGOralCapsule[Myorisan]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1243052-ivacaftor150MGOralTablet[Kalydeco]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|1543069-Lidocaine0.05MG/MGTopicalOintment|ADULT 2020 632|1001|N|N|Y||Preferred Brand|311026-insulinisophane,human100UNT/MLInjectableSuspension[HumulinN]|ADULT 2020 632|1001|N|N|N||Preferred Brand|206978-Ketoconazole20MG/MLMedicatedShampoo[Nizoral]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|226917-orlistat120MGOralCapsule[Xenical]|ADULT 2020 632|1001|N|N|N||Preferred Generic|197596-Dicloxacillin500MGOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1429282-NeostigmineMethylsulfate0.5MG/MLInjectableSolution[Bloxiverz]|ADULT 2020 632|1001|N|N|N||Preferred Generic|992441-PromethazineHydrochloride12.5MGRectalSuppository|ADULT 2020 632|1001|N|N|Y||Preferred Generic|310190-estradiolvalerate20MG/MLInjectableSolution|ADULT 2020 632|1001|Y|N|N||Preferred Generic|485436-entecavir1MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|995278-HydroxyzinePamoate50MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|309112-Cephalexin250MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|312504-PotassiumChloride10MEQExtendedReleaseOralCapsule|ADULT 2020 632|1001|N|Y|Y||Preferred Generic|856569-24HRPropranololHydrochloride80MGExtendedReleaseOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Brand|1087012-thyroid(USP)32.5MGOralTablet[Westhroid]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|310152-Erythromycin0.02MG/MGTopicalGel|ADULT 2020 632|1001|N|N|Y||Preferred Generic|1649401-DoxycyclineMonohydrate50MGOralCapsule|ADULT 2020 632|1001|N|N|Y||Preferred Generic|1091392-MethylphenidateHydrochloride20MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|206961-Nadolol20MGOralTablet[Corgard]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1243040-Linagliptin2.5MG/Metforminhydrochloride850MGOralTablet[Jentadueto]|ADULT 2020 632|1001|N|Y|N||Preferred Generic|308865-calcipotriene0.05MG/MLTopicalSolution|ADULT 2020 632|1001|N|Y|Y||Preferred Generic|856535-24HRPropranololHydrochloride60MGExtendedReleaseOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|835564-ImipramineHydrochloride25MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|896001-120ACTUATFluticasonepropionate0.11MG/ACTUATMeteredDoseInhaler[Flovent]|ADULT 2020 632|1001|N|N|N||Preferred Generic|309114-Cephalexin500MGOralCapsule|ADULT 2020 632|1001|N|N|Y||Preferred Generic|899518-dexmethylphenidatehydrochloride5MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|198039-Nitroglycerin0.4MGSublingualTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|1304979-icosapentethyl1000MGOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1654955-1MLdarbepoetinalfa0.2MG/MLInjection[Aranesp]|ADULT 2020 632|1001|N|N|N||Preferred Generic|756209-Zidovudine10MG/MLOralSolution|ADULT 2020 632|1001|N|N|N||Preferred Generic|855324-WarfarinSodium4MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2463733-epoetinalfa-epbx10000UNT/MLInjectableSolution[Retacrit]|ADULT 2020 632|1001|N|N|N||Preferred Generic|310431-gabapentin300MGOralCapsule|ADULT 2020 632|1001|N|Y|N||Preferred Generic|1246673-Ivermectin5MG/MLTopicalLotion|ADULT 2020 632|1001|Y|N|N||Preferred Generic|861960-armodafinil200MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|242438-montelukast5MGChewableTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|208083-sargramostim0.25MG/MLInjectableSolution[Leukine]|ADULT 2020 632|1001|N|N|N||Preferred Generic|198240-Tamoxifen10MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|310380-Fluorouracil50MG/MLTopicalSolution|ADULT 2020 632|1001|N|N|N||Preferred Brand|198467-Aspirin325MGDelayedReleaseOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|197380-Atenolol25MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|197595-Dicloxacillin250MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|198861-SodiumBicarbonate650MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|1358780-Junel1/2021DayPack|ADULT 2020 632|1001|Y|N|N||Preferred Generic|197696-72HRFentanyl0.075MG/HRTransdermalSystem|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1242613-Isotretinoin20MGOralCapsule[Myorisan]|ADULT 2020 632|1001|N|N|N||Preferred Generic|238600-seleniumsulfide25MG/MLMedicatedShampoo|ADULT 2020 632|1001|N|N|N||Preferred Generic|310798-Hydrochlorothiazide25MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|577057-72HRFentanyl0.012MG/HRTransdermalSystem|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1043567-24HRMetforminhydrochloride1000MG/saxagliptin2.5MGExtendedReleaseOralTablet[Kombiglyze]|ADULT 2020 632|1001|N|N|N||Preferred Generic|197582-Dexamethasone4MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|897659-Verapamilhydrochloride120MGExtendedReleaseOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|213284-hydroxyurea400MGOralCapsule[Droxia]|ADULT 2020 632|1001|N|N|N||Preferred Brand|2562996-0.5MLinfluenzaAvirusA/Cambodia/e0826360/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.|ADULT 2020 632|1001|N|N|N||Preferred Generic|309291-ciclopirox80MG/MLTopicalSolution|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1729053-selexipag0.2MGOralTablet[Uptravi]|ADULT 2020 632|1001|N|Y|Y||Preferred Generic|1806185-50/50Release24HRMethylphenidateHydrochloride60MGExtendedReleaseOralCapsule|ADULT 2020 632|1001|N|Y|N||Preferred Generic|1368417-alogliptin12.5MG/pioglitazone45MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Brand|762602-SalmonellatyphiTy21aliveantigen2000000000UNTDelayedReleaseOralCapsule[Vivotif]|ADULT 2020 632|1001|Y|N|N||Preferred Generic|1860154-Abuse-Deterrent12HROxycodoneHydrochloride15MGExtendedReleaseOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1429367-lenalidomide20MGOralCapsule[Revlimid]|ADULT 2020 632|1001|Y|N|N||Preferred Generic|999986-Amlodipine10MG/Hydrochlorothiazide12.5MG/Olmesartanmedoxomil40MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1729047-selexipag1.6MGOralTablet[Uptravi]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|857005-Acetaminophen325MG/HydrocodoneBitartrate7.5MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|904932-ibandronicacid150MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|310442-Ganciclovir500MGInjection|ADULT 2020 632|1001|N|N|N||Preferred Generic|855296-WarfarinSodium10MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1242968-exenatide2MGInjection[Bydureon]|ADULT 2020 632|1001|Y|N|N||Preferred Generic|639537-candesartancilexetil32MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|854832-lisdexamfetaminedimesylate20MGOralCapsule[Vyvanse]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|1650142-DoxycyclineMonohydrate100MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Brand|1190919-0.5MLdiphtheriatoxoidvaccine,inactivated4UNT/ML/tetanustoxoidvaccine,inactivated10UNT/MLPrefilledSyringe[Tenivac]|ADULT 2020 632|1001|N|N|Y||Preferred Brand|901518-0.5MLNeisseriameningitidisserogroupAoligosaccharidediphtheriaCRM197proteinconjugatevaccine0.02MG/ML/Neisseriameningiti|ADULT 2020 632|1001|N|N|Y||Preferred Brand|1601407-0.5MLmeningococcalgroupBvaccine0.1MG/ML/NeisseriameningitidisserogroupBrecombinantFHBPfusionproteinantigen0.1MG/ML/Ne|ADULT 2020 632|1001|N|N|N||Preferred Brand|2563039-0.5MLinfluenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.03MG/|ADULT 2020 632|1001|N|N|N||Preferred Generic|197407-Betamethasone1MG/MLTopicalCream|ADULT 2020 632|1001|N|N|N||Preferred Generic|544455-Lactulose667MG/MLOralSolution[Generlac]|ADULT 2020 632|1001|N|N|N||Preferred Brand|1595292-amylase14000UNT/lipase3000UNT/protease10000UNTDelayedReleaseOralCapsule[Zenpep]|ADULT 2020 632|1001|N|N|N||Preferred Generic|1245468-DocusateSodium250MGOralCapsule|ADULT 2020 632|1001|N|N|Y||Preferred Generic|884386-DextroamphetamineSulfate5MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|672149-lapatinib250MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|198032-Nifedipine10MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|897666-Verapamilhydrochloride120MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|860805-Azelastinehydrochloride0.5MG/MLOphthalmicSolution|ADULT 2020 632|1001|Y|N|N||Preferred Generic|1547561-Isotretinoin25MGOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2054995-lusutrombopag3MGOralTablet[Mulpleta]|ADULT 2020 632|1001|N|N|Y||Preferred Brand|836634-1MLhepatitisAvirusstrainCR326Fantigen,inactivated50UNT/MLPrefilledSyringe[Vaqta]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1544404-0.15MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|858044-saxagliptin2.5MGOralTablet[Onglyza]|ADULT 2020 632|1001|N|N|N||Preferred Generic|830882-24HRDiltiazemHydrochloride300MGExtendedReleaseOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|359817-Nicotine2MGOralLozenge|ADULT 2020 632|1001|N|N|N||Preferred Generic|1191256-FluocinoloneAcetonide0.00025MG/MGTopicalOintment|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1729029-selexipag1.2MGOralTablet[Uptravi]|ADULT 2020 632|1001|N|N|N||Preferred Generic|198040-Nitroglycerin0.6MGSublingualTablet|ADULT 2020 632|1001|N|Y|N||Preferred Generic|745791-200ACTUATLevalbuterol0.045MG/ACTUATMeteredDoseInhaler|ADULT 2020 632|1001|N|N|N||Preferred Brand|749151-Tri-Norinyl28DayPack|ADULT 2020 632|1001|N|N|Y||Preferred Brand|2050059-0.5MLHepatitisBSurfaceAntigenVaccine0.04MG/MLPrefilledSyringe[Heplisav-B]|ADULT 2020 632|1001|N|N|N||Preferred Generic|898690-Benazeprilhydrochloride20MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|1923424-SotalolHydrochloride160MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|197843-Isotretinoin10MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|313919-salmoncalcitonin200UNT/ACTUATNasalSpray|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1439896-riociguat1MGOralTablet[Adempas]|ADULT 2020 632|1001|N|N|N||Preferred Generic|1099625-DivalproexSodium125MGDelayedReleaseOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1539893-30ACTUATfluticasonefuroate0.1MG/ACTUAT/vilanterol0.025MG/ACTUATDryPowderInhaler[Breo]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1811182-icosapentethyl500MGOralCapsule[Vascepa]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|1091145-8HRMethylphenidateHydrochloride10MGExtendedReleaseOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|855344-WarfarinSodium7.5MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|617423-Amoxicillin40MG/ML/Clavulanate5.7MG/MLOralSuspension|ADULT 2020 632|1001|N|N|N||Preferred Generic|896209-60ACTUATFluticasonepropionate0.25MG/ACTUAT/salmeterol0.05MG/ACTUATDryPowderInhaler|ADULT 2020 632|1001|N|N|N||Preferred Generic|197960-Hydrochlorothiazide25MG/Methyldopa250MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|244967-PolymyxinB10000UNT/ML/Trimethoprim1MG/MLOphthalmicSolution|ADULT 2020 632|1001|N|N|N||Preferred Brand|213282-hydroxyurea200MGOralCapsule[Droxia]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2371768-Oriahnn28DayKit|ADULT 2020 632|1001|N|N|N||Preferred Generic|905395-HydralazineHydrochloride50MGOralTablet|ADULT 2020 632|1001|N|Y|Y||Preferred Generic|311671-Metolazone5MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|404550-Estrogens,Conjugated(USP)0.45MGOralTablet[Premarin]|ADULT 2020 632|1001|N|N|N||Preferred Generic|1923428-Timolol2.5MG/MLOphthalmicSolution|ADULT 2020 632|1001|Y|N|N||Preferred Brand|995156-lacosamide10MG/MLOralSolution[Vimpat]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|477562-Fenofibrate48MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|312357-Phenobarbital15MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2205634-1MLbenralizumab30MG/MLAuto-Injector[Fasenra]|ADULT 2020 632|1001|N|N|N||Preferred Brand|1358765-JunelFe1/2028DayPack|ADULT 2020 632|1001|N|N|N||Preferred Generic|197986-Minoxidil10MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|856422-Hydrochlorothiazide25MG/PropranololHydrochloride40MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|391937-Lactulose667MG/MLOralSolution|ADULT 2020 632|1001|Y|N|N||Preferred Brand|205923-1MLEpoetinAlfa4000UNT/MLInjection[Epogen]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1546189-0.5MLpeginterferonbeta-1a0.25MG/MLPrefilledSyringe[Plegridy]|ADULT 2020 632|1001|N|N|N||Preferred Generic|311288-Levetiracetam250MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2373941-bedaquiline20MGOralTablet[Sirturo]|ADULT 2020 632|1001|Y|N|N||Preferred Generic|579148-Galantamine12MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|859052-Pramipexoledihydrochloride1MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|861237-24HRAmphetamineaspartate1.25MG/AmphetamineSulfate1.25MG/Dextroamphetaminesaccharate1.25MG/DextroamphetamineSulfate1.25|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1649491-ivabradine5MGOralTablet[Corlanor]|ADULT 2020 632|1001|N|N|N||Preferred Brand|1995479-amylase168000UNT/lipase40000UNT/protease126000UNTDelayedReleaseOralCapsule[Zenpep]|ADULT 2020 632|1001|N|N|N||Preferred Brand|1998774-Breath-Actuated120ACTUATBeclomethasoneDipropionate0.04MG/ACTUATMeteredDoseInhaler[Qvar]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|862019-24HRGuanfacine3MGExtendedReleaseOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|802652-1MLEtanercept50MG/MLPrefilledSyringe[Enbrel]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|310793-Hydrochlorothiazide12.5MG/irbesartan300MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|311975-Nicotine4MGChewingGum|ADULT 2020 632|1001|N|N|N||Preferred Generic|1298072-Cyclopentolatehydrochloride5MG/MLOphthalmicSolution|ADULT 2020 632|1001|N|N|Y||Preferred Generic|861227-24HRAmphetamineaspartate6.25MG/AmphetamineSulfate6.25MG/Dextroamphetaminesaccharate6.25MG/DextroamphetamineSulfate6.25|ADULT 2020 632|1001|Y|N|N||Preferred Generic|802749-candesartancilexetil32MG/Hydrochlorothiazide25MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|866018-buspironehydrochloride15MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|578018-bromfenac0.9MG/MLOphthalmicSolution|ADULT 2020 632|1001|N|N|N||Preferred Generic|856733-PropranololHydrochloride8MG/MLOralSolution|ADULT 2020 632|1001|Y|N|N||Preferred Brand|978950-Natazia28DayPack|ADULT 2020 632|1001|Y|N|N||Preferred Generic|794639-lubiprostone0.008MGOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Generic|900164-24HRlamotrigine25MGExtendedReleaseOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|312441-pioglitazone45MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|863559-valganciclovir50MG/MLOralSolution|ADULT 2020 632|1001|N|N|Y||Preferred Generic|728113-Oseltamivir45MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Brand|261353-Trimethoprim10MG/MLOralSolution[Primsol]|ADULT 2020 632|1001|Y|N|N||Preferred Generic|850087-24HRlamotrigine100MGExtendedReleaseOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|315102-SodiumFluoride1.1MG/MLOralSolution|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2257013-trikafta100MG/50MG/75MGand150MGPack|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1606870-ivacaftor75MGOralGranules[Kalydeco]|ADULT 2020 632|1001|N|Y|N||Preferred Brand|402092-Cyclosporine0.5MG/MLOphthalmicSuspension[Restasis]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|197738-Glycopyrrolate1MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1439903-riociguat2.5MGOralTablet[Adempas]|ADULT 2020 632|1001|N|N|Y||Preferred Brand|1364441-apixaban2.5MGOralTablet[Eliquis]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2170993-1MLmepolizumab100MG/MLAuto-Injector[Nucala]|ADULT 2020 632|1001|Y|N|N||Preferred Generic|197844-Isotretinoin20MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|856373-TrazodoneHydrochloride100MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|855633-DiclofenacSodium0.01MG/MGTopicalGel|ADULT 2020 632|1001|N|N|N||Preferred Generic|992184-methenaminemandelate500MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|197963-Hydrochlorothiazide15MG/Methyldopa250MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1441424-0.4MLMethotrexate62.5MG/MLAuto-Injector[Otrexup]|ADULT 2020 632|1001|N|N|N||Preferred Generic|309362-clopidogrel75MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|311665-Metipranolol3MG/MLOphthalmicSolution|ADULT 2020 632|1001|N|N|N||Preferred Generic|238154-Acetaminophen325MG/butalbital50MG/Caffeine40MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|198630-ferrousgluconate324MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|197580-Dexamethasone1.5MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|311197-IsosorbideMononitrate20MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Brand|1549683-Xarelto30-DayStarterPackKit|ADULT 2020 632|1001|N|N|N||Preferred Generic|1085633-TriamcinoloneAcetonide0.00025MG/MGTopicalOintment|ADULT 2020 632|1001|N|N|N||Preferred Generic|197958-Methyldopa500MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|1793916-0.5MLSumatriptan8MG/MLAuto-Injector|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1796091-24HRLinagliptin2.5MG/Metforminhydrochloride1000MGExtendedReleaseOralTablet[Jentadueto]|ADULT 2020 632|1001|Y|N|N||Preferred Generic|860103-KetorolacTromethamine4MG/MLOphthalmicSolution|ADULT 2020 632|1001|N|N|Y||Preferred Brand|1547950-CarboxymethylcelluloseSodium2.5MG/MLOphthalmicSolution[TheraTears]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1653225-1MLEtanercept50MG/MLAuto-Injector[Enbrel]|ADULT 2020 632|1001|N|N|N||Preferred Generic|198292-Tolazamide250MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|310385-Fluoxetine20MGOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1544394-0.4MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|ADULT 2020 632|1001|N|N|N||Preferred Generic|692783-Loratadine1MG/MLOralSolution|ADULT 2020 632|1001|Y|N|N||Preferred Brand|795085-certolizumabpegol200MGInjection[Cimzia]|ADULT 2020 632|1001|N|N|N||Preferred Generic|312515-PotassiumChloride1.33MEQ/MLOralSolution|ADULT 2020 632|1001|Y|N|N||Preferred Brand|828364-hydrocortisoneacetate10MG/ML/Pramoxinehydrochloride10MG/MLRectalFoam[Proctofoam-HC]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|861232-24HRAmphetamineaspartate7.5MG/AmphetamineSulfate7.5MG/Dextroamphetaminesaccharate7.5MG/DextroamphetamineSulfate7.5MGEx|ADULT 2020 632|1001|Y|N|N||Preferred Generic|198243-Temazepam7.5MGOralCapsule|ADULT 2020 632|1001|N|Y|N||Preferred Generic|1368006-alogliptin25MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1235157-azilsartanmedoxomil40MG/Chlorthalidone25MGOralTablet[Edarbyclor]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|753442-9HRMethylphenidate2.22MG/HRTransdermalSystem[Daytrana]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1790546-infliximab-dyyb100MGInjection[Inflectra]|ADULT 2020 632|1001|N|N|Y||Preferred Brand|1115892-MineralOil0.15MG/MG/Petrolatum0.85MG/MGOphthalmicOintment[Puralube]|ADULT 2020 632|1001|N|N|N||Preferred Generic|748800-{21(drospirenone3MG/EthinylEstradiol0.03MGOralTablet)/7(InertIngredients1MGOralTablet)}Pack|ADULT 2020 632|1001|N|Y|N||Preferred Generic|1368034-alogliptin12.5MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|861221-24HRAmphetamineaspartate2.5MG/AmphetamineSulfate2.5MG/Dextroamphetaminesaccharate2.5MG/DextroamphetamineSulfate2.5MGEx|ADULT 2020 632|1001|N|N|N||Preferred Generic|855480-alclometasonedipropionate0.0005MG/MGTopicalOintment|ADULT 2020 632|1001|N|Y|N||Preferred Generic|1368385-alogliptin12.5MG/Metforminhydrochloride1000MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1310144-everolimus3MGTabletforOralSuspension[Afinitor]|ADULT 2020 632|1001|N|N|N||Preferred Generic|884173-ClonidineHydrochloride0.1MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|238151-mesalamine66.7MG/MLEnema|ADULT 2020 632|1001|N|Y|N||Preferred Generic|317094-entacapone200MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|753482-Apri28DayPack|ADULT 2020 632|1001|N|N|N||Preferred Generic|199351-trandolapril2MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|1373327-amylase180000UNT/lipase36000UNT/protease114000UNTDelayedReleaseOralCapsule[Creon]|ADULT 2020 632|1001|N|N|Y||Preferred Brand|1292459-0.5MLVaricella-ZosterVirusVaccineLive(Oka-Merck)strain2700UNT/MLInjection[Varivax]|ADULT 2020 632|1001|N|N|N||Preferred Generic|199703-cabergoline0.5MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1091650-azilsartanmedoxomil40MGOralTablet[Edarbi]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1091843-Roflumilast0.5MGOralTablet[Daliresp]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|830801-24HRDiltiazemHydrochloride300MGExtendedReleaseOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1544388-0.3MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2559707-1.14MLdupilumab175MG/MLAuto-Injector[Dupixent]|ADULT 2020 632|1001|N|N|N||Preferred Generic|749784-{7(EthinylEstradiol0.035MG/norgestimate0.18MGOralTablet)/7(EthinylEstradiol0.035MG/norgestimate0.215MGOralTablet)/7(Et|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1544390-0.35MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|ADULT 2020 632|1001|N|N|N||Preferred Generic|855474-alclometasonedipropionate0.5MG/MLTopicalCream|ADULT 2020 632|1001|N|Y|Y||Preferred Generic|483440-pregabalin150MGOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Brand|607579-entecavir0.05MG/MLOralSolution[Baraclude]|ADULT 2020 632|1001|N|N|N||Preferred Generic|211365-chlorhexidinegluconate40MG/MLMedicatedLiquidSoap|ADULT 2020 632|1001|N|N|Y||Preferred Generic|1000126-1MLmedroxyprogesteroneacetate150MG/MLInjection|ADULT 2020 632|1001|N|N|N||Preferred Generic|596843-lansoprazole15MGDelayedReleaseOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|197627-Doxazosin4MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|834127-chlorhexidinegluconate1.2MG/MLMouthwash|ADULT 2020 632|1001|Y|N|N||Preferred Generic|1373491-dimethylfumarate240MGDelayedReleaseOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|312593-Prazosin1MGOralCapsule|ADULT 2020 632|1001|N|Y|N||Preferred Generic|1855389-Levalbuterol2.5MG/MLInhalationSolution|ADULT 2020 632|1001|Y|N|N||Preferred Generic|724859-armodafinil150MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|310154-Erythromycin250MGDelayedReleaseOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|861487-ClobetasolPropionate0.5MG/MLTopicalSolution|ADULT 2020 632|1001|N|N|Y||Preferred Brand|830245-1MLHepatitisBSurfaceAntigenVaccine0.01MG/MLPrefilledSyringe[Recombivax]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1605071-0.5MLFILGRASTIM-SNDZ0.6MG/MLPrefilledSyringe[Zarxio]|ADULT 2020 632|1001|N|Y|Y||Preferred Generic|483448-pregabalin50MGOralCapsule|ADULT 2020 632|1001|N|Y|N||Preferred Brand|2395779-0.5MLdulaglutide6MG/MLAuto-Injector[Trulicity]|ADULT 2020 632|1001|Y|N|Y||Preferred Generic|106303-Tretinoin0.5MG/MLTopicalCream|ADULT 2020 632|1001|N|Y|N||Preferred Brand|833143-Milnacipranhydrochloride12.5MGOralTablet[Savella]|ADULT 2020 632|1001|N|N|N||Preferred Generic|1313885-Phenytoin50MGChewableTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|199164-Phenobarbital97.2MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|197971-Methylprednisolone32MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|283858-ropinirole3MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|349483-valsartan40MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Brand|1597099-0.5MLL1protein,Humanpapillomavirustype11Vaccine0.08MG/ML/L1protein,Humanpapillomavirustype16Vaccine0.12MG/ML/L1protei|ADULT 2020 632|1001|N|N|Y||Preferred Generic|892672-MorphineSulfate30MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|310289-Fenofibrate200MGOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Generic|1111641-1MLglatirameracetate20MG/MLPrefilledSyringe|ADULT 2020 632|1001|N|Y|Y||Preferred Generic|577127-pregabalin225MGOralCapsule|ADULT 2020 632|1001|N|Y|Y||Preferred Generic|797274-Clindamycin10MG/MLMedicatedPad|ADULT 2020 632|1001|N|N|N||Preferred Generic|1116150-bacitracinzinc0.4UNT/MG/hydrocortisoneacetate0.01MG/MG/NeomycinSulfate0.0035MG/MG/PolymyxinBSulfate10UNT/MGOphthalmic|ADULT 2020 632|1001|N|Y|N||Preferred Generic|1368018-alogliptin6.25MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|866111-buspironehydrochloride7.5MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|199193-famciclovir250MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|207588-Procarbazine50MGOralCapsule[Matulane]|ADULT 2020 632|1001|N|N|N||Preferred Generic|1000897-PilocarpineHydrochloride40MG/MLOphthalmicSolution|ADULT 2020 632|1001|N|N|Y||Preferred Generic|2123111-NDA020503200ACTUATAlbuterol0.09MG/ACTUATMeteredDoseInhaler|ADULT 2020 632|1001|N|N|N||Preferred Generic|315107-24HRGlipizide10MGExtendedReleaseOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|209890-Acetaminophen500MGOralCapsule[Mapap]|ADULT 2020 632|1001|N|N|N||Preferred Generic|857328-BethanecholChloride25MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Brand|1364447-apixaban5MGOralTablet[Eliquis]|ADULT 2020 632|1001|N|N|N||Preferred Generic|966914-POLYETHYLENEGLYCOL3350240000MG/PotassiumChloride2980MG/SodiumBicarbonate6720MG/SodiumChloride5840MG/sodiumsulfate22720|ADULT 2020 632|1001|N|N|Y||Preferred Generic|197902-Lorazepam2MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Brand|211140-PentosanPolysulfate100MGOralCapsule[Elmiron]|ADULT 2020 632|1001|N|N|N||Preferred Generic|993691-BupropionHydrochloride75MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|308988-Carbidopa25MG/Levodopa100MGExtendedReleaseOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2182340-1MLEtanercept50MG/MLCartridge[Enbrel]|ADULT 2020 632|1001|N|Y|N||Preferred Generic|197507-Cimetidine400MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|1440936-Hydrocortisone25MG/MLTopicalCream[ProctozoneHC]|ADULT 2020 632|1001|N|N|N||Preferred Generic|253039-Melatonin1MG/MLOralSolution|ADULT 2020 632|1001|Y|N|N||Preferred Generic|803353-PhentermineHydrochloride37.5MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1439901-riociguat2MGOralTablet[Adempas]|ADULT 2020 632|1001|N|Y|N||Preferred Brand|1992821-ertugliflozin15MGOralTablet[Steglatro]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1544383-0.2MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|ADULT 2020 632|1001|Y|N|Y||Preferred Generic|197636-dronabinol5MGOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Generic|1359861-Budesonide0.16MG/ACTUAT/formoterolfumarate0.0045MG/ACTUATMeteredDoseInhaler|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1858833-12HRTreprostinil5MGExtendedReleaseOralTablet[Orenitram]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1873087-HumiraPrefilledSyringe80MG/0.8MLStarterPack-PediatricCrohn'sDisease(3count)|ADULT 2020 632|1001|Y|N|N||Preferred Brand|810079-24HRFesoterodineFumarate8MGExtendedReleaseOralTablet[Toviaz]|ADULT 2020 632|1001|Y|N|N||Preferred Generic|2123194-PulmonaryHypertensiontadalafil20MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|197941-Methimazole10MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|686400-ErythromycinEthylsuccinate40MG/MLOralSuspension|ADULT 2020 632|1001|N|N|Y||Preferred Brand|1363484-hypromellose0.003MG/MGOphthalmicGel[SystaneOvernightTherapy]|ADULT 2020 632|1001|N|N|N||Preferred Generic|1860100-ferroussulfate324MGDelayedReleaseOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1149667-Camrese91DayPack|ADULT 2020 632|1001|N|Y|Y||Preferred Generic|606726-Esomeprazole20MGDelayedReleaseOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|309371-Clotrimazole10MGOralLozenge|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1721690-1MLEpoetinAlfa10000UNT/MLInjection[Procrit]|ADULT 2020 632|1001|N|Y|Y||Preferred Generic|483450-pregabalin75MGOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1868016-pirfenidone267MGOralTablet[Esbriet]|ADULT 2020 632|1001|N|N|N||Preferred Brand|105551-Busulfan2MGOralTablet[Myleran]|ADULT 2020 632|1001|N|N|N||Preferred Generic|349420-desloratadine5MGOralTablet|ADULT 2020 632|1001|Y|N|Y||Preferred Generic|312084-Ondansetron24MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|1988980-24HRpregabalin82.5MGExtendedReleaseOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1657982-20MLtocilizumab20MG/MLInjection[Actemra]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1429284-NeostigmineMethylsulfate1MG/MLInjectableSolution[Bloxiverz]|ADULT 2020 632|1001|N|N|N||Preferred Generic|198224-Hydrochlorothiazide25MG/Spironolactone25MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|313762-zaleplon5MGOralCapsule|ADULT 2020 632|1001|N|N|Y||Preferred Brand|1723478-dabigatranetexilate110MGOralCapsule[Pradaxa]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|897710-HydromorphoneHydrochloride8MGOralTablet|ADULT 2020 632|1001|N|Y|Y||Preferred Brand|2200654-semaglutide3MGOralTablet[Rybelsus]|ADULT 2020 632|1001|N|N|N||Preferred Generic|312617-Prednisone5MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1115468-1.5MLLeuprolideAcetate15MG/MLPrefilledSyringe[Lupron]|ADULT 2020 632|1001|N|N|N||Preferred Generic|198045-Nortriptyline10MGOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Brand|902626-dexlansoprazole60MGDelayedReleaseOralCapsule[Dexilant]|ADULT 2020 632|1001|N|N|N||Preferred Brand|542059-Didanosine10MG/MLOralSolution[Videx]|ADULT 2020 632|1001|N|N|N||Preferred Generic|311893-nabumetone750MGOralTablet|ADULT 2020 632|1001|N|Y|Y||Preferred Generic|314266-Tacrolimus0.001MG/MGTopicalOintment|ADULT 2020 632|1001|N|N|N||Preferred Generic|995632-MeclizineHydrochloride25MGChewableTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|884308-Nystatin100UNT/MGTopicalOintment|ADULT 2020 632|1001|N|N|N||Preferred Brand|207273-Nitroglycerin0.02MG/MGTopicalOintment[Nitro-Bid]|ADULT 2020 632|1001|Y|N|N||Preferred Generic|1547565-Isotretinoin35MGOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2102705-0.6MLpegfilgrastim-cbqv10MG/MLPrefilledSyringe[Udenyca]|ADULT 2020 632|1001|N|N|N||Preferred Generic|486152-24HRNitroglycerin0.4MG/HRTransdermalSystem|ADULT 2020 632|1001|N|N|N||Preferred Generic|1000862-PilocarpineHydrochloride20MG/MLOphthalmicSolution|ADULT 2020 632|1001|N|N|N||Preferred Generic|1000058-DoxepinHydrochloride100MGOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Brand|731231-0.3MLdarbepoetinalfa0.5MG/MLPrefilledSyringe[Aranesp]|ADULT 2020 632|1001|N|N|N||Preferred Generic|312059-Nystatin500000UNTOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|861010-Metforminhydrochloride850MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|197659-Estradiol2MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|310324-ferroussulfate325MGDelayedReleaseOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|308891-CalciumCarbonate250MG/MLOralSuspension|ADULT 2020 632|1001|Y|N|N||Preferred Generic|1308569-24HRrivastigmine0.554MG/HRTransdermalSystem|ADULT 2020 632|1001|N|N|Y||Preferred Generic|199370-Ciprofloxacin100MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|857301-ClomipramineHydrochloride50MGOralCapsule|ADULT 2020 632|1001|N|N|Y||Preferred Generic|403923-168HREstradiol0.0025MG/HRTransdermalSystem|ADULT 2020 632|1001|Y|N|N||Preferred Generic|1000001-Amlodipine5MG/Hydrochlorothiazide25MG/Olmesartanmedoxomil40MGOralTablet|ADULT 2020 632|1001|N|Y|Y||Preferred Generic|2001566-BXRating24HRMethylphenidateHydrochloride36MGExtendedReleaseOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|261962-Ramipril10MGOralCapsule|ADULT 2020 632|1001|N|N|Y||Preferred Generic|349591-atomoxetine10MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Brand|863836-amylase30000UNT/lipase6000UNT/protease19000UNTDelayedReleaseOralCapsule[Creon]|ADULT 2020 632|1001|Y|N|N||Preferred Generic|199521-Vigabatrin500MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|966920-POLYETHYLENEGLYCOL3350236000MG/PotassiumChloride2970MG/SodiumBicarbonate6740MG/SodiumChloride5860MG/sodiumsulfate22740|ADULT 2020 632|1001|N|N|Y||Preferred Generic|854873-Zolpidemtartrate10MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|313580-venlafaxine100MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|1020155-Introvale91DayPack|ADULT 2020 632|1001|N|N|N||Preferred Brand|1046771-12HRHyoscyamineSulfate0.375MGExtendedReleaseOralTablet[Levbid]|ADULT 2020 632|1001|N|N|N||Preferred Generic|197557-Dapsone100MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|197511-Ciprofloxacin250MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|314055-IsosorbideDinitrate5MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|2563032-0.5MLinfluenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.03MG/|ADULT 2020 632|1001|N|N|N||Preferred Generic|617296-Amoxicillin500MG/Clavulanate125MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2107351-prucalopride1MGOralTablet[Motegrity]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1357547-tofacitinib5MGOralTablet[Xeljanz]|ADULT 2020 632|1001|N|N|N||Preferred Brand|1667916-5MLIsoproterenolHydrochloride0.2MG/MLInjection[Isuprel]|ADULT 2020 632|1001|N|N|N||Preferred Brand|206216-2MLIron-DextranComplex50MG/MLInjection[InFed]|ADULT 2020 632|1001|Y|N|N||Preferred Generic|198070-Penicillamine250MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|1099596-DivalproexSodium125MGDelayedReleaseOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|351249-Escitalopram5MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|993536-12HRBupropionHydrochloride200MGExtendedReleaseOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|283316-Hydrochlorothiazide12.5MG/telmisartan40MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1310535-teriflunomide7MGOralTablet[Aubagio]|ADULT 2020 632|1001|N|N|N||Preferred Brand|201337-Nadolol40MGOralTablet[Corgard]|ADULT 2020 632|1001|N|N|N||Preferred Generic|197320-Allopurinol300MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|866094-buspironehydrochloride5MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|854252-1MLEnoxaparinsodium150MG/MLPrefilledSyringe|ADULT 2020 632|1001|N|N|N||Preferred Generic|197383-Atenolol50MG/Chlorthalidone25MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|602635-lanthanumcarbonate1000MGChewableTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|904447-Alendronicacid0.933MG/MLOralSolution|ADULT 2020 632|1001|Y|N|N||Preferred Brand|153324-Interferonbeta-1a0.03MGInjection[Avonex]|ADULT 2020 632|1001|Y|N|N||Preferred Generic|200327-capecitabine150MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|858804-EnalaprilMaleate2.5MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|1293639-Caffeine100MG/ErgotamineTartrate2MGRectalSuppository[Migergot]|ADULT 2020 632|1001|N|N|N||Preferred Generic|857187-FosinoprilSodium40MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|2561275-0.5MLinfluenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.03MG/|ADULT 2020 632|1001|N|N|N||Preferred Generic|1313112-Phenytoin25MG/MLOralSuspension|ADULT 2020 632|1001|N|N|Y||Preferred Generic|200311-Fenofibrate67MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|197803-Ibuprofen20MG/MLOralSuspension|ADULT 2020 632|1001|N|N|N||Preferred Generic|198377-Tacrolimus1MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|198102-vitaminK15MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|197944-Methocarbamol750MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|905369-ChlordiazepoxideHydrochloride10MGOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1801322-3.5MLevolocumab120MG/MLCartridge[Repatha]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|349196-Clonazepam1MGDisintegratingOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|854241-0.8MLEnoxaparinsodium100MG/MLPrefilledSyringe|ADULT 2020 632|1001|N|N|N||Preferred Generic|995232-HydroxyzinePamoate100MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|861200-Brimonidinetartrate2MG/MLOphthalmicSolution|ADULT 2020 632|1001|N|N|N||Preferred Generic|312748-quinapril10MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|834040-PenicillinVPotassium50MG/MLOralSolution|ADULT 2020 632|1001|N|N|N||Preferred Generic|198440-Acetaminophen500MGOralTablet|ADULT 2020 632|1001|Y|N|Y||Preferred Generic|883826-TranexamicAcid650MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|834241-febuxostat80MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|197942-Methimazole5MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1492746-apremilast30MGOralTablet[Otezla]|ADULT 2020 632|1001|N|N|N||Preferred Generic|311989-Nitrofurantoin5MG/MLOralSuspension|ADULT 2020 632|1001|N|N|N||Preferred Generic|598025-Amoxicillin250MGChewableTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|198252-tetracyclinehydrochloride500MGOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Generic|834235-febuxostat40MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|903847-PyridostigmineBromide180MGExtendedReleaseOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|314231-Simvastatin10MGOralTablet|ADULT 2020 632|1001|N|Y|N||Preferred Brand|833151-Savella4-WeekTitrationPack|ADULT 2020 632|1001|N|N|N||Preferred Brand|202301-Estrogens,Conjugated(USP)1.25MGOralTablet[Premarin]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|846378-24HRLevetiracetam750MGExtendedReleaseOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|861043-2.7MLpramlintideacetate1MG/MLPenInjector[Symlin]|ADULT 2020 632|1001|N|N|N||Preferred Generic|198038-Nitroglycerin0.3MGSublingualTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|1362720-MexiletineHydrochloride250MGOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Generic|848131-Amlodipine10MG/Hydrochlorothiazide12.5MG/valsartan160MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2268231-ubrogepant50MGOralTablet[Ubrelvy]|ADULT 2020 632|1001|N|N|N||Preferred Generic|884189-ClonidineHydrochloride0.3MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|197623-Disulfiram250MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|311354-Lisinopril5MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|966249-LevothyroxineSodium0.175MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|309307-Ciprofloxacin3MG/MLOphthalmicSolution|ADULT 2020 632|1001|N|N|N||Preferred Generic|199168-Phenobarbital64.8MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|102250-Hydrocortisone1.67MG/MLEnema[Cortenema]|ADULT 2020 632|1001|N|N|N||Preferred Generic|197818-Indomethacin50MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|855812-prasugrel10MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|863664-Oxybutyninchloride5MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|197805-Ibuprofen400MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|991486-CodeinePhosphate2MG/ML/PromethazineHydrochloride1.25MG/MLOralSolution|ADULT 2020 632|1001|N|N|Y||Preferred Generic|993890-Acetaminophen300MG/CodeinePhosphate60MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|314182-PotassiumChloride2.67MEQ/MLOralSolution|ADULT 2020 632|1001|N|Y|N||Preferred Generic|1368954-mesalamine400MGDelayedReleaseOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Brand|810075-24HRFesoterodineFumarate4MGExtendedReleaseOralTablet[Toviaz]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|349197-Clonazepam2MGDisintegratingOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|995253-HydroxyzinePamoate25MGOralCapsule|ADULT 2020 632|1001|N|Y|Y||Preferred Generic|483444-pregabalin300MGOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Generic|725023-24HRrivastigmine0.396MG/HRTransdermalSystem|ADULT 2020 632|1001|N|N|Y||Preferred Brand|1547582-0.5MLStreptococcuspneumoniaetype1capsularpolysaccharideantigen0.05MG/ML/Streptococcuspneumoniaetype10Acapsularpolysac|ADULT 2020 632|1001|N|N|Y||Preferred Generic|359818-Nicotine4MGOralLozenge|ADULT 2020 632|1001|Y|N|N||Preferred Generic|1299917-Tiagabinehydrochloride4MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|856556-PropranololHydrochloride60MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2282320-Rimegepant75MGDisintegratingOralTablet[Nurtec]|ADULT 2020 632|1001|Y|N|Y||Preferred Brand|861821-Metforminhydrochloride500MG/sitagliptin50MGOralTablet[Janumet]|ADULT 2020 632|1001|N|N|N||Preferred Brand|1000487-Premphase28DayPack|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2536752-24HRviloxazine150MGExtendedReleaseOralCapsule[Qelbree]|ADULT 2020 632|1001|N|N|N||Preferred Generic|151226-topiramate50MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|993687-BupropionHydrochloride100MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|312899-Salsalate500MGOralTablet|ADULT 2020 632|1001|N|Y|Y||Preferred Generic|483442-pregabalin25MGOralCapsule|ADULT 2020 632|1001|N|N|Y||Preferred Generic|1918194-60ACTUATfluticasonepropionate0.113MG/ACTUAT/salmeterol0.014MG/ACTUATDryPowderInhaler|ADULT 2020 632|1001|N|Y|N||Preferred Brand|856666-rifaximin550MGOralTablet[XIFAXAN]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1546198-PlegridyStarterPack|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1653144-0.5MLgolimumab100MG/MLAuto-Injector[Simponi]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|313160-Sumatriptan100MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|1000054-DoxepinHydrochloride10MG/MLOralSolution|ADULT 2020 632|1001|N|N|N||Preferred Generic|995281-HydroxyzineHydrochloride50MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|212218-EpoetinAlfa20000UNT/MLInjectableSolution[Epogen]|ADULT 2020 632|1001|N|N|N||Preferred Brand|866049-60ACTUATsalmeterol0.05MG/ACTUATDryPowderInhaler[Serevent]|ADULT 2020 632|1001|N|N|N||Preferred Generic|861004-Metforminhydrochloride1000MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|993466-midodrinehydrochloride2.5MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|197832-isoniazid300MGOralTablet|ADULT 2020 632|1001|Y|N|Y||Preferred Generic|891874-MorphineSulfate100MGExtendedReleaseOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|1298066-Cyclopentolatehydrochloride10MG/MLOphthalmicSolution|ADULT 2020 632|1001|N|Y|Y||Preferred Generic|197519-Clindamycin10MG/MLTopicalLotion|ADULT 2020 632|1001|N|N|Y||Preferred Generic|200284-Hydrochlorothiazide12.5MG/valsartan80MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|892251-LevothyroxineSodium0.2MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|617430-Amoxicillin80MG/ML/Clavulanate11.4MG/MLOralSuspension|ADULT 2020 632|1001|N|N|N||Preferred Generic|995218-HydroxyzineHydrochloride10MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|311960-Niacin500MGExtendedReleaseOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|404509-CalciumCarbonate1000MG/Simethicone60MGChewableTablet[MaaloxMaxQuickDissolve]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|854228-0.3MLEnoxaparinsodium100MG/MLPrefilledSyringe|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1488667-12HRTreprostinil0.125MGExtendedReleaseOralTablet[Orenitram]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1660938-60ACTUATformoterolfumarate0.005MG/ACTUAT/mometasonefuroate0.2MG/ACTUATMeteredDoseInhaler[Dulera]|ADULT 2020 632|1001|N|N|N||Preferred Generic|197622-Dipyridamole50MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|314208-ropinirole1MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|596926-duloxetine20MGDelayedReleaseOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Brand|616116-lenalidomide5MGOralCapsule[Revlimid]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1243033-Linagliptin2.5MG/Metforminhydrochloride500MGOralTablet[Jentadueto]|ADULT 2020 632|1001|N|N|N||Preferred Generic|205305-telmisartan80MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|857677-TerbutalineSulfate2.5MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|387003-Levetiracetam1000MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1747194-0.4MLMethotrexate56.3MG/MLAuto-Injector[Otrexup]|ADULT 2020 632|1001|Y|N|N||Preferred Generic|616578-lubiprostone0.024MGOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Generic|845515-everolimus5MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|996520-DextromethorphanHydrobromide2MG/ML/Guaifenesin20MG/MLOralSolution|ADULT 2020 632|1001|N|N|N||Preferred Generic|896766-Labetalolhydrochloride300MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|1116758-chloroquinephosphate500MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|762001-Kariva28DayPack|ADULT 2020 632|1001|N|N|N||Preferred Generic|834046-PenicillinVPotassium25MG/MLOralSolution|ADULT 2020 632|1001|N|N|N||Preferred Generic|198546-CalciumGluconate500MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|308194-Amoxicillin875MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|197362-ammoniumlactate120MG/MLTopicalLotion|ADULT 2020 632|1001|N|N|N||Preferred Brand|616450-MycophenolicAcid180MGDelayedReleaseOralTablet[Myfortic]|ADULT 2020 632|1001|N|N|N||Preferred Generic|197657-Estradiol0.5MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|992668-homatropinemethylbromide0.3MG/ML/HydrocodoneBitartrate1MG/MLOralSolution|ADULT 2020 632|1001|N|N|N||Preferred Brand|751875-Necon0.5/3528DayPack|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2121096-siponimod0.25MGOralTablet[Mayzent]|ADULT 2020 632|1001|N|N|N||Preferred Generic|197606-Digoxin0.25MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|314203-quinapril40MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|966248-LevothyroxineSodium0.112MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|198334-Sulfamethoxazole400MG/Trimethoprim80MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|199224-anastrozole1MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|847191-3MLinsulinaspartprotamine,human70UNT/ML/insulinaspart,human30UNT/MLPenInjector|ADULT 2020 632|1001|N|N|Y||Preferred Generic|993470-midodrinehydrochloride5MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|896031-28ACTUATFluticasonepropionate0.1MG/ACTUATDryPowderInhaler[Flovent]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|854848-lisdexamfetaminedimesylate60MGOralCapsule[Vyvanse]|ADULT 2020 632|1001|N|N|N||Preferred Generic|835568-ImipramineHydrochloride50MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|751870-Nortrel1/3528DayPack|ADULT 2020 632|1001|N|N|N||Preferred Brand|213283-hydroxyurea300MGOralCapsule[Droxia]|ADULT 2020 632|1001|N|N|N||Preferred Generic|312013-Nitroglycerin2.5MGExtendedReleaseOralCapsule|ADULT 2020 632|1001|N|N|Y||Preferred Generic|485442-Eszopiclone2MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1244632-AmethiaLo91DayPack|ADULT 2020 632|1001|N|N|N||Preferred Brand|855871-Phenytoinsodium30MGExtendedReleaseOralCapsule[Dilantin]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|580286-mesalamine500MGExtendedReleaseOralCapsule[Pentasa]|ADULT 2020 632|1001|N|N|N||Preferred Generic|205304-telmisartan40MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|995666-MeclizineHydrochloride25MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|312938-Sertraline100MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1488675-12HRTreprostinil1MGExtendedReleaseOralTablet[Orenitram]|ADULT 2020 632|1001|N|N|N||Preferred Generic|198148-Prednisone50MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|2110510-60ACTUATFluticasonepropionate0.1MG/ACTUAT/salmeterol0.05MG/ACTUATDryPowderInhaler[Wixela]|ADULT 2020 632|1001|N|N|N||Preferred Generic|884185-ClonidineHydrochloride0.2MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|863038-bepotastinebesilate15MG/MLOphthalmicSolution|ADULT 2020 632|1001|N|N|N||Preferred Generic|855873-Phenytoinsodium300MGExtendedReleaseOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Brand|750839-erythromycinstearate250MGOralTablet[ErythrocinStearate]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|404059-Isotretinoin10MGOralCapsule[Claravis]|ADULT 2020 632|1001|N|N|N||Preferred Generic|197604-Digoxin0.125MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|996757-CodeinePhosphate2MG/ML/PhenylephrineHydrochloride1MG/ML/PromethazineHydrochloride1.25MG/MLOralSolution|ADULT 2020 632|1001|N|N|N||Preferred Generic|310362-Fluocinonide0.0005MG/MGTopicalGel|ADULT 2020 632|1001|N|N|N||Preferred Generic|904475-PravastatinSodium40MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|859048-Pramipexoledihydrochloride1.5MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|1000141-medroxyprogesteroneacetate5MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|1099304-DesipramineHydrochloride50MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|797023-DexPakTaperPak13DayPack|ADULT 2020 632|1001|Y|N|Y||Preferred Generic|313450-Tretinoin0.0001MG/MGTopicalGel|ADULT 2020 632|1001|N|Y|Y||Preferred Generic|483438-pregabalin100MGOralCapsule|ADULT 2020 632|1001|N|N|Y||Preferred Generic|854245-0.8MLEnoxaparinsodium150MG/MLPrefilledSyringe|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1876609-naldemedine0.2MGOralTablet[Symproic]|ADULT 2020 632|1001|N|Y|Y||Preferred Generic|1797865-mometasonefuroate0.05MG/ACTUATMeteredDoseNasalSpray|ADULT 2020 632|1001|N|N|Y||Preferred Brand|2106334-0.5MLdiphtheriatoxoidvaccine,inactivated4UNT/ML/tetanustoxoidvaccine,inactivated4UNT/MLInjection[Tdvax]|ADULT 2020 632|1001|Y|N|N||Preferred Generic|848135-Amlodipine10MG/Hydrochlorothiazide25MG/valsartan320MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|197382-Atenolol100MG/Chlorthalidone25MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|845488-Ramipril1.25MGOralCapsule|ADULT 2020 632|1001|N|N|Y||Preferred Brand|1300370-0.5MLBordetellapertussisfilamentoushemagglutininvaccine,inactivated0.016MG/ML/Bordetellapertussispertactinvaccine,ina|ADULT 2020 632|1001|N|N|N||Preferred Generic|311963-Niacin750MGExtendedReleaseOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Brand|847199-3MLinsulinisophane,human100UNT/MLPenInjector[HumulinN]|ADULT 2020 632|1001|N|N|N||Preferred Generic|197553-Cyclosporine25MGOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Generic|205316-topiramate15MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|351137-Albuterol0.21MG/MLInhalationSolution|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1601373-naloxegol25MGOralTablet[Movantik]|ADULT 2020 632|1001|N|N|N||Preferred Generic|856706-AmitriptylineHydrochloride10MG/Perphenazine2MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|1992303-12HRTimolol5MG/MLOphthalmicSolution|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1486977-dapagliflozin10MGOralTablet[Farxiga]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|242461-cilostazol100MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|1307427-sildenafil10MG/MLOralSuspension|ADULT 2020 632|1001|N|N|N||Preferred Generic|310537-Glyburide5MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|643722-lenalidomide25MGOralCapsule[Revlimid]|ADULT 2020 632|1001|N|N|N||Preferred Generic|197783-Hydrocortisone20MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|313786-AceticAcid20MG/ML/Hydrocortisone10MG/MLOticSolution|ADULT 2020 632|1001|Y|N|N||Preferred Brand|864820-Oxybutyninchloride0.1MG/MGTopicalGel[Gelnique]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|706872-Azithromycin10MG/MLOphthalmicSolution[AzaSite]|ADULT 2020 632|1001|N|Y|N||Preferred Generic|242831-Griseofulvin125MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1599797-1MLsecukinumab150MG/MLPrefilledSyringe[Cosentyx]|ADULT 2020 632|1001|Y|N|N||Preferred Generic|1860137-Abuse-Deterrent12HROxycodoneHydrochloride40MGExtendedReleaseOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|352047-1MLdarbepoetinalfa0.1MG/MLInjection[Aranesp]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1660934-60ACTUATformoterolfumarate0.005MG/ACTUAT/mometasonefuroate0.1MG/ACTUATMeteredDoseInhaler[Dulera]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1870956-deflazacort18MGOralTablet[Emflaza]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|205323-celecoxib200MGOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Brand|731250-0.3MLdarbepoetinalfa0.2MG/MLPrefilledSyringe[Aranesp]|ADULT 2020 632|1001|N|N|N||Preferred Generic|866090-buspironehydrochloride30MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|248109-Ribavirin200MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|310796-Hydrochlorothiazide12.5MG/quinapril10MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|226343-Dexamethasonephosphate1MG/MLOphthalmicSolution|ADULT 2020 632|1001|N|N|N||Preferred Generic|198372-torsemide5MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|314200-pantoprazole40MGDelayedReleaseOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Brand|2045382-30ACTUATfluticasonefuroate0.05MG/ACTUATDryPowderInhaler[Arnuity]|ADULT 2020 632|1001|N|Y|N||Preferred Brand|1992695-ertugliflozin2.5MG/Metforminhydrochloride500MGOralTablet[Segluromet]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2536554-24HRviloxazine100MGExtendedReleaseOralCapsule[Qelbree]|ADULT 2020 632|1001|N|N|N||Preferred Generic|199903-Hydrochlorothiazide12.5MGOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1482513-eslicarbazepineacetate200MGOralTablet[Aptiom]|ADULT 2020 632|1001|N|N|N||Preferred Generic|313217-Terazosin2MGOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1747187-0.4MLMethotrexate43.8MG/MLAuto-Injector[Otrexup]|ADULT 2020 632|1001|N|N|N||Preferred Generic|103951-Tolnaftate10MG/MLTopicalCream|ADULT 2020 632|1001|N|N|Y||Preferred Generic|205322-celecoxib100MGOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2268227-ubrogepant100MGOralTablet[Ubrelvy]|ADULT 2020 632|1001|N|N|N||Preferred Generic|198352-Zidovudine100MGOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1115459-1MLLeuprolideAcetate3.75MG/MLPrefilledSyringe[Lupron]|ADULT 2020 632|1001|N|N|Y||Preferred Brand|1593140-0.5MLNeisseriameningitidisserogroupBrecombinantLP2086A05proteinvariantantigen0.12MG/ML/Neisseriameningitidisserogroup|ADULT 2020 632|1001|N|N|N||Preferred Generic|1797867-Azelastinehydrochloride0.137MG/ACTUATMeteredDoseNasalSpray|ADULT 2020 632|1001|N|N|N||Preferred Generic|197855-Ketoprofen50MGOralCapsule|ADULT 2020 632|1001|N|N|Y||Preferred Generic|854248-1MLEnoxaparinsodium100MG/MLPrefilledSyringe|ADULT 2020 632|1001|N|N|N||Preferred Generic|861007-Metforminhydrochloride500MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|352262-1MLdarbepoetinalfa0.3MG/MLInjection[Aranesp]|ADULT 2020 632|1001|N|Y|N||Preferred Generic|1085816-spinosad9MG/MLMedicatedShampoo|ADULT 2020 632|1001|N|N|N||Preferred Brand|992759-Homatropinehydrobromide50MG/MLOphthalmicSolution[Homatropaire]|ADULT 2020 632|1001|N|N|N||Preferred Generic|197987-Minoxidil2.5MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Brand|1731317-3MLinsulin,regular,human500UNT/MLPenInjector[HumulinR]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1653166-1MLgolimumab100MG/MLAuto-Injector[Simponi]|ADULT 2020 632|1001|Y|N|Y||Preferred Generic|313451-Tretinoin0.00025MG/MGTopicalGel|ADULT 2020 632|1001|N|N|N||Preferred Generic|259966-Methylprednisolone4MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|106336-Ketoconazole20MG/MLMedicatedShampoo|ADULT 2020 632|1001|N|N|N||Preferred Generic|308964-Captopril50MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|200031-carvedilol6.25MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|307718-Acetylcysteine100MG/MLInhalationSolution|ADULT 2020 632|1001|N|N|N||Preferred Generic|284215-Clindamycin300MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|831103-DiltiazemHydrochloride60MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|1359030-Junel1.5/3021DayPack|ADULT 2020 632|1001|N|N|N||Preferred Generic|702249-ferroussulfate44MG/MLOralSolution|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1799230-1MLabatacept125MG/MLAuto-Injector[Orencia]|ADULT 2020 632|1001|N|N|N||Preferred Generic|197448-Levocarnitine330MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|352046-1MLdarbepoetinalfa0.06MG/MLInjection[Aranesp]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|748738-Topotecan0.25MGOralCapsule[Hycamtin]|ADULT 2020 632|1001|N|N|N||Preferred Generic|583170-Salsalate750MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|198707-Hydrocortisone5MG/MLTopicalCream|ADULT 2020 632|1001|N|N|Y||Preferred Brand|1658060-1MLHepatitisAVaccine(Inactivated)StrainHM1751440UNT/MLInjection[Havrix]|ADULT 2020 632|1001|N|N|N||Preferred Generic|197670-Estrogens,Esterified(USP)1.25MG/Methyltestosterone2.5MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|308989-Carbidopa50MG/Levodopa200MGExtendedReleaseOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1115473-1.5MLLeuprolideAcetate7.5MG/MLPrefilledSyringe[Lupron]|ADULT 2020 632|1001|N|N|N||Preferred Generic|617993-Amoxicillin120MG/ML/Clavulanate8.58MG/MLOralSuspension|ADULT 2020 632|1001|N|N|N||Preferred Brand|1595473-amylase63000UNT/lipase15000UNT/protease47000UNTDelayedReleaseOralCapsule[Zenpep]|ADULT 2020 632|1001|N|N|N||Preferred Generic|197785-Hydrocortisone25MG/MLTopicalLotion|ADULT 2020 632|1001|N|N|N||Preferred Generic|1099563-24HRDivalproexSodium250MGExtendedReleaseOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|967012-POLYETHYLENEGLYCOL3350236000MG/PotassiumChloride2970MG/SodiumBicarbonate6740MG/SodiumChloride5860MG/sodiumsulfate22740|ADULT 2020 632|1001|N|N|N||Preferred Generic|856720-AmitriptylineHydrochloride10MG/Perphenazine4MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|1006688-SulfacetamideSodium100MG/MLTopicalLotion|ADULT 2020 632|1001|N|N|N||Preferred Generic|859033-Pramipexoledihydrochloride0.125MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|198052-Ondansetron4MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|896237-120ACTUATFluticasonepropionate0.045MG/ACTUAT/salmeterol0.021MG/ACTUATMeteredDoseInhaler[Advair]|ADULT 2020 632|1001|N|N|N||Preferred Generic|198378-Tacrolimus5MGOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1605172-0.4MLdarbepoetinalfa0.025MG/MLPrefilledSyringe[Aranesp]|ADULT 2020 632|1001|Y|N|N||Preferred Brand|845512-everolimus10MGOralTablet[Afinitor]|ADULT 2020 632|1001|N|N|N||Preferred Generic|582926-podofilox5MG/MLTopicalSolution|ADULT 2020 632|1001|N|N|Y||Preferred Generic|899548-dexmethylphenidatehydrochloride10MGOralTablet|ADULT 2020 632|1001|Y|N|Y||Preferred Brand|665044-sitagliptin50MGOralTablet[Januvia]|ADULT 2020 632|1001|N|N|N||Preferred Generic|284245-Famotidine40MGOralTablet|ADULT 2020 632|1001|Y|N|Y||Preferred Generic|197634-dronabinol10MGOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Generic|999967-Amlodipine5MG/Hydrochlorothiazide12.5MG/Olmesartanmedoxomil20MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1728099-romiplostim0.5MGInjection[Nplate]|ADULT 2020 632|1001|N|N|N||Preferred Generic|1724439-thyroid(USP)30MGOralTablet[NPThyroid]|ADULT 2020 632|1001|Y|N|N||Preferred Generic|1799212-sofosbuvir400MG/velpatasvir100MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|824295-rufinamide200MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|597772-deferasirox500MGTabletforOralSuspension|ADULT 2020 632|1001|N|N|N||Preferred Generic|1190570-AtropineSulfate0.01MG/MGOphthalmicOintment|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1873704-Mibelas24FeChewable28DayPack|ADULT 2020 632|1001|N|Y|N||Preferred Brand|1991317-1MGDose1.5MLsemaglutide1.34MG/MLPenInjector[Ozempic]|ADULT 2020 632|1001|N|N|N||Preferred Generic|199047-Famotidine10MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|313584-venlafaxine37.5MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|2166401-ivacaftor25MGOralGranules[Kalydeco]|ADULT 2020 632|1001|N|N|N||Preferred Generic|313215-Terazosin1MGOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Generic|197845-Isotretinoin40MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|197303-Acetazolamide125MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|904458-PravastatinSodium10MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|311678-Metronidazole7.5MG/MLTopicalCream|ADULT 2020 632|1001|N|N|N||Preferred Generic|198014-Naproxen500MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|317573-pioglitazone15MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1114096-Vandetanib300MGOralTablet[Caprelsa]|ADULT 2020 632|1001|N|N|N||Preferred Generic|311666-Metoclopramide10MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|237723-Ergocalciferol0.2MG/MLOralSolution|ADULT 2020 632|1001|N|N|N||Preferred Generic|858817-EnalaprilMaleate10MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|1049167-PseudoephedrineHydrochloride60MGOralTablet|ADULT 2020 632|1001|Y|N|Y||Preferred Generic|245723-Tretinoin0.0005MG/MGTopicalGel|ADULT 2020 632|1001|N|N|N||Preferred Generic|647121-5MLLevetiracetam100MG/MLInjection|ADULT 2020 632|1001|N|N|N||Preferred Generic|1359779-Fluticasonepropionate0.1MG/ACTUAT/salmeterol0.05MG/ACTUATDryPowderInhaler|ADULT 2020 632|1001|N|N|Y||Preferred Generic|485440-Eszopiclone1MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|200220-tolcapone100MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|857169-FosinoprilSodium10MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|200346-cefdinir300MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|359296-calciumacetate667MGOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Generic|848151-Amlodipine10MG/Hydrochlorothiazide25MG/valsartan160MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|360110-Sirolimus2MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|197583-Dexamethasone6MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|753443-9HRMethylphenidate3.33MG/HRTransdermalSystem[Daytrana]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|1812013-Osmotic24HRNifedipine60MGExtendedReleaseOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1043582-24HRMetforminhydrochloride500MG/saxagliptin5MGExtendedReleaseOralTablet[Kombiglyze]|ADULT 2020 632|1001|N|N|Y||Preferred Generic|856999-Acetaminophen325MG/HydrocodoneBitartrate10MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|686418-ErythromycinEthylsuccinate80MG/MLOralSuspension|ADULT 2020 632|1001|N|N|N||Preferred Generic|995258-HydroxyzineHydrochloride25MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1232190-asparaginaseErwiniachrysanthemi10000UNTInjection[Erwinaze]|ADULT 2020 632|1001|N|N|N||Preferred Generic|199159-Tretinoin10MGOralCapsule|ADULT 2020 632|1001|N|N|Y||Preferred Generic|897702-HydromorphoneHydrochloride4MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1431647-4MLgolimumab12.5MG/MLInjection[Simponi]|ADULT 2020 632|1001|N|N|N||Preferred Generic|311679-Metronidazole0.0075MG/MGTopicalGel|ADULT 2020 632|1001|Y|N|N||Preferred Brand|404449-Thalidomide100MGOralCapsule[Thalomid]|ADULT 2020 632|1001|N|N|N||Preferred Generic|856457-PropranololHydrochloride20MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|311759-montelukast4MGChewableTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|602862-magnesiumaminoacidchelate133MGOralTablet[MGPlusProtein]|ADULT 2020 632|1001|N|N|N||Preferred Generic|199885-Levofloxacin500MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|856783-AmitriptylineHydrochloride10MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|993804-Gianvi28-DayPack|ADULT 2020 632|1001|N|N|N||Preferred Generic|105292-isoniazid10MG/MLOralSolution|ADULT 2020 632|1001|N|N|Y||Preferred Generic|897696-HydromorphoneHydrochloride2MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|630475-SodiumFluoride5.56MG/MLOralSolution[FluoraDay]|ADULT 2020 632|1001|N|N|N||Preferred Generic|313227-terconazole8MG/MLVaginalCream|ADULT 2020 632|1001|N|N|N||Preferred Generic|310797-Hydrochlorothiazide12.5MG/quinapril20MGOralTablet|ADULT 2020 632|1001|N|N|Y||Preferred Generic|197877-Lidocaine25MG/ML/Prilocaine25MG/MLTopicalCream|ADULT 2020 632|1001|Y|N|N||Preferred Generic|881341-adefovirdipivoxil10MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|884707-Estradiol0.01MGVaginalInsert|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1441418-0.4MLMethotrexate50MG/MLAuto-Injector[Otrexup]|ADULT 2020 632|1001|N|N|N||Preferred Generic|284185-Didanosine200MGDelayedReleaseOralCapsule|ADULT 2020 632|1001|N|Y|Y||Preferred Generic|860654-epinastinehydrochloride0.5MG/MLOphthalmicSolution|ADULT 2020 632|1001|N|N|N||Preferred Generic|966220-LevothyroxineSodium0.025MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|1359134-TiliaFe28DayPack|ADULT 2020 632|1001|N|N|N||Preferred Generic|197650-Erythromycin500MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|284988-Didanosine400MGDelayedReleaseOralCapsule|ADULT 2020 632|1001|Y|N|N||Preferred Brand|261362-alosetron1MGOralTablet[Lotronex]|ADULT 2020 632|1001|N|N|N||Preferred Generic|205285-leflunomide20MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|310891-Hydrocortisone25MG/MLTopicalCream|ADULT 2020 632|1001|N|N|N||Preferred Generic|722131-Amlodipine10MG/valsartan320MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|562251-Amoxicillin250MG/Clavulanate125MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|860221-MegestrolAcetate40MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|314234-Sucralfate1000MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|835886-cyclosporine,modified100MG/MLOralSolution|ADULT 2020 632|1001|Y|N|N||Preferred Brand|1148506-crizotinib250MGOralCapsule[Xalkori]|ADULT 2020 632|1001|N|N|N||Preferred Generic|317110-24HRIsosorbideMononitrate30MGExtendedReleaseOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Generic|860715-24HRgalantaminehydrobromide8MGExtendedReleaseOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|309337-Clindamycin20MG/MLVaginalCream|ADULT 2020 632|1001|N|N|N||Preferred Generic|197701-Fluconazole50MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Brand|762663-Jolessa91DayPack|ADULT 2020 632|1001|N|N|N||Preferred Generic|855172-levocetirizinedihydrochloride5MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|198316-Hydrochlorothiazide25MG/Triamterene37.5MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|904467-PravastatinSodium20MGOralTablet|ADULT 2020 632|1001|N|N|N||Preferred Generic|1242786-Alyacen1/3528-DayKit|ADULT 2020 632|1001|N|N|N||Preferred Generic|103457-Fluocinonide0.0005MG/MGTopicalOintment|ADULT 2020 632|1001|N|N|Y||Preferred Generic|1049214-Acetaminophen325MG/OxycodoneHydrochloride10MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|746609-nilotinib200MGOralCapsule[Tasigna]|ADULT 2020 632|1001|N|N|N||Preferred Generic|562704-ropinirole4MGOralTablet|ADULT 2020 632|1001|N|Y|N||Preferred Generic|749206-sevelamercarbonate800MGOralTablet|ADULT 2020 632|1001|Y|N|N||Preferred Brand|213360-Thalidomide50MGOralCapsule[Thalomid]|ADULT 2020 632|1001|N|N|N||Preferred Generic|1000076-DoxepinHydrochloride50MGOralCapsule|ADULT 2020 632|1001|N|N|N||Preferred Generic|313423-Tolnaftate10MG/MLTopicalSolution|CHILD 2020 632|1001|N|N|N||Preferred Brand|1095362-Balziva28DayPack|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1544390-0.35MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|200096-irbesartan300MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|751884-Lutera28DayPack|CHILD 2020 632|1001|N|N|N||Preferred Generic|197942-Methimazole5MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|852877-QuinidineSulfate200MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|150840-Estrogens,Conjugated(USP)0.625MGOralTablet[Premarin]|CHILD 2020 632|1001|N|N|N||Preferred Generic|979468-Hydrochlorothiazide12.5MG/LosartanPotassium50MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|311963-Niacin750MGExtendedReleaseOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|1085745-TriamcinoloneAcetonide1MG/MLTopicalLotion|CHILD 2020 632|1001|N|N|Y||Preferred Generic|862025-24HRGuanfacine4MGExtendedReleaseOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|199246-glimepiride2MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2283236-bempedoicacid180MG/ezetimibe10MGOralTablet[Nexlizet]|CHILD 2020 632|1001|N|N|N||Preferred Generic|966270-LevothyroxineSodium0.137MGOralTablet|CHILD 2020 632|1001|N|Y|N||Preferred Generic|1368954-mesalamine400MGDelayedReleaseOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|596843-lansoprazole15MGDelayedReleaseOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|749860-{21(EthinylEstradiol0.035MG/norgestimate0.25MGOralTablet)/7(InertIngredients1MGOralTablet)}Pack|CHILD 2020 632|1001|Y|N|N||Preferred Brand|854836-lisdexamfetaminedimesylate30MGOralCapsule[Vyvanse]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1925257-0.7MLabatacept125MG/MLPrefilledSyringe[Orencia]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1551923-naloxegol12.5MGOralTablet[Movantik]|CHILD 2020 632|1001|N|N|N||Preferred Generic|1005856-SulfacetamideSodium100MG/ML/Sulfur50MG/MLTopicalLotion|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1871459-lisdexamfetaminedimesylate40MGChewableTablet[Vyvanse]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|846378-24HRLevetiracetam750MGExtendedReleaseOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|309679-Dexamethasone0.001MG/MG/Neomycin0.0035MG/MG/PolymyxinB10UNT/MGOphthalmicOintment|CHILD 2020 632|1001|Y|N|N||Preferred Generic|198071-Penicillamine250MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1488667-12HRTreprostinil0.125MGExtendedReleaseOralTablet[Orenitram]|CHILD 2020 632|1001|N|N|N||Preferred Generic|966253-LevothyroxineSodium0.088MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|310793-Hydrochlorothiazide12.5MG/irbesartan300MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|198051-Omeprazole20MGDelayedReleaseOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|835568-ImipramineHydrochloride50MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Brand|1547582-0.5MLStreptococcuspneumoniaetype1capsularpolysaccharideantigen0.05MG/ML/Streptococcuspneumoniaetype10Acapsularpolysac|CHILD 2020 632|1001|N|N|N||Preferred Generic|597852-anagrelide1MGOralCapsule|CHILD 2020 632|1001|N|N|Y||Preferred Generic|205322-celecoxib100MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|197628-Doxazosin8MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|1000897-PilocarpineHydrochloride40MG/MLOphthalmicSolution|CHILD 2020 632|1001|N|N|Y||Preferred Generic|596926-duloxetine20MGDelayedReleaseOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|226343-Dexamethasonephosphate1MG/MLOphthalmicSolution|CHILD 2020 632|1001|N|N|N||Preferred Generic|834127-chlorhexidinegluconate1.2MG/MLMouthwash|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2262731-MicronizedIsotretinoin8MGOralCapsule[Absorica]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|477562-Fenofibrate48MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1726846-0.4MLadalimumab100MG/MLPrefilledSyringe[Humira]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|861225-24HRAmphetamineaspartate5MG/AmphetamineSulfate5MG/Dextroamphetaminesaccharate5MG/DextroamphetamineSulfate5MGExtendedRe|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1488671-12HRTreprostinil0.25MGExtendedReleaseOralTablet[Orenitram]|CHILD 2020 632|1001|N|N|N||Preferred Generic|1313112-Phenytoin25MG/MLOralSuspension|CHILD 2020 632|1001|N|N|N||Preferred Generic|197411-Bromocriptine2.5MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2268231-ubrogepant50MGOralTablet[Ubrelvy]|CHILD 2020 632|1001|N|N|N||Preferred Generic|198107-Piroxicam10MGOralCapsule|CHILD 2020 632|1001|Y|N|N||Preferred Brand|854840-lisdexamfetaminedimesylate40MGOralCapsule[Vyvanse]|CHILD 2020 632|1001|N|Y|Y||Preferred Generic|483438-pregabalin100MGOralCapsule|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1871461-lisdexamfetaminedimesylate30MGChewableTablet[Vyvanse]|CHILD 2020 632|1001|N|N|N||Preferred Generic|309955-Dipyridamole75MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|197553-Cyclosporine25MGOralCapsule|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1488679-12HRTreprostinil2.5MGExtendedReleaseOralTablet[Orenitram]|CHILD 2020 632|1001|Y|N|N||Preferred Generic|803353-PhentermineHydrochloride37.5MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|1373497-{14(dimethylfumarate120MGDelayedReleaseOralCapsule)/46(dimethylfumarate240MGDelayedReleaseOralCapsule)}Pack|CHILD 2020 632|1001|N|N|N||Preferred Generic|859040-Pramipexoledihydrochloride0.25MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|312036-Nortriptyline2MG/MLOralSolution|CHILD 2020 632|1001|N|N|N||Preferred Generic|831261-CromolynSodium20MG/MLOralSolution|CHILD 2020 632|1001|N|N|N||Preferred Generic|197944-Methocarbamol750MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2203897-ledipasvir45MG/sofosbuvir200MGOralTablet[Harvoni]|CHILD 2020 632|1001|N|N|Y||Preferred Brand|2045382-30ACTUATfluticasonefuroate0.05MG/ACTUATDryPowderInhaler[Arnuity]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1801278-HumiraPsoriasisStarterPack40MG/0.8MLPen(4count)|CHILD 2020 632|1001|N|N|Y||Preferred Generic|854873-Zolpidemtartrate10MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|617296-Amoxicillin500MG/Clavulanate125MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|1085633-TriamcinoloneAcetonide0.00025MG/MGTopicalOintment|CHILD 2020 632|1001|Y|N|N||Preferred Brand|153324-Interferonbeta-1a0.03MGInjection[Avonex]|CHILD 2020 632|1001|N|N|N||Preferred Generic|617430-Amoxicillin80MG/ML/Clavulanate11.4MG/MLOralSuspension|CHILD 2020 632|1001|N|N|N||Preferred Brand|1250090-Nonoxynol-90.03MG/MGVaginalGel[GynolII]|CHILD 2020 632|1001|Y|N|N||Preferred Generic|824295-rufinamide200MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|253059-Levocarnitine500MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|722137-Amlodipine5MG/valsartan320MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|2047882-1MLtestosteronecypionate200MG/MLInjection|CHILD 2020 632|1001|N|N|N||Preferred Brand|1114135-amylase16000UNT/lipase3000UNT/protease10000UNTDelayedReleaseOralCapsule[Zenpep]|CHILD 2020 632|1001|N|N|N||Preferred Brand|751870-Nortrel1/3528DayPack|CHILD 2020 632|1001|N|N|N||Preferred Generic|198083-Phenobarbital100MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|311296-Levofloxacin750MGOralTablet|CHILD 2020 632|1001|Y|N|Y||Preferred Generic|577033-sildenafil20MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|199903-Hydrochlorothiazide12.5MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|749784-{7(EthinylEstradiol0.035MG/norgestimate0.18MGOralTablet)/7(EthinylEstradiol0.035MG/norgestimate0.215MGOralTablet)/7(Et|CHILD 2020 632|1001|N|N|N||Preferred Brand|105551-Busulfan2MGOralTablet[Myleran]|CHILD 2020 632|1001|N|N|Y||Preferred Brand|901644-0.5MLStreptococcuspneumoniaeserotype1capsularantigendiphtheriaCRM197proteinconjugatevaccine0.0044MG/ML/Streptococcuspn|CHILD 2020 632|1001|N|N|N||Preferred Generic|1000058-DoxepinHydrochloride100MGOralCapsule|CHILD 2020 632|1001|Y|N|N||Preferred Brand|896273-120ACTUATFluticasonepropionate0.23MG/ACTUAT/salmeterol0.021MG/ACTUATMeteredDoseInhaler[Advair]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1544383-0.2MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1657212-omalizumab150MGInjection[Xolair]|CHILD 2020 632|1001|N|N|N||Preferred Generic|312136-oxcarbazepine150MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|1373491-dimethylfumarate240MGDelayedReleaseOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|197787-Hydrocortisone5MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|856422-Hydrochlorothiazide25MG/PropranololHydrochloride40MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|754766-Metronidazole0.0075MG/MGVaginalGel[MetroGel]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1592752-nintedanib150MGOralCapsule[Ofev]|CHILD 2020 632|1001|Y|N|N||Preferred Generic|860707-24HRgalantaminehydrobromide24MGExtendedReleaseOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|2101899-Sodiumpolystyrenesulfonate15000MGPowderforOralSuspension|CHILD 2020 632|1001|N|N|N||Preferred Generic|197797-hydroxyurea500MGOralCapsule|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1870956-deflazacort18MGOralTablet[Emflaza]|CHILD 2020 632|1001|N|N|N||Preferred Brand|312020-Nitroglycerin9MGExtendedReleaseOralCapsule|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1721685-1MLEpoetinAlfa10000UNT/MLInjection[Epogen]|CHILD 2020 632|1001|N|N|N||Preferred Brand|207478-Primidone50MGOralTablet[Mysoline]|CHILD 2020 632|1001|N|N|N||Preferred Generic|617311-atorvastatin40MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|749780-{3(Azithromycin500MGOralTablet)}Pack|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1544404-0.15MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|CHILD 2020 632|1001|N|N|N||Preferred Generic|1050077-DiphenhydramineHydrochloride20MG/MLTopicalCream|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1661567-TOBIPodhalerDailyKit,8|CHILD 2020 632|1001|N|N|Y||Preferred Generic|861223-24HRAmphetamineaspartate3.75MG/AmphetamineSulfate3.75MG/Dextroamphetaminesaccharate3.75MG/DextroamphetamineSulfate3.75|CHILD 2020 632|1001|N|N|N||Preferred Generic|315102-SodiumFluoride1.1MG/MLOralSolution|CHILD 2020 632|1001|Y|N|N||Preferred Generic|197843-Isotretinoin10MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|197958-Methyldopa500MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1544918-0.65MLexenatide3.08MG/MLPenInjector[Bydureon]|CHILD 2020 632|1001|N|N|N||Preferred Generic|309045-Cefaclor250MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Brand|753482-Apri28DayPack|CHILD 2020 632|1001|N|N|N||Preferred Generic|748800-{21(drospirenone3MG/EthinylEstradiol0.03MGOralTablet)/7(InertIngredients1MGOralTablet)}Pack|CHILD 2020 632|1001|N|N|N||Preferred Generic|313123-Sucralfate100MG/MLOralSuspension|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1655934-ivacaftor125MG/lumacaftor200MGOralTablet[ORKAMBI]|CHILD 2020 632|1001|N|N|N||Preferred Generic|199245-glimepiride1MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|686405-ErythromycinEthylsuccinate400MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|198032-Nifedipine10MGOralCapsule|CHILD 2020 632|1001|Y|N|N||Preferred Brand|205923-1MLEpoetinAlfa4000UNT/MLInjection[Epogen]|CHILD 2020 632|1001|N|N|N||Preferred Generic|722134-Amlodipine5MG/valsartan160MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|310380-Fluorouracil50MG/MLTopicalSolution|CHILD 2020 632|1001|N|N|N||Preferred Brand|863836-amylase30000UNT/lipase6000UNT/protease19000UNTDelayedReleaseOralCapsule[Creon]|CHILD 2020 632|1001|N|N|N||Preferred Generic|722126-Amlodipine10MG/valsartan160MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|834102-PenicillinVPotassium500MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|105583-Fluorouracil50MG/MLTopicalCream|CHILD 2020 632|1001|Y|N|N||Preferred Brand|848164-0.5MLgolimumab100MG/MLPrefilledSyringe[Simponi]|CHILD 2020 632|1001|N|N|Y||Preferred Brand|998666-carboxymethylcellulosesodium0.01MG/MGOphthalmicGel[TheraTears]|CHILD 2020 632|1001|N|N|N||Preferred Generic|313306-Theophylline5.33MG/MLOralSolution|CHILD 2020 632|1001|N|N|N||Preferred Generic|966222-LevothyroxineSodium0.075MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|312301-Pentoxifylline400MGExtendedReleaseOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|1100075-abirateroneacetate250MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|197577-Dexamethasone0.5MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|198013-Naproxen250MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|686924-carvedilol3.125MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|1116150-bacitracinzinc0.4UNT/MG/hydrocortisoneacetate0.01MG/MG/NeomycinSulfate0.0035MG/MG/PolymyxinBSulfate10UNT/MGOphthalmic|CHILD 2020 632|1001|N|N|Y||Preferred Generic|862006-24HRGuanfacine1MGExtendedReleaseOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1544402-0.6MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|CHILD 2020 632|1001|N|N|N||Preferred Generic|310155-Erythromycin250MGDelayedReleaseOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|238003-168HREstradiol0.00208MG/HRTransdermalSystem|CHILD 2020 632|1001|N|N|Y||Preferred Brand|2050059-0.5MLHepatitisBSurfaceAntigenVaccine0.04MG/MLPrefilledSyringe[Heplisav-B]|CHILD 2020 632|1001|N|N|N||Preferred Generic|197659-Estradiol2MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|1995479-amylase168000UNT/lipase40000UNT/protease126000UNTDelayedReleaseOralCapsule[Zenpep]|CHILD 2020 632|1001|N|N|N||Preferred Generic|198108-Piroxicam20MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|856429-Hydrochlorothiazide25MG/PropranololHydrochloride80MGOralTablet|CHILD 2020 632|1001|N|Y|Y||Preferred Generic|313159-Sumatriptan5MG/ACTUATNasalSpray|CHILD 2020 632|1001|N|N|Y||Preferred Brand|1547950-CarboxymethylcelluloseSodium2.5MG/MLOphthalmicSolution[TheraTears]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|205922-1MLEpoetinAlfa3000UNT/MLInjection[Procrit]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|313762-zaleplon5MGOralCapsule|CHILD 2020 632|1001|N|N|Y||Preferred Generic|862019-24HRGuanfacine3MGExtendedReleaseOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|725021-24HRrivastigmine0.192MG/HRTransdermalSystem|CHILD 2020 632|1001|N|N|N||Preferred Generic|312362-Phenobarbital30MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|1373483-dimethylfumarate120MGDelayedReleaseOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|197986-Minoxidil10MGOralTablet|CHILD 2020 632|1001|N|Y|Y||Preferred Generic|313189-Tacrolimus0.0003MG/MGTopicalOintment|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1594358-HumiraPediatricCrohn'sDiseaseStarterPackage(3count)|CHILD 2020 632|1001|N|N|N||Preferred Generic|283672-Citalopram10MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|617322-Amoxicillin50MG/ML/Clavulanate12.5MG/MLOralSuspension|CHILD 2020 632|1001|N|N|N||Preferred Brand|207273-Nitroglycerin0.02MG/MGTopicalOintment[Nitro-Bid]|CHILD 2020 632|1001|N|N|N||Preferred Generic|639566-VitaminB650MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2205634-1MLbenralizumab30MG/MLAuto-Injector[Fasenra]|CHILD 2020 632|1001|N|N|N||Preferred Brand|992759-Homatropinehydrobromide50MG/MLOphthalmicSolution[Homatropaire]|CHILD 2020 632|1001|N|N|N||Preferred Generic|628953-PotassiumChloride10MEQExtendedReleaseOralTablet|CHILD 2020 632|1001|N|Y|N||Preferred Brand|1551300-0.5MLdulaglutide1.5MG/MLAuto-Injector[Trulicity]|CHILD 2020 632|1001|N|N|N||Preferred Generic|197500-Chlorthalidone50MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|259966-Methylprednisolone4MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|1737459-PamidronateDisodium30MGInjection|CHILD 2020 632|1001|Y|N|N||Preferred Brand|854832-lisdexamfetaminedimesylate20MGOralCapsule[Vyvanse]|CHILD 2020 632|1001|N|N|N||Preferred Generic|860221-MegestrolAcetate40MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|311166-isoniazid100MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|349483-valsartan40MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|477560-Fenofibrate145MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|197963-Hydrochlorothiazide15MG/Methyldopa250MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|1536586-168HREthinylEstradiol0.00146MG/HR/norelgestromin0.00625MG/HRTransdermalSystem[Xulane]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1546189-0.5MLpeginterferonbeta-1a0.25MG/MLPrefilledSyringe[Plegridy]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1546198-PlegridyStarterPack|CHILD 2020 632|1001|N|Y|Y||Preferred Generic|309332-Clindamycin0.01MG/MGTopicalGel|CHILD 2020 632|1001|Y|N|N||Preferred Generic|1988974-24HRpregabalin165MGExtendedReleaseOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|845305-Nonoxynol-90.04MG/MGVaginalGel[Conceptrol]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|312840-rizatriptan5MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2166401-ivacaftor25MGOralGranules[Kalydeco]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|884386-DextroamphetamineSulfate5MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|617316-Amoxicillin400MG/Clavulanate57MGChewableTablet|CHILD 2020 632|1001|N|Y|Y||Preferred Generic|309333-Clindamycin10MG/MLTopicalSolution|CHILD 2020 632|1001|N|Y|N||Preferred Generic|1368385-alogliptin12.5MG/Metforminhydrochloride1000MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1872980-0.4MLadalimumab100MG/MLAuto-Injector[Humira]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1544396-0.45MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|CHILD 2020 632|1001|N|N|N||Preferred Generic|197580-Dexamethasone1.5MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|1360304-Budesonide0.08MG/ACTUAT/formoterolfumarate0.0045MG/ACTUATMeteredDoseInhaler|CHILD 2020 632|1001|N|N|N||Preferred Generic|312289-Naloxone0.5MG/Pentazocine50MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|284185-Didanosine200MGDelayedReleaseOralCapsule|CHILD 2020 632|1001|N|Y|Y||Preferred Generic|284201-zolmitriptan2.5MGDisintegratingOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|724863-armodafinil50MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|197956-Methyldopa250MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|260409-prednisolone1MG/MLOralSolution[Pediapred]|CHILD 2020 632|1001|N|N|N||Preferred Generic|197700-Fluconazole200MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1657980-10MLtocilizumab20MG/MLInjection[Actemra]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1544394-0.4MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|1650142-DoxycyclineMonohydrate100MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|1595462-amylase42000UNT/lipase10000UNT/protease32000UNTDelayedReleaseOralCapsule[Zenpep]|CHILD 2020 632|1001|N|N|N||Preferred Generic|598025-Amoxicillin250MGChewableTablet|CHILD 2020 632|1001|N|N|Y||Preferred Brand|847189-3MLinsulinisophane,human70UNT/ML/insulin,regular,human30UNT/MLPenInjector[Humulin]|CHILD 2020 632|1001|N|N|N||Preferred Generic|1049909-DiphenhydramineHydrochloride25MGOralCapsule|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1488675-12HRTreprostinil1MGExtendedReleaseOralTablet[Orenitram]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|892589-MorphineSulfate2MG/MLOralSolution|CHILD 2020 632|1001|N|N|N||Preferred Generic|861007-Metforminhydrochloride500MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|197444-Carbidopa25MG/Levodopa100MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|1293864-ErgotamineTartrate2MGSublingualTablet[Ergomar]|CHILD 2020 632|1001|N|N|N||Preferred Generic|310157-Erythromycin500MGDelayedReleaseOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|1244214-Budesonide3MGDelayedReleaseOralCapsule|CHILD 2020 632|1001|N|N|Y||Preferred Generic|892672-MorphineSulfate30MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|197782-Hydrocortisone10MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|213284-hydroxyurea400MGOralCapsule[Droxia]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|861221-24HRAmphetamineaspartate2.5MG/AmphetamineSulfate2.5MG/Dextroamphetaminesaccharate2.5MG/DextroamphetamineSulfate2.5MGEx|CHILD 2020 632|1001|N|N|Y||Preferred Generic|894780-MorphineSulfate4MG/MLOralSolution|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1442143-Macitentan10MGOralTablet[Opsumit]|CHILD 2020 632|1001|N|N|N||Preferred Generic|992153-methenaminemandelate1000MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|200032-carvedilol12.5MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|198036-24HRNifedipine90MGExtendedReleaseOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|198240-Tamoxifen10MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|856364-TrazodoneHydrochloride150MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|966225-LevothyroxineSodium0.15MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|311665-Metipranolol3MG/MLOphthalmicSolution|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1726639-ponatinib30MGOralTablet[Iclusig]|CHILD 2020 632|1001|N|N|N||Preferred Generic|309044-Cefaclor25MG/MLOralSuspension|CHILD 2020 632|1001|N|Y|N||Preferred Generic|1368410-alogliptin12.5MG/pioglitazone30MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|312529-PotassiumChloride8MEQExtendedReleaseOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1439899-riociguat1.5MGOralTablet[Adempas]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2262719-MicronizedIsotretinoin24MGOralCapsule[Absorica]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|200345-Simvastatin80MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2121096-siponimod0.25MGOralTablet[Mayzent]|CHILD 2020 632|1001|N|N|N||Preferred Generic|199425-Melatonin1MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1439894-riociguat0.5MGOralTablet[Adempas]|CHILD 2020 632|1001|N|N|N||Preferred Generic|617310-atorvastatin20MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|202301-Estrogens,Conjugated(USP)1.25MGOralTablet[Premarin]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|897630-24HRVerapamilhydrochloride360MGExtendedReleaseOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|646333-Capsaicin1MG/MLTopicalCream|CHILD 2020 632|1001|N|N|N||Preferred Generic|544455-Lactulose667MG/MLOralSolution[Generlac]|CHILD 2020 632|1001|N|N|N||Preferred Generic|198040-Nitroglycerin0.6MGSublingualTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1665906-1MLevolocumab140MG/MLPrefilledSyringe[Repatha]|CHILD 2020 632|1001|N|N|Y||Preferred Brand|2053927-sodiumzirconiumcyclosilicate10000MGPowderforOralSuspension[Lokelma]|CHILD 2020 632|1001|N|N|N||Preferred Generic|197658-Estradiol1MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|2564038-influenzaAvirusA/Cambodia/e0826360/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.03MG/|CHILD 2020 632|1001|N|N|N||Preferred Brand|212232-Estrogens,Esterified(USP)0.625MGOralTablet[Menest]|CHILD 2020 632|1001|N|N|N||Preferred Generic|617423-Amoxicillin40MG/ML/Clavulanate5.7MG/MLOralSuspension|CHILD 2020 632|1001|N|N|N||Preferred Generic|863669-Tamsulosinhydrochloride0.4MGOralCapsule|CHILD 2020 632|1001|N|N|Y||Preferred Generic|897659-Verapamilhydrochloride120MGExtendedReleaseOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|198316-Hydrochlorothiazide25MG/Triamterene37.5MGOralCapsule|CHILD 2020 632|1001|N|N|Y||Preferred Generic|311265-lamotrigine5MGChewableTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|992184-methenaminemandelate500MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1364477-teduglutide5MGInjection[Gattex]|CHILD 2020 632|1001|Y|N|N||Preferred Generic|990982-2MLphysostigminesalicylate1MG/MLInjection|CHILD 2020 632|1001|N|N|N||Preferred Generic|309337-Clindamycin20MG/MLVaginalCream|CHILD 2020 632|1001|Y|N|N||Preferred Generic|198243-Temazepam7.5MGOralCapsule|CHILD 2020 632|1001|N|N|Y||Preferred Generic|856999-Acetaminophen325MG/HydrocodoneBitartrate10MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|310261-exemestane25MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2059189-amikacinliposomal70.3MG/MLInhalationSuspension[Arikayce]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|905369-ChlordiazepoxideHydrochloride10MGOralCapsule|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2170993-1MLmepolizumab100MG/MLAuto-Injector[Nucala]|CHILD 2020 632|1001|N|N|N||Preferred Generic|1801294-MicroencapsulatedPotassiumChloride20MEQExtendedReleaseOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|312593-Prazosin1MGOralCapsule|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1665900-1MLevolocumab140MG/MLAuto-Injector[Repatha]|CHILD 2020 632|1001|N|N|N||Preferred Brand|1595292-amylase14000UNT/lipase3000UNT/protease10000UNTDelayedReleaseOralCapsule[Zenpep]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|198189-Ramipril5MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|1098134-24HRNiacin1000MGExtendedReleaseOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1654630-1MLglatirameracetate20MG/MLPrefilledSyringe[Glatopa]|CHILD 2020 632|1001|N|N|N||Preferred Generic|198630-ferrousgluconate324MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|432401-cinacalcet60MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|1308569-24HRrivastigmine0.554MG/HRTransdermalSystem|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2262727-MicronizedIsotretinoin32MGOralCapsule[Absorica]|CHILD 2020 632|1001|N|N|N||Preferred Brand|797023-DexPakTaperPak13DayPack|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1302856-24HRPhentermine15MG/topiramate92MGExtendedReleaseOralCapsule[Qsymia]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1302845-24HRPhentermine3.75MG/topiramate23MGExtendedReleaseOralCapsule[Qsymia]|CHILD 2020 632|1001|Y|N|N||Preferred Generic|2123194-PulmonaryHypertensiontadalafil20MGOralTablet|CHILD 2020 632|1001|N|Y|N||Preferred Generic|1368006-alogliptin25MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|199167-Phenobarbital32.4MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|151226-topiramate50MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|1047895-HyoscyamineSulfate0.125MG/MLOralSolution|CHILD 2020 632|1001|N|N|N||Preferred Generic|312617-Prednisone5MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|749157-{7(EthinylEstradiol0.025MG/norgestimate0.18MGOralTablet)/7(EthinylEstradiol0.025MG/norgestimate0.215MGOralTablet)/7(Et|CHILD 2020 632|1001|N|N|N||Preferred Generic|1000097-DoxepinHydrochloride75MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|282401-lamotrigine25MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|644304-Tamoxifen2MG/MLOralSolution[Soltamox]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1244064-0.4MLMethylnaltrexonebromide20MG/MLPrefilledSyringe[Relistor]|CHILD 2020 632|1001|N|N|N||Preferred Generic|966248-LevothyroxineSodium0.112MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|861753-Glyburide5MG/Metforminhydrochloride500MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|403854-Hydrochlorothiazide12.5MG/Olmesartanmedoxomil40MGOralTablet|CHILD 2020 632|1001|Y|N|Y||Preferred Brand|665040-sitagliptin25MGOralTablet[Januvia]|CHILD 2020 632|1001|N|N|N||Preferred Generic|197884-Lisinopril40MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|578018-bromfenac0.9MG/MLOphthalmicSolution|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1747194-0.4MLMethotrexate56.3MG/MLAuto-Injector[Otrexup]|CHILD 2020 632|1001|N|N|N||Preferred Brand|2110510-60ACTUATFluticasonepropionate0.1MG/ACTUAT/salmeterol0.05MG/ACTUATDryPowderInhaler[Wixela]|CHILD 2020 632|1001|N|N|N||Preferred Brand|762001-Kariva28DayPack|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1243040-Linagliptin2.5MG/Metforminhydrochloride850MGOralTablet[Jentadueto]|CHILD 2020 632|1001|N|N|N||Preferred Generic|199164-Phenobarbital97.2MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|402696-24HRFelodipine5MGExtendedReleaseOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|835894-cyclosporine,modified25MGOralCapsule|CHILD 2020 632|1001|N|N|Y||Preferred Generic|899557-dexmethylphenidatehydrochloride2.5MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|248420-mesalamine1000MGRectalSuppository|CHILD 2020 632|1001|N|N|N||Preferred Generic|831102-DiltiazemHydrochloride90MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|312615-Prednisone20MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|253039-Melatonin1MG/MLOralSolution|CHILD 2020 632|1001|Y|N|N||Preferred Brand|979115-0.6MLMethylnaltrexonebromide20MG/MLInjection[Relistor]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1242613-Isotretinoin20MGOralCapsule[Myorisan]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|238004-168HREstradiol0.00417MG/HRTransdermalSystem|CHILD 2020 632|1001|Y|N|N||Preferred Generic|1366550-24HRBudesonide9MGExtendedReleaseOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Brand|2059017-rivaroxaban2.5MGOralTablet[Xarelto]|CHILD 2020 632|1001|N|N|Y||Preferred Brand|901518-0.5MLNeisseriameningitidisserogroupAoligosaccharidediphtheriaCRM197proteinconjugatevaccine0.02MG/ML/Neisseriameningiti|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1235267-CamreseLo91DayPack|CHILD 2020 632|1001|N|N|N||Preferred Generic|197861-Leucovorin15MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|992780-MiconazoleNitrate100MGVaginalInsert|CHILD 2020 632|1001|N|N|N||Preferred Brand|836368-200ACTUATIpratropiumBromide0.017MG/ACTUATMeteredDoseInhaler[Atrovent]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|897640-Verapamilhydrochloride180MGExtendedReleaseOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1235150-azilsartanmedoxomil40MG/Chlorthalidone12.5MGOralTablet[Edarbyclor]|CHILD 2020 632|1001|N|Y|Y||Preferred Generic|2001566-BXRating24HRMethylphenidateHydrochloride36MGExtendedReleaseOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1649593-0.5MLpeginterferonbeta-1a0.25MG/MLAuto-Injector[Plegridy]|CHILD 2020 632|1001|Y|N|N||Preferred Generic|577208-Omega-3AcidEthylEsters(USP)1000MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|205326-Lisinopril30MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|904447-Alendronicacid0.933MG/MLOralSolution|CHILD 2020 632|1001|N|Y|Y||Preferred Generic|2001564-BXRating24HRMethylphenidateHydrochloride18MGExtendedReleaseOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|905199-HydralazineHydrochloride10MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Brand|1547664-14ACTUATfluticasonefuroate0.1MG/ACTUATDryPowderInhaler[Arnuity]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1551888-0.2MLadalimumab50MG/MLPrefilledSyringe[Humira]|CHILD 2020 632|1001|N|N|N||Preferred Generic|197657-Estradiol0.5MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Brand|1037181-dabigatranetexilate75MGOralCapsule[Pradaxa]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|213360-Thalidomide50MGOralCapsule[Thalomid]|CHILD 2020 632|1001|N|N|N||Preferred Generic|353538-24HRIsosorbideMononitrate60MGExtendedReleaseOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|106336-Ketoconazole20MG/MLMedicatedShampoo|CHILD 2020 632|1001|N|N|N||Preferred Generic|1190572-AtropineSulfate0.025MG/DiphenoxylateHydrochloride2.5MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|810075-24HRFesoterodineFumarate4MGExtendedReleaseOralTablet[Toviaz]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1115468-1.5MLLeuprolideAcetate15MG/MLPrefilledSyringe[Lupron]|CHILD 2020 632|1001|N|N|N||Preferred Generic|833217-DiltiazemHydrochloride30MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|311197-IsosorbideMononitrate20MGOralTablet|CHILD 2020 632|1001|Y|N|Y||Preferred Generic|883826-TranexamicAcid650MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1115459-1MLLeuprolideAcetate3.75MG/MLPrefilledSyringe[Lupron]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|314200-pantoprazole40MGDelayedReleaseOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|351172-Dutasteride0.5MGOralCapsule|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1870952-deflazacort30MGOralTablet[Emflaza]|CHILD 2020 632|1001|N|N|N||Preferred Generic|308868-Calcitriol0.0005MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Brand|863841-amylase60000UNT/lipase12000UNT/protease38000UNTDelayedReleaseOralCapsule[Creon]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|205917-1MLEpoetinAlfa2000UNT/MLInjection[Epogen]|CHILD 2020 632|1001|N|N|N||Preferred Brand|105553-Chlorambucil2MGOralTablet[Leukeran]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|905516-ChlordiazepoxideHydrochloride5MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|311264-lamotrigine25MGChewableTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|200327-capecitabine150MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|197839-IsosorbideDinitrate30MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1091654-azilsartanmedoxomil80MGOralTablet[Edarbi]|CHILD 2020 632|1001|N|N|N||Preferred Generic|349405-Olmesartanmedoxomil40MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|905495-ChlordiazepoxideHydrochloride25MGOralCapsule|CHILD 2020 632|1001|N|Y|N||Preferred Brand|996633-NamendaXR28DayTitrationPack|CHILD 2020 632|1001|Y|N|N||Preferred Brand|828703-1.2MLPlerixafor20MG/MLInjection[Mozobil]|CHILD 2020 632|1001|N|N|Y||Preferred Brand|261315-Oseltamivir75MGOralCapsule[Tamiflu]|CHILD 2020 632|1001|N|N|Y||Preferred Brand|1593140-0.5MLNeisseriameningitidisserogroupBrecombinantLP2086A05proteinvariantantigen0.12MG/ML/Neisseriameningitidisserogroup|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2268227-ubrogepant100MGOralTablet[Ubrelvy]|CHILD 2020 632|1001|N|N|N||Preferred Generic|103456-Fluocinonide0.5MG/MLTopicalCream|CHILD 2020 632|1001|N|N|N||Preferred Generic|349332-Escitalopram10MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1043567-24HRMetforminhydrochloride1000MG/saxagliptin2.5MGExtendedReleaseOralTablet[Kombiglyze]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|1806193-30/70Release24HRMethylphenidateHydrochloride50MGExtendedReleaseOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Brand|2563002-0.5MLinfluenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.09MG/ML/influenzaAvirusA/Wisconsin/588/2019(H1N1)antigen0.09MG/|CHILD 2020 632|1001|N|N|Y||Preferred Generic|904419-Alendronicacid10MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|897696-HydromorphoneHydrochloride2MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|207949-Succimer100MGOralCapsule[Chemet]|CHILD 2020 632|1001|N|N|N||Preferred Brand|1594673-amylase105000UNT/lipase25000UNT/protease79000UNTDelayedReleaseOralCapsule[Zenpep]|CHILD 2020 632|1001|N|N|N||Preferred Generic|1010878-LidocaineHydrochloride40MG/MLMucousMembraneTopicalSolution|CHILD 2020 632|1001|N|Y|Y||Preferred Generic|197979-Metolazone2.5MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|311759-montelukast4MGChewableTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1873087-HumiraPrefilledSyringe80MG/0.8MLStarterPack-PediatricCrohn'sDisease(3count)|CHILD 2020 632|1001|N|N|N||Preferred Generic|197817-Indomethacin25MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|197745-Guanfacine1MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|312846-ropinirole0.5MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1873704-Mibelas24FeChewable28DayPack|CHILD 2020 632|1001|N|N|Y||Preferred Brand|1190919-0.5MLdiphtheriatoxoidvaccine,inactivated4UNT/ML/tetanustoxoidvaccine,inactivated10UNT/MLPrefilledSyringe[Tenivac]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1876609-naldemedine0.2MGOralTablet[Symproic]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|809994-lacosamide150MGOralTablet[Vimpat]|CHILD 2020 632|1001|N|N|N||Preferred Generic|197816-Indapamide2.5MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|310325-ferroussulfate325MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|876529-Amlodipine5MG/telmisartan80MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|992668-homatropinemethylbromide0.3MG/ML/HydrocodoneBitartrate1MG/MLOralSolution|CHILD 2020 632|1001|N|N|N||Preferred Brand|1190225-120ACTUATAlbuterol0.1MG/ACTUAT/IpratropiumBromide0.02MG/ACTUATInhalationSpray[Combivent]|CHILD 2020 632|1001|N|Y|Y||Preferred Generic|998671-168HRClonidine0.00417MG/HRTransdermalSystem|CHILD 2020 632|1001|N|N|Y||Preferred Generic|198318-Triazolam0.25MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|795749-RebifTitrationPack|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1921010-0.1MLadalimumab100MG/MLPrefilledSyringe[Humira]|CHILD 2020 632|1001|N|N|N||Preferred Generic|312847-ropinirole2MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|199193-famciclovir250MGOralTablet|CHILD 2020 632|1001|N|Y|N||Preferred Brand|856666-rifaximin550MGOralTablet[XIFAXAN]|CHILD 2020 632|1001|Y|N|N||Preferred Generic|485421-24HRdarifenacin15MGExtendedReleaseOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|197606-Digoxin0.25MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|1000135-medroxyprogesteroneacetate2.5MGOralTablet|CHILD 2020 632|1001|N|Y|Y||Preferred Generic|854868-Rabeprazolesodium20MGDelayedReleaseOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2121100-siponimod2MGOralTablet[Mayzent]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|861227-24HRAmphetamineaspartate6.25MG/AmphetamineSulfate6.25MG/Dextroamphetaminesaccharate6.25MG/DextroamphetamineSulfate6.25|CHILD 2020 632|1001|N|N|N||Preferred Generic|317128-Misoprostol0.2MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Brand|637188-varenicline0.5MGOralTablet[Chantix]|CHILD 2020 632|1001|N|N|N||Preferred Generic|312849-ropinirole5MGOralTablet|CHILD 2020 632|1001|N|Y|Y||Preferred Generic|1806185-50/50Release24HRMethylphenidateHydrochloride60MGExtendedReleaseOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|1000862-PilocarpineHydrochloride20MG/MLOphthalmicSolution|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1660938-60ACTUATformoterolfumarate0.005MG/ACTUAT/mometasonefuroate0.2MG/ACTUATMeteredDoseInhaler[Dulera]|CHILD 2020 632|1001|N|N|Y||Preferred Brand|1115892-MineralOil0.15MG/MG/Petrolatum0.85MG/MGOphthalmicOintment[Puralube]|CHILD 2020 632|1001|N|N|N||Preferred Generic|283406-Mirtazapine15MGDisintegratingOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|315187-Prednisone1MG/MLOralSolution|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1487076-DiclofenacSodium20MG/MLTopicalSolution[Pennsaid]|CHILD 2020 632|1001|N|N|N||Preferred Generic|308989-Carbidopa50MG/Levodopa200MGExtendedReleaseOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|903847-PyridostigmineBromide180MGExtendedReleaseOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1365866-nepafenac3MG/MLOphthalmicSuspension[Ilevro]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|608143-atomoxetine80MGOralCapsule|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2120195-1MLerenumab-aooe140MG/MLAuto-Injector[Aimovig]|CHILD 2020 632|1001|N|Y|Y||Preferred Generic|351134-zolmitriptan5MGDisintegratingOralTablet|CHILD 2020 632|1001|N|Y|N||Preferred Generic|403850-Carbidopa12.5MG/entacapone200MG/Levodopa50MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|141963-Azithromycin40MG/MLOralSuspension|CHILD 2020 632|1001|N|N|Y||Preferred Generic|313761-zaleplon10MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Brand|750244-Low-Ogestrel28DayPack|CHILD 2020 632|1001|N|N|N||Preferred Generic|997226-Donepezilhydrochloride5MGDisintegratingOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|847191-3MLinsulinaspartprotamine,human70UNT/ML/insulinaspart,human30UNT/MLPenInjector|CHILD 2020 632|1001|N|N|N||Preferred Generic|311989-Nitrofurantoin5MG/MLOralSuspension|CHILD 2020 632|1001|N|N|N||Preferred Generic|1797913-TriamcinoloneAcetonide0.055MG/ACTUATMeteredDoseNasalSpray|CHILD 2020 632|1001|N|N|N||Preferred Brand|1005928-ulipristalacetate30MGOralTablet[Ella]|CHILD 2020 632|1001|N|N|N||Preferred Generic|198141-Prazosin5MGOralCapsule|CHILD 2020 632|1001|N|N|Y||Preferred Generic|993890-Acetaminophen300MG/CodeinePhosphate60MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|205315-topiramate25MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|309686-Dexamethasone0.1MG/MLOralSolution|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1657982-20MLtocilizumab20MG/MLInjection[Actemra]|CHILD 2020 632|1001|N|N|N||Preferred Generic|197517-Clarithromycin500MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|197785-Hydrocortisone25MG/MLTopicalLotion|CHILD 2020 632|1001|N|N|N||Preferred Generic|314238-Tropicamide10MG/MLOphthalmicSolution|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2056670-AimovigAutoinjector2-Pack(140MGDose)|CHILD 2020 632|1001|N|Y|Y||Preferred Generic|2001568-BXRating24HRMethylphenidateHydrochloride54MGExtendedReleaseOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1486981-dapagliflozin5MGOralTablet[Farxiga]|CHILD 2020 632|1001|N|N|N||Preferred Generic|855812-prasugrel10MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|855633-DiclofenacSodium0.01MG/MGTopicalGel|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1486977-dapagliflozin10MGOralTablet[Farxiga]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|1596780-60ACTUATTestosterone12.5MG/ACTUATTopicalGel|CHILD 2020 632|1001|N|N|N||Preferred Generic|308714-Betamethasone0.5MG/ML/Clotrimazole10MG/MLTopicalCream|CHILD 2020 632|1001|N|Y|Y||Preferred Generic|483444-pregabalin300MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|1014673-cetirizinehydrochloride1MG/MLOralSolution|CHILD 2020 632|1001|Y|N|N||Preferred Generic|603203-erlotinib100MGOralTablet|CHILD 2020 632|1001|N|Y|N||Preferred Brand|833151-Savella4-WeekTitrationPack|CHILD 2020 632|1001|N|N|N||Preferred Brand|830470-1MLrabiesvirusvaccinewistarstrainPM-1503-3M(Human),Inactivated2.5UNT/MLInjection[Imovax]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2003757-1.14MLsarilumab132MG/MLAuto-Injector[Kevzara]|CHILD 2020 632|1001|N|N|N||Preferred Generic|861448-ClobetasolPropionate0.0005MG/MGTopicalOintment|CHILD 2020 632|1001|N|N|N||Preferred Generic|310346-Finasteride5MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|834046-PenicillinVPotassium25MG/MLOralSolution|CHILD 2020 632|1001|N|N|N||Preferred Generic|198038-Nitroglycerin0.3MGSublingualTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|313215-Terazosin1MGOralCapsule|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1728095-romiplostim0.25MGInjection[Nplate]|CHILD 2020 632|1001|N|N|N||Preferred Generic|314182-PotassiumChloride2.67MEQ/MLOralSolution|CHILD 2020 632|1001|N|N|N||Preferred Generic|1000141-medroxyprogesteroneacetate5MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|310809-Hydrochlorothiazide25MG/quinapril20MGOralTablet|CHILD 2020 632|1001|N|Y|Y||Preferred Brand|2200658-semaglutide7MGOralTablet[Rybelsus]|CHILD 2020 632|1001|N|Y|Y||Preferred Brand|2200654-semaglutide3MGOralTablet[Rybelsus]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|1091392-MethylphenidateHydrochloride20MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|602635-lanthanumcarbonate1000MGChewableTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|314111-Mirtazapine30MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|314106-Metronidazole250MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|748868-{21(EthinylEstradiol0.02MG/Levonorgestrel0.1MGOralTablet)/7(InertIngredients1MGOralTablet)}Pack|CHILD 2020 632|1001|N|N|Y||Preferred Brand|1292459-0.5MLVaricella-ZosterVirusVaccineLive(Oka-Merck)strain2700UNT/MLInjection[Varivax]|CHILD 2020 632|1001|N|N|N||Preferred Generic|197624-Disulfiram500MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|1000001-Amlodipine5MG/Hydrochlorothiazide25MG/Olmesartanmedoxomil40MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|199224-anastrozole1MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|1649401-DoxycyclineMonohydrate50MGOralCapsule|CHILD 2020 632|1001|Y|N|N||Preferred Brand|809159-0.5MLEtanercept50MG/MLPrefilledSyringe[Enbrel]|CHILD 2020 632|1001|N|N|N||Preferred Generic|197741-Guaifenesin200MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Brand|836634-1MLhepatitisAvirusstrainCR326Fantigen,inactivated50UNT/MLPrefilledSyringe[Vaqta]|CHILD 2020 632|1001|Y|N|N||Preferred Generic|603208-erlotinib25MGOralTablet|CHILD 2020 632|1001|N|Y|N||Preferred Brand|1551306-0.5MLdulaglutide3MG/MLAuto-Injector[Trulicity]|CHILD 2020 632|1001|N|Y|N||Preferred Generic|857560-trospiumchloride20MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|211633-AluminumHydroxide200MG/MagnesiumHydroxide200MG/Simethicone25MGChewableTablet[Gelusil]|CHILD 2020 632|1001|N|N|N||Preferred Generic|1547771-Tetracainehydrochloride5MG/MLOphthalmicSolution|CHILD 2020 632|1001|N|Y|N||Preferred Generic|855189-24HRtolterodinetartrate4MGExtendedReleaseOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|1291082-hydrocortisoneacetate25MGRectalSuppository|CHILD 2020 632|1001|N|N|N||Preferred Generic|1923422-SotalolHydrochloride120MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|200285-Hydrochlorothiazide12.5MG/valsartan160MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|597772-deferasirox500MGTabletforOralSuspension|CHILD 2020 632|1001|N|Y|Y||Preferred Generic|1111339-olopatadine1MG/MLOphthalmicSolution|CHILD 2020 632|1001|N|N|N||Preferred Generic|314006-24HRGlipizide5MGExtendedReleaseOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Brand|895756-PolyethyleneGlycol4000.004MG/MG/Propyleneglycol0.003MG/MGOphthalmicGel[Systane]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|1049221-Acetaminophen325MG/OxycodoneHydrochloride5MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1720606-mepolizumab100MGInjection[Nucala]|CHILD 2020 632|1001|Y|N|N||Preferred Generic|848140-Amlodipine5MG/Hydrochlorothiazide12.5MG/valsartan160MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|1359030-Junel1.5/3021DayPack|CHILD 2020 632|1001|N|Y|N||Preferred Brand|1991317-1MGDose1.5MLsemaglutide1.34MG/MLPenInjector[Ozempic]|CHILD 2020 632|1001|N|N|N||Preferred Generic|197726-Flutamide125MGOralCapsule|CHILD 2020 632|1001|Y|N|N||Preferred Generic|904952-3MLibandronicacid1MG/MLPrefilledSyringe|CHILD 2020 632|1001|N|Y|N||Preferred Generic|606730-Esomeprazole40MGDelayedReleaseOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|1362712-MexiletineHydrochloride200MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|198144-Prednisone1MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|197941-Methimazole10MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|197625-Doxazosin1MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|313888-Cefaclor50MG/MLOralSuspension|CHILD 2020 632|1001|N|N|N||Preferred Generic|310353-Fluconazole40MG/MLOralSuspension|CHILD 2020 632|1001|N|N|N||Preferred Generic|863628-24HROxybutyninchloride15MGExtendedReleaseOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1649605-PlegridyPenStarterPack|CHILD 2020 632|1001|N|N|N||Preferred Generic|309680-Dexamethasone1MG/ML/Neomycin3.5MG/ML/PolymyxinB10000UNT/MLOphthalmicSuspension|CHILD 2020 632|1001|N|Y|N||Preferred Brand|1992695-ertugliflozin2.5MG/Metforminhydrochloride500MGOralTablet[Segluromet]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|200094-irbesartan75MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Brand|1300370-0.5MLBordetellapertussisfilamentoushemagglutininvaccine,inactivated0.016MG/ML/Bordetellapertussispertactinvaccine,ina|CHILD 2020 632|1001|N|N|N||Preferred Generic|313786-AceticAcid20MG/ML/Hydrocortisone10MG/MLOticSolution|CHILD 2020 632|1001|N|N|N||Preferred Generic|197805-Ibuprofen400MGOralTablet|CHILD 2020 632|1001|N|Y|N||Preferred Generic|311347-linezolid600MGOralTablet|CHILD 2020 632|1001|N|Y|N||Preferred Brand|833146-Milnacipranhydrochloride50MGOralTablet[Savella]|CHILD 2020 632|1001|N|Y|N||Preferred Generic|311286-Levalbuterol0.21MG/MLInhalationSolution|CHILD 2020 632|1001|N|N|N||Preferred Generic|311679-Metronidazole0.0075MG/MGTopicalGel|CHILD 2020 632|1001|N|Y|N||Preferred Brand|1992700-ertugliflozin7.5MG/Metforminhydrochloride1000MGOralTablet[Segluromet]|CHILD 2020 632|1001|N|N|N||Preferred Generic|835886-cyclosporine,modified100MG/MLOralSolution|CHILD 2020 632|1001|N|N|N||Preferred Generic|861416-Azithromycin1000MGPowderforOralSuspension|CHILD 2020 632|1001|N|Y|N||Preferred Generic|308865-calcipotriene0.05MG/MLTopicalSolution|CHILD 2020 632|1001|N|N|N||Preferred Generic|1014571-12HRcetirizinehydrochloride5MG/PseudoephedrineHydrochloride120MGExtendedReleaseOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|197626-Doxazosin2MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|692694-thyroid(USP)65MGOralTablet[Westhroid]|CHILD 2020 632|1001|N|N|N||Preferred Generic|1006688-SulfacetamideSodium100MG/MLTopicalLotion|CHILD 2020 632|1001|N|N|N||Preferred Generic|313583-24HRvenlafaxine37.5MGExtendedReleaseOralCapsule|CHILD 2020 632|1001|Y|N|N||Preferred Generic|1299903-Tiagabinehydrochloride12MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|205918-1MLEpoetinAlfa2000UNT/MLInjection[Procrit]|CHILD 2020 632|1001|N|N|N||Preferred Brand|827713-MineralOil0.03MG/MG/Petrolatum0.94MG/MGOphthalmicOintment[SystaneNighttime]|CHILD 2020 632|1001|N|N|N||Preferred Generic|283523-gabapentin50MG/MLOralSolution|CHILD 2020 632|1001|Y|N|N||Preferred Brand|763565-0.4MLadalimumab50MG/MLPrefilledSyringe[Humira]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1649996-0.5MLInterferonbeta-1a0.044MG/MLAuto-Injector[Rebif]|CHILD 2020 632|1001|N|N|N||Preferred Generic|313195-Tamoxifen20MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|197685-Etodolac300MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|313096-Spironolactone25MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|308689-BenzoylPeroxide0.025MG/MGTopicalGel|CHILD 2020 632|1001|N|Y|N||Preferred Generic|197507-Cimetidine400MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|562704-ropinirole4MGOralTablet|CHILD 2020 632|1001|N|Y|N||Preferred Generic|197505-Cimetidine200MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|847913-60ACTUATexenatide0.01MG/ACTUATPenInjector[Byetta]|CHILD 2020 632|1001|N|N|N||Preferred Generic|198033-Nifedipine20MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|283858-ropinirole3MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|207059-interferonbeta-1b0.3MGInjection[Betaseron]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1592285-pirfenidone267MGOralCapsule[Esbriet]|CHILD 2020 632|1001|N|N|N||Preferred Generic|997229-Donepezilhydrochloride5MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|904396-Alendronicacid35MGOralTablet|CHILD 2020 632|1001|N|Y|N||Preferred Generic|1368431-alogliptin25MG/pioglitazone30MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Brand|211140-PentosanPolysulfate100MGOralCapsule[Elmiron]|CHILD 2020 632|1001|N|Y|N||Preferred Brand|833143-Milnacipranhydrochloride12.5MGOralTablet[Savella]|CHILD 2020 632|1001|N|Y|N||Preferred Generic|1368417-alogliptin12.5MG/pioglitazone45MGOralTablet|CHILD 2020 632|1001|N|Y|N||Preferred Brand|2395785-0.5MLdulaglutide9MG/MLAuto-Injector[Trulicity]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|359818-Nicotine4MGOralLozenge|CHILD 2020 632|1001|N|N|N||Preferred Generic|309114-Cephalexin500MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Brand|895996-120ACTUATFluticasonepropionate0.044MG/ACTUATMeteredDoseInhaler[Flovent]|CHILD 2020 632|1001|N|N|N||Preferred Generic|313227-terconazole8MG/MLVaginalCream|CHILD 2020 632|1001|N|Y|N||Preferred Generic|1368018-alogliptin6.25MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|2178792-0.3MLEpinephrine0.5MG/MLPrefilledSyringe[Symjepi]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1592748-nintedanib100MGOralCapsule[Ofev]|CHILD 2020 632|1001|N|N|Y||Preferred Brand|1363484-hypromellose0.003MG/MGOphthalmicGel[SystaneOvernightTherapy]|CHILD 2020 632|1001|Y|N|N||Preferred Generic|1146690-24HRlamotrigine250MGExtendedReleaseOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Brand|311027-insulinisophane,human100UNT/MLInjectableSuspension[NovolinN]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|198241-Temazepam15MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|197682-Ethosuximide250MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|863619-24HROxybutyninchloride10MGExtendedReleaseOralTablet|CHILD 2020 632|1001|N|Y|N||Preferred Brand|835721-Ethionamide250MGOralTablet[Trecator]|CHILD 2020 632|1001|N|N|N||Preferred Generic|995218-HydroxyzineHydrochloride10MGOralTablet|CHILD 2020 632|1001|N|Y|N||Preferred Brand|402092-Cyclosporine0.5MG/MLOphthalmicSuspension[Restasis]|CHILD 2020 632|1001|N|N|N||Preferred Generic|562510-SodiumFluoride2MG/MLMouthwash|CHILD 2020 632|1001|N|N|N||Preferred Generic|312961-Simvastatin20MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|310818-Hydrochlorothiazide50MG/Triamterene75MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|886634-ButorphanolTartrate1MG/ACTUATMeteredDoseNasalSpray|CHILD 2020 632|1001|N|N|N||Preferred Generic|317136-Nortriptyline25MGOralCapsule|CHILD 2020 632|1001|Y|N|N||Preferred Brand|212219-EpoetinAlfa20000UNT/MLInjectableSolution[Procrit]|CHILD 2020 632|1001|N|Y|Y||Preferred Brand|1716219-patiromer16800MGPowderforOralSuspension[Veltassa]|CHILD 2020 632|1001|N|N|N||Preferred Generic|313190-Tacrolimus0.5MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|311486-meloxicam7.5MGOralTablet|CHILD 2020 632|1001|N|Y|N||Preferred Brand|2398842-3MLsemaglutide1.34MG/MLPenInjector[Ozempic]|CHILD 2020 632|1001|N|N|N||Preferred Generic|1000673-SulfacetamideSodium0.1MG/MGOphthalmicOintment|CHILD 2020 632|1001|N|N|N||Preferred Generic|313134-Sulfamethoxazole40MG/ML/Trimethoprim8MG/MLOralSuspension|CHILD 2020 632|1001|N|Y|N||Preferred Brand|2395779-0.5MLdulaglutide6MG/MLAuto-Injector[Trulicity]|CHILD 2020 632|1001|N|N|N||Preferred Generic|197627-Doxazosin4MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|2173508-Nonoxynol-91000MGVaginalSponge[TodaySponge]|CHILD 2020 632|1001|N|Y|N||Preferred Brand|212381-aminosalicylicacid4000MGOralGranules[PaserD/R]|CHILD 2020 632|1001|N|N|N||Preferred Generic|197381-Atenolol50MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|859052-Pramipexoledihydrochloride1MGOralTablet|CHILD 2020 632|1001|N|Y|N||Preferred Brand|1992821-ertugliflozin15MGOralTablet[Steglatro]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|349514-celecoxib400MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|313092-Sorbitol700MG/MLOralSolution|CHILD 2020 632|1001|N|N|N||Preferred Generic|1000647-PilocarpineHydrochloride10MG/MLOphthalmicSolution|CHILD 2020 632|1001|N|N|N||Preferred Generic|199352-trandolapril4MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|313222-terbinafine250MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|1250490-hydrocortisoneacetate5MG/MLTopicalCream|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2182340-1MLEtanercept50MG/MLCartridge[Enbrel]|CHILD 2020 632|1001|N|N|Y||Preferred Brand|847199-3MLinsulinisophane,human100UNT/MLPenInjector[HumulinN]|CHILD 2020 632|1001|N|N|N||Preferred Generic|312962-Simvastatin5MGOralTablet|CHILD 2020 632|1001|Y|N|Y||Preferred Generic|245723-Tretinoin0.0005MG/MGTopicalGel|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1439896-riociguat1MGOralTablet[Adempas]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|311207-Ivermectin3MGOralTablet|CHILD 2020 632|1001|N|Y|N||Preferred Generic|403852-Carbidopa37.5MG/entacapone200MG/Levodopa150MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|643714-lenalidomide15MGOralCapsule[Revlimid]|CHILD 2020 632|1001|N|N|N||Preferred Generic|849506-DesmopressinAcetate0.01MG/ACTUATNasalSpray|CHILD 2020 632|1001|N|N|N||Preferred Generic|312941-Sertraline50MGOralTablet|CHILD 2020 632|1001|N|Y|N||Preferred Brand|1356673-BenzylAlcohol0.05ML/MLTopicalLotion[Ulesfia]|CHILD 2020 632|1001|N|N|N||Preferred Generic|992454-PromethazineHydrochloride25MGRectalSuppository|CHILD 2020 632|1001|Y|N|N||Preferred Brand|845512-everolimus10MGOralTablet[Afinitor]|CHILD 2020 632|1001|Y|N|Y||Preferred Generic|891874-MorphineSulfate100MGExtendedReleaseOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|197623-Disulfiram250MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|310377-Fluorometholone1MG/MLOphthalmicSuspension|CHILD 2020 632|1001|N|N|N||Preferred Generic|310891-Hydrocortisone25MG/MLTopicalCream|CHILD 2020 632|1001|N|N|N||Preferred Brand|213621-Bacitracin0.5UNT/MG/PolymyxinB10UNT/MGOphthalmicOintment[Polycin]|CHILD 2020 632|1001|N|N|N||Preferred Generic|897722-Verapamilhydrochloride40MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1923338-1.14MLsarilumab132MG/MLPrefilledSyringe[Kevzara]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|200311-Fenofibrate67MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|863636-24HROxybutyninchloride5MGExtendedReleaseOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|993470-midodrinehydrochloride5MGOralTablet|CHILD 2020 632|1001|N|Y|N||Preferred Generic|997406-12HRFexofenadinehydrochloride60MG/PseudoephedrineHydrochloride120MGExtendedReleaseOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|197382-Atenolol100MG/Chlorthalidone25MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|313919-salmoncalcitonin200UNT/ACTUATNasalSpray|CHILD 2020 632|1001|N|Y|Y||Preferred Generic|606726-Esomeprazole20MGDelayedReleaseOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|309290-ciclopirox7.7MG/MLTopicalLotion|CHILD 2020 632|1001|N|N|Y||Preferred Generic|991528-DextromethorphanHydrobromide3MG/ML/PromethazineHydrochloride1.25MG/MLOralSolution|CHILD 2020 632|1001|N|N|N||Preferred Generic|855344-WarfarinSodium7.5MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|312750-quinapril5MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|1000114-medroxyprogesteroneacetate10MGOralTablet|CHILD 2020 632|1001|N|Y|N||Preferred Generic|996615-24HRMemantinehydrochloride7MGExtendedReleaseOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|310154-Erythromycin250MGDelayedReleaseOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|312749-quinapril20MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|904589-SotalolHydrochloride240MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|197931-mercaptopurine50MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|284184-Didanosine250MGDelayedReleaseOralCapsule|CHILD 2020 632|1001|Y|N|N||Preferred Brand|226917-orlistat120MGOralCapsule[Xenical]|CHILD 2020 632|1001|Y|N|N||Preferred Generic|1307427-sildenafil10MG/MLOralSuspension|CHILD 2020 632|1001|Y|N|N||Preferred Brand|810002-lacosamide50MGOralTablet[Vimpat]|CHILD 2020 632|1001|N|N|N||Preferred Generic|198211-Simvastatin40MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|312635-Prochlorperazine5MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|856578-PropranololHydrochloride80MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|899518-dexmethylphenidatehydrochloride5MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|308416-Aspirin81MGDelayedReleaseOralTablet|CHILD 2020 632|1001|N|Y|N||Preferred Generic|403851-Carbidopa25MG/entacapone200MG/Levodopa100MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|1547561-Isotretinoin25MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|241834-cyclosporine,modified100MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|1190655-AtropineSulfate10MG/MLOphthalmicSolution|CHILD 2020 632|1001|N|N|N||Preferred Generic|312594-Prazosin2MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|239191-Amoxicillin50MG/MLOralSuspension|CHILD 2020 632|1001|N|N|Y||Preferred Generic|897618-24HRVerapamilhydrochloride180MGExtendedReleaseOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|308459-Azithromycin20MG/MLOralSuspension|CHILD 2020 632|1001|N|N|N||Preferred Generic|1000076-DoxepinHydrochloride50MGOralCapsule|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1375922-bromfenac0.7MG/MLOphthalmicSolution[Prolensa]|CHILD 2020 632|1001|N|N|N||Preferred Generic|197581-Dexamethasone2MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Brand|1547672-30ACTUATfluticasonefuroate0.2MG/ACTUATDryPowderInhaler[Arnuity]|CHILD 2020 632|1001|N|N|N||Preferred Brand|213291-ParoxetineHydrochloride2MG/MLOralSuspension[Paxil]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|892625-MorphineSulfate20MG/MLOralSolution|CHILD 2020 632|1001|N|N|N||Preferred Generic|897624-24HRVerapamilhydrochloride240MGExtendedReleaseOralCapsule|CHILD 2020 632|1001|Y|N|N||Preferred Generic|1547565-Isotretinoin35MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Brand|1359027-MicrogestinFe1.5/3028DayPack|CHILD 2020 632|1001|N|N|N||Preferred Brand|1039273-Hydrocortisone10MG/MLTopicalSolution[ScalpicinItchRelief]|CHILD 2020 632|1001|N|N|N||Preferred Generic|312441-pioglitazone45MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|1000070-DoxepinHydrochloride25MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|310982-imiquimod50MG/MLTopicalCream|CHILD 2020 632|1001|N|N|N||Preferred Generic|105585-Methotrexate2.5MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|863559-valganciclovir50MG/MLOralSolution|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1654955-1MLdarbepoetinalfa0.2MG/MLInjection[Aranesp]|CHILD 2020 632|1001|N|N|Y||Preferred Brand|731281-InsulinLispro50UNT/ML/insulinlisproprotamine,human50UNT/MLInjectableSuspension[HumalogMix]|CHILD 2020 632|1001|N|N|N||Preferred Generic|866018-buspironehydrochloride15MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|197739-Glycopyrrolate2MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|310379-Fluorouracil20MG/MLTopicalSolution|CHILD 2020 632|1001|N|N|N||Preferred Generic|197684-Etodolac200MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Brand|896019-60ACTUATFluticasonepropionate0.05MG/ACTUATDryPowderInhaler[Flovent]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1923347-1.14MLsarilumab175MG/MLPrefilledSyringe[Kevzara]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|861232-24HRAmphetamineaspartate7.5MG/AmphetamineSulfate7.5MG/Dextroamphetaminesaccharate7.5MG/DextroamphetamineSulfate7.5MGEx|CHILD 2020 632|1001|N|N|N||Preferred Generic|317769-Theophylline300MGExtendedReleaseOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|205912-EpoetinAlfa10000UNT/MLInjectableSolution[Epogen]|CHILD 2020 632|1001|Y|N|N||Preferred Generic|864769-MethadoneHydrochloride2MG/MLOralSolution|CHILD 2020 632|1001|N|N|N||Preferred Generic|898353-Amlodipine5MG/Benazeprilhydrochloride10MGOralCapsule|CHILD 2020 632|1001|N|N|Y||Preferred Generic|197877-Lidocaine25MG/ML/Prilocaine25MG/MLTopicalCream|CHILD 2020 632|1001|N|N|N||Preferred Generic|197575-Desoximetasone0.0025MG/MGTopicalOintment|CHILD 2020 632|1001|N|N|N||Preferred Generic|312137-oxcarbazepine300MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|857005-Acetaminophen325MG/HydrocodoneBitartrate7.5MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Brand|1549683-Xarelto30-DayStarterPackKit|CHILD 2020 632|1001|N|N|N||Preferred Generic|308979-Carbamazepine200MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|809998-lacosamide200MGOralTablet[Vimpat]|CHILD 2020 632|1001|N|Y|N||Preferred Generic|1368424-alogliptin25MG/pioglitazone15MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1373333-Isotretinoin10MGOralCapsule[Zenatane]|CHILD 2020 632|1001|N|N|Y||Preferred Brand|1300468-0.5MLHaemophilusinfluenzaetypebstrain1482,capsularpolysaccharideinactivatedtetanustoxoidconjugatevaccine0.068MG/MLInj|CHILD 2020 632|1001|N|N|Y||Preferred Generic|854252-1MLEnoxaparinsodium150MG/MLPrefilledSyringe|CHILD 2020 632|1001|N|N|N||Preferred Generic|198202-Rifampin300MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|312013-Nitroglycerin2.5MGExtendedReleaseOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|311995-NITROFURANTOIN,MACROCRYSTALS50MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|197518-Clindamycin150MGOralCapsule|CHILD 2020 632|1001|N|N|Y||Preferred Generic|854235-0.4MLEnoxaparinsodium100MG/MLPrefilledSyringe|CHILD 2020 632|1001|N|N|N||Preferred Brand|213283-hydroxyurea300MGOralCapsule[Droxia]|CHILD 2020 632|1001|N|N|N||Preferred Generic|903697-liothyroninesodium0.025MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|311994-NITROFURANTOIN,MACROCRYSTALS25MGOralCapsule|CHILD 2020 632|1001|N|N|Y||Preferred Generic|847252-3MLInsulinLispro25UNT/ML/insulinlisproprotamine,human75UNT/MLPenInjector|CHILD 2020 632|1001|N|N|N||Preferred Generic|1245919-Marlissa28DayPack|CHILD 2020 632|1001|N|N|Y||Preferred Generic|835829-testosteronecypionate100MG/MLInjectableSolution|CHILD 2020 632|1001|N|N|N||Preferred Generic|1000048-DoxepinHydrochloride10MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|835925-cyclosporine,modified50MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Brand|1373327-amylase180000UNT/lipase36000UNT/protease114000UNTDelayedReleaseOralCapsule[Creon]|CHILD 2020 632|1001|N|N|N||Preferred Generic|197516-Clarithromycin250MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|205323-celecoxib200MGOralCapsule|CHILD 2020 632|1001|Y|N|N||Preferred Generic|900164-24HRlamotrigine25MGExtendedReleaseOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|201747-Primidone250MGOralTablet[Mysoline]|CHILD 2020 632|1001|N|N|N||Preferred Generic|310384-Fluoxetine10MGOralCapsule|CHILD 2020 632|1001|N|N|Y||Preferred Generic|866042-NeomycinSulfate500MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|859747-Rosuvastatincalcium10MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1364362-ponatinib45MGOralTablet[Iclusig]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1729013-selexipag1MGOralTablet[Uptravi]|CHILD 2020 632|1001|N|N|N||Preferred Generic|197313-Acyclovir800MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2058887-1MLgalcanezumab-gnlm120MG/MLPrefilledSyringe[Emgality]|CHILD 2020 632|1001|N|N|N||Preferred Brand|856467-Tri-Lo-Sprintec28DayPack|CHILD 2020 632|1001|N|N|N||Preferred Generic|198378-Tacrolimus5MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|310385-Fluoxetine20MGOralCapsule|CHILD 2020 632|1001|Y|N|N||Preferred Generic|876519-Amlodipine10MG/telmisartan80MGOralTablet|CHILD 2020 632|1001|Y|N|Y||Preferred Generic|892646-MorphineSulfate200MGExtendedReleaseOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|485489-Temazepam22.5MGOralCapsule|CHILD 2020 632|1001|N|Y|N||Preferred Generic|857564-24HRtrospiumchloride60MGExtendedReleaseOralCapsule|CHILD 2020 632|1001|N|Y|N||Preferred Generic|1855389-Levalbuterol2.5MG/MLInhalationSolution|CHILD 2020 632|1001|N|N|Y||Preferred Brand|797641-0.5MLNeisseriameningitidisserogroupAcapsularpolysaccharidediphtheriatoxoidproteinconjugatevaccine0.104MG/ML/Neisseriam|CHILD 2020 632|1001|N|N|N||Preferred Generic|197379-Atenolol100MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|308191-Amoxicillin500MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|308694-BenzoylPeroxide0.05MG/MGTopicalGel|CHILD 2020 632|1001|N|N|N||Preferred Generic|284988-Didanosine400MGDelayedReleaseOralCapsule|CHILD 2020 632|1001|N|N|Y||Preferred Generic|485465-Eszopiclone3MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|152854-Itraconazole10MG/MLOralSolution[Sporanox]|CHILD 2020 632|1001|N|N|Y||Preferred Brand|795735-ChantixContinuingMonthsOfTherapy1MGPack|CHILD 2020 632|1001|N|N|Y||Preferred Brand|1601407-0.5MLmeningococcalgroupBvaccine0.1MG/ML/NeisseriameningitidisserogroupBrecombinantFHBPfusionproteinantigen0.1MG/ML/Ne|CHILD 2020 632|1001|N|N|Y||Preferred Generic|1550940-Colchicine0.6MGOralCapsule|CHILD 2020 632|1001|N|N|Y||Preferred Generic|197902-Lorazepam2MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|999986-Amlodipine10MG/Hydrochlorothiazide12.5MG/Olmesartanmedoxomil40MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|2561270-0.5MLinfluenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.03MG/|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1364358-ponatinib15MGOralTablet[Iclusig]|CHILD 2020 632|1001|N|N|Y||Preferred Brand|1656346-sacubitril24MG/valsartan26MGOralTablet[Entresto]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1729053-selexipag0.2MGOralTablet[Uptravi]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|310467-Gentamicin3MG/MLOphthalmicSolution|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1921240-0.8MLadalimumab100MG/MLAuto-Injector[Humira]|CHILD 2020 632|1001|Y|N|N||Preferred Generic|1597129-5000MGTestosterone0.01MG/MGTopicalGel|CHILD 2020 632|1001|Y|N|N||Preferred Generic|197696-72HRFentanyl0.075MG/HRTransdermalSystem|CHILD 2020 632|1001|N|N|N||Preferred Generic|308725-bexarotene75MGOralCapsule|CHILD 2020 632|1001|N|N|Y||Preferred Brand|1656351-sacubitril49MG/valsartan51MGOralTablet[Entresto]|CHILD 2020 632|1001|N|N|N||Preferred Generic|898723-Benazeprilhydrochloride5MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|763181-{21(Prednisone5MGOralTablet)}Pack|CHILD 2020 632|1001|N|N|N||Preferred Brand|212039-Estrogens,Esterified(USP)0.3MGOralTablet[Menest]|CHILD 2020 632|1001|N|N|N||Preferred Generic|310490-Glipizide5MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|206314-Hydrocortisone0.01MG/MGTopicalOintment[Cortizone]|CHILD 2020 632|1001|N|N|N||Preferred Generic|198047-Nortriptyline75MGOralCapsule|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2057216-0.8MLfilgrastim-aafi0.6MG/MLPrefilledSyringe[Nivestym]|CHILD 2020 632|1001|N|N|N||Preferred Generic|855296-WarfarinSodium10MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|859424-Rosuvastatincalcium5MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|240912-Granisetron1MG/MLInjectableSolution|CHILD 2020 632|1001|N|N|N||Preferred Generic|307718-Acetylcysteine100MG/MLInhalationSolution|CHILD 2020 632|1001|N|N|N||Preferred Generic|313565-valacyclovir500MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|308189-Amoxicillin80MG/MLOralSuspension|CHILD 2020 632|1001|N|N|Y||Preferred Brand|630981-PolyvinylAlcohol27MG/ML/Povidone20MG/MLOphthalmicSolution[Freshkote]|CHILD 2020 632|1001|N|N|N||Preferred Brand|864010-ammoniumlactate120MG/MLTopicalLotion[Geri-Hydrolac]|CHILD 2020 632|1001|N|N|N||Preferred Brand|896031-28ACTUATFluticasonepropionate0.1MG/ACTUATDryPowderInhaler[Flovent]|CHILD 2020 632|1001|N|N|N||Preferred Generic|702519-Phenobarbital4MG/MLOralSolution|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1650282-RebifRebidoseTitrationPack|CHILD 2020 632|1001|N|N|N||Preferred Generic|312440-pioglitazone30MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|724861-armodafinil250MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|836645-Zolpidemtartrate10MGSublingualTablet[Edluar]|CHILD 2020 632|1001|N|N|N||Preferred Generic|1191310-FluocinoloneAcetonide0.1MG/MLTopicalSolution|CHILD 2020 632|1001|N|N|Y||Preferred Generic|203088-Ketoconazole20MG/MLTopicalCream|CHILD 2020 632|1001|Y|N|N||Preferred Generic|1119400-everolimus7.5MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|313564-valacyclovir1000MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|836649-Zolpidemtartrate5MGSublingualTablet[Edluar]|CHILD 2020 632|1001|N|N|N||Preferred Brand|751871-Nortrel1/3521DayPack|CHILD 2020 632|1001|N|N|N||Preferred Generic|307719-Acetylcysteine200MG/MLInhalationSolution|CHILD 2020 632|1001|N|N|Y||Preferred Generic|313571-Vancomycin250MGOralCapsule|CHILD 2020 632|1001|N|N|Y||Preferred Brand|1658102-1MLhepatitisAvirusstrainCR326Fantigen,inactivated50UNT/MLInjection[Vaqta]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2047623-1MLepoetinalfa-epbx40000UNT/MLInjection[Retacrit]|CHILD 2020 632|1001|N|N|N||Preferred Generic|310536-Glyburide3MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|310430-gabapentin100MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Brand|1000158-0.65MLmedroxyprogesteroneacetate160MG/MLPrefilledSyringe[depo-subQprovera]|CHILD 2020 632|1001|N|N|N||Preferred Generic|198181-Pyrazinamide500MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|403884-Levetiracetam100MG/MLOralSolution|CHILD 2020 632|1001|N|Y|N||Preferred Generic|855194-tolterodinetartrate2MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|152695-meloxicam15MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|995868-CodeinePhosphate2MG/ML/Guaifenesin20MG/MLOralSolution|CHILD 2020 632|1001|N|N|Y||Preferred Generic|996757-CodeinePhosphate2MG/ML/PhenylephrineHydrochloride1MG/ML/PromethazineHydrochloride1.25MG/MLOralSolution|CHILD 2020 632|1001|N|N|N||Preferred Generic|309952-Dipyridamole25MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|828348-Cyclobenzaprinehydrochloride10MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|313581-24HRvenlafaxine150MGExtendedReleaseOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|197391-Baclofen10MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|308891-CalciumCarbonate250MG/MLOralSuspension|CHILD 2020 632|1001|N|N|N||Preferred Generic|200346-cefdinir300MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Brand|905379-HydralazineHydrochloride37.5MG/IsosorbideDinitrate20MGOralTablet[Bidil]|CHILD 2020 632|1001|N|N|N||Preferred Brand|1113046-amylase15000UNT/lipase3000UNT/protease9500UNTDelayedReleaseOralCapsule[Creon]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|310289-Fenofibrate200MGOralCapsule|CHILD 2020 632|1001|N|N|Y||Preferred Generic|596934-duloxetine60MGDelayedReleaseOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|240029-Cholecalciferol0.125MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|328161-Methylprednisolone16MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|876193-POLYETHYLENEGLYCOL335017000MGPowderforOralSolution|CHILD 2020 632|1001|N|N|N||Preferred Brand|896001-120ACTUATFluticasonepropionate0.11MG/ACTUATMeteredDoseInhaler[Flovent]|CHILD 2020 632|1001|N|N|N||Preferred Brand|1440936-Hydrocortisone25MG/MLTopicalCream[ProctozoneHC]|CHILD 2020 632|1001|N|N|N||Preferred Generic|200257-repaglinide0.5MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Brand|1658472-0.5MLStreptococcuspneumoniaetype1capsularpolysaccharideantigen0.05MG/ML/Streptococcuspneumoniaetype10Acapsularpolysac|CHILD 2020 632|1001|N|N|N||Preferred Generic|308696-BenzoylPeroxide50MG/MLMedicatedLiquidSoap|CHILD 2020 632|1001|N|N|N||Preferred Generic|884173-ClonidineHydrochloride0.1MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|313209-temozolomide20MGOralCapsule|CHILD 2020 632|1001|Y|N|N||Preferred Generic|1793916-0.5MLSumatriptan8MG/MLAuto-Injector|CHILD 2020 632|1001|N|N|N||Preferred Generic|884185-ClonidineHydrochloride0.2MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|1607792-deferasirox360MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|351487-thyroid(USP)130MGOralTablet[Westhroid]|CHILD 2020 632|1001|N|N|N||Preferred Generic|310797-Hydrochlorothiazide12.5MG/quinapril20MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1310138-everolimus2MGTabletforOralSuspension[Afinitor]|CHILD 2020 632|1001|N|N|N||Preferred Brand|866049-60ACTUATsalmeterol0.05MG/ACTUATDryPowderInhaler[Serevent]|CHILD 2020 632|1001|N|N|N||Preferred Generic|308135-Amlodipine10MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2053519-ivacaftor188MG/lumacaftor150MGOralGranules[ORKAMBI]|CHILD 2020 632|1001|Y|N|N||Preferred Generic|1796690-1MLhydroxyprogesteronecaproate(USP)250MG/MLInjection|CHILD 2020 632|1001|Y|N|N||Preferred Generic|402506-12HRCarbamazepine400MGExtendedReleaseOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|992432-PromethazineHydrochloride1.25MG/MLOralSolution|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1945048-30ACTUATfluticasonefuroate0.1MG/ACTUAT/umeclidinium0.0625MG/ACTUAT/vilanterol0.025MG/ACTUATDryPowderInhaler[Trelegy]|CHILD 2020 632|1001|Y|N|N||Preferred Generic|1607796-deferasirox90MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|836358-IpratropiumBromide0.2MG/MLInhalationSolution|CHILD 2020 632|1001|N|N|N||Preferred Brand|1000499-Prempro0.625/2.528DayPack|CHILD 2020 632|1001|N|N|N||Preferred Generic|311289-Levetiracetam500MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Brand|1731317-3MLinsulin,regular,human500UNT/MLPenInjector[HumulinR]|CHILD 2020 632|1001|N|N|N||Preferred Generic|801054-POLYETHYLENEGLYCOL3350420000MG/PotassiumChloride1480MG/SodiumBicarbonate5720MG/SodiumChloride11200MGPowderforOralSolut|CHILD 2020 632|1001|N|N|N||Preferred Generic|979492-LosartanPotassium50MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|308136-Amlodipine2.5MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|309273-cholinesalicylate58.6MG/ML/MagnesiumSalicylate72.4MG/MLOralSolution|CHILD 2020 632|1001|N|N|N||Preferred Generic|1946772-Methotrexate25MG/MLInjectableSolution|CHILD 2020 632|1001|Y|N|N||Preferred Generic|1860137-Abuse-Deterrent12HROxycodoneHydrochloride40MGExtendedReleaseOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|197362-ammoniumlactate120MG/MLTopicalLotion|CHILD 2020 632|1001|N|N|Y||Preferred Brand|804186-0.5MLMeaslesVirusVaccineLive,Enders'attenuatedEdmonstonstrain2000UNT/ML/MumpsVirusVaccineLive,JerylLynnStrain25000UNT/|CHILD 2020 632|1001|N|N|N||Preferred Generic|198175-Propylthiouracil50MGOralTablet|CHILD 2020 632|1001|N|Y|N||Preferred Generic|197506-Cimetidine300MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|309370-Clotrimazole10MG/MLTopicalSolution|CHILD 2020 632|1001|N|Y|N||Preferred Generic|242831-Griseofulvin125MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|864718-MethadoneHydrochloride5MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Brand|1736863-3MLInsulinGlargine100UNT/MLPenInjector[Basaglar]|CHILD 2020 632|1001|N|N|N||Preferred Generic|1099870-DivalproexSodium500MGDelayedReleaseOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|876514-Amlodipine10MG/telmisartan40MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|799830-dasatinib100MGOralTablet[Sprycel]|CHILD 2020 632|1001|N|N|N||Preferred Generic|884707-Estradiol0.01MGVaginalInsert|CHILD 2020 632|1001|N|N|Y||Preferred Generic|309307-Ciprofloxacin3MG/MLOphthalmicSolution|CHILD 2020 632|1001|N|N|Y||Preferred Generic|349591-atomoxetine10MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Brand|753543-Reclipsen28DayPack|CHILD 2020 632|1001|N|N|N||Preferred Generic|308177-Amoxicillin125MGChewableTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|197737-Glyburide1.25MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|1190570-AtropineSulfate0.01MG/MGOphthalmicOintment|CHILD 2020 632|1001|N|N|Y||Preferred Brand|1658060-1MLHepatitisAVaccine(Inactivated)StrainHM1751440UNT/MLInjection[Havrix]|CHILD 2020 632|1001|N|N|N||Preferred Brand|1101778-Monobasicpotassiumphosphate0.0408MEQ/MLOralSolution[K-Phos]|CHILD 2020 632|1001|N|Y|N||Preferred Generic|1368034-alogliptin12.5MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|831103-DiltiazemHydrochloride60MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|310488-Glipizide10MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|1860157-Abuse-Deterrent12HROxycodoneHydrochloride10MGExtendedReleaseOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|996572-{21(Memantinehydrochloride10MGOralTablet)/28(Memantinehydrochloride5MGOralTablet)}Pack|CHILD 2020 632|1001|Y|N|N||Preferred Brand|723846-orlistat60MGOralCapsule[Alli]|CHILD 2020 632|1001|N|N|N||Preferred Generic|859751-Rosuvastatincalcium20MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|992481-PromethazineHydrochloride50MGRectalSuppository[Promethegan]|CHILD 2020 632|1001|N|N|N||Preferred Brand|762663-Jolessa91DayPack|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1812470-ivacaftor125MG/lumacaftor100MGOralTablet[ORKAMBI]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|259081-12HRAspirin25MG/Dipyridamole200MGExtendedReleaseOralCapsule|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2047602-1MLepoetinalfa-epbx2000UNT/MLInjection[Retacrit]|CHILD 2020 632|1001|N|N|N||Preferred Generic|995632-MeclizineHydrochloride25MGChewableTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|1860127-Abuse-Deterrent12HROxycodoneHydrochloride60MGExtendedReleaseOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|854905-BisoprololFumarate5MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|1860129-Abuse-Deterrent12HROxycodoneHydrochloride20MGExtendedReleaseOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|746609-nilotinib200MGOralCapsule[Tasigna]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|310191-estradiolvalerate40MG/MLInjectableSolution|CHILD 2020 632|1001|N|N|Y||Preferred Brand|351429-24HRNicotine0.875MG/HRTransdermalSystem[NicodermC-Q]|CHILD 2020 632|1001|N|N|N||Preferred Generic|197392-Baclofen20MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|199888-topiramate25MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|308182-Amoxicillin250MGOralCapsule|CHILD 2020 632|1001|N|N|Y||Preferred Brand|803371-1MLHepatitisAVaccine(Inactivated)StrainHM175720UNT/ML/HepatitisBSurfaceAntigenVaccine0.02MG/MLPrefilledSyringe[Twinrix|CHILD 2020 632|1001|Y|N|N||Preferred Generic|1098608-24HRlamotrigine300MGExtendedReleaseOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|310149-Erythromycin0.005MG/MGOphthalmicOintment|CHILD 2020 632|1001|N|N|N||Preferred Brand|205669-Dexamethasone1MG/MLOphthalmicSuspension[Maxidex]|CHILD 2020 632|1001|N|N|N||Preferred Generic|886666-FlecainideAcetate100MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|1298091-FlurazepamHydrochloride30MGOralCapsule|CHILD 2020 632|1001|N|N|Y||Preferred Brand|762602-SalmonellatyphiTy21aliveantigen2000000000UNTDelayedReleaseOralCapsule[Vivotif]|CHILD 2020 632|1001|N|N|N||Preferred Generic|308976-Carbamazepine20MG/MLOralSuspension|CHILD 2020 632|1001|N|N|N||Preferred Generic|1738495-ParoxetineHydrochloride20MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|197361-Amlodipine5MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|349434-voriconazole200MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2475852-vericiguat10MGOralTablet[Verquvo]|CHILD 2020 632|1001|N|N|N||Preferred Generic|1724437-thyroid(USP)90MGOralTablet[NPThyroid]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1593831-24HRdapagliflozin5MG/Metforminhydrochloride500MGExtendedReleaseOralTablet[Xigduo]|CHILD 2020 632|1001|N|N|N||Preferred Generic|859419-Rosuvastatincalcium40MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|312087-Ondansetron8MGDisintegratingOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Brand|1992428-Eliquis30-DayStarterPack|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1310147-everolimus5MGTabletforOralSuspension[Afinitor]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|310152-Erythromycin0.02MG/MGTopicalGel|CHILD 2020 632|1001|N|N|N||Preferred Generic|858810-EnalaprilMaleate20MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1868016-pirfenidone267MGOralTablet[Esbriet]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|706872-Azithromycin10MG/MLOphthalmicSolution[AzaSite]|CHILD 2020 632|1001|N|N|N||Preferred Brand|630475-SodiumFluoride5.56MG/MLOralSolution[FluoraDay]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|318202-Erythromycin20MG/MLTopicalSolution|CHILD 2020 632|1001|Y|N|N||Preferred Generic|1923828-deferasirox180MGOralGranules|CHILD 2020 632|1001|N|N|N||Preferred Generic|886671-FlecainideAcetate150MGOralTablet|CHILD 2020 632|1001|N|Y|N||Preferred Generic|242754-Levalbuterol0.417MG/MLInhalationSolution|CHILD 2020 632|1001|N|N|Y||Preferred Generic|485486-tizanidine2MGOralCapsule|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2475406-voclosporin7.9MGOralCapsule[Lupkynis]|CHILD 2020 632|1001|N|N|N||Preferred Generic|847121-CalciumCitrate1500MG/Cholecalciferol250UNTOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|197746-Guanfacine2MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|314209-rizatriptan10MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|825170-HumiraPen40MG/0.8ML-Crohn'sDiseaseStarterPack|CHILD 2020 632|1001|N|N|Y||Preferred Brand|1300206-0.5MLBordetellapertussisfilamentoushemagglutininvaccine,inactivated0.01MG/ML/Bordetellapertussisfimbriae2/3vaccine,in|CHILD 2020 632|1001|N|Y|N||Preferred Generic|310600-Griseofulvin500MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|890786-Butoconazolenitrate20MG/MLVaginalCream[Gynazole-1]|CHILD 2020 632|1001|N|N|N||Preferred Generic|577040-CalciumCarbonate648MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|197310-Acyclovir200MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|310432-gabapentin400MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|310015-dorzolamide20MG/MLOphthalmicSolution|CHILD 2020 632|1001|N|Y|N||Preferred Generic|855182-24HRtolterodinetartrate2MGExtendedReleaseOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Brand|2564021-0.5MLinfluenzaAvirusA/Cambodia/e0826360/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.|CHILD 2020 632|1001|N|N|Y||Preferred Brand|351427-24HRNicotine0.583MG/HRTransdermalSystem[NicodermC-Q]|CHILD 2020 632|1001|Y|N|N||Preferred Generic|197730-Furosemide10MG/MLOralSolution|CHILD 2020 632|1001|N|N|N||Preferred Generic|833528-Amiodaronehydrochloride200MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|1099026-Loryna28DayPack|CHILD 2020 632|1001|N|N|Y||Preferred Generic|1543069-Lidocaine0.05MG/MGTopicalOintment|CHILD 2020 632|1001|Y|N|N||Preferred Generic|1874559-24HRdesvenlafaxinesuccinate50MGExtendedReleaseOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|311376-Lorazepam2MG/MLOralSolution|CHILD 2020 632|1001|Y|N|N||Preferred Generic|1745091-Lidocaine0.05MG/MGMedicatedPatch|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1011755-aliskiren300MG/Hydrochlorothiazide25MGOralTablet[TekturnaHCT]|CHILD 2020 632|1001|N|N|N||Preferred Brand|2561275-0.5MLinfluenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.03MG/|CHILD 2020 632|1001|N|N|N||Preferred Generic|1738503-ParoxetineHydrochloride30MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Brand|999965-Glycopyrrolate0.2MG/MLOralSolution[Cuvposa]|CHILD 2020 632|1001|N|N|N||Preferred Generic|1731350-deferoxaminemesylate500MGInjection|CHILD 2020 632|1001|N|N|N||Preferred Generic|283485-Mirtazapine45MGDisintegratingOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|834040-PenicillinVPotassium50MG/MLOralSolution|CHILD 2020 632|1001|N|N|N||Preferred Generic|898359-Amlodipine5MG/Benazeprilhydrochloride40MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Brand|206961-Nadolol20MGOralTablet[Corgard]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1870960-deflazacort36MGOralTablet[Emflaza]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|1806197-30/70Release24HRMethylphenidateHydrochloride60MGExtendedReleaseOralCapsule|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2047608-1MLepoetinalfa-epbx3000UNT/MLInjection[Retacrit]|CHILD 2020 632|1001|Y|N|N||Preferred Generic|900156-24HRlamotrigine200MGExtendedReleaseOralTablet|CHILD 2020 632|1001|N|Y|N||Preferred Generic|686429-mesalamine1200MGDelayedReleaseOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|197845-Isotretinoin40MGOralCapsule|CHILD 2020 632|1001|Y|N|N||Preferred Generic|1657173-0.5MLSumatriptan8MG/MLCartridge|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1729076-UptraviTitrationPack|CHILD 2020 632|1001|N|N|N||Preferred Generic|854801-DiclofenacSodium1MG/MLOphthalmicSolution|CHILD 2020 632|1001|Y|N|N||Preferred Generic|998189-everolimus2.5MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|309054-cefdinir25MG/MLOralSuspension|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1990869-0.85MLexenatide2.35MG/MLAuto-Injector[Bydureon]|CHILD 2020 632|1001|Y|N|N||Preferred Generic|198070-Penicillamine250MGOralCapsule|CHILD 2020 632|1001|N|N|Y||Preferred Brand|311036-insulin,regular,human100UNT/MLInjectableSolution[HumulinR]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|197541-Colchicine0.6MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1746898-10MLreslizumab10MG/MLInjection[Cinqair]|CHILD 2020 632|1001|N|N|N||Preferred Generic|197903-Lovastatin10MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|197591-Diazepam5MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|1011739-aliskiren300MGOralTablet|CHILD 2020 632|1001|N|Y|N||Preferred Brand|1991311-0.25MG,0.5MGDose1.5MLsemaglutide1.34MG/MLPenInjector[Ozempic]|CHILD 2020 632|1001|N|N|N||Preferred Generic|242590-ferrousgluconate240MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|895487-Fluticasonepropionate0.00005MG/MGTopicalOintment|CHILD 2020 632|1001|N|N|N||Preferred Generic|476576-cefdinir50MG/MLOralSuspension|CHILD 2020 632|1001|N|N|Y||Preferred Brand|2047639-sodiumzirconiumcyclosilicate5000MGPowderforOralSuspension[Lokelma]|CHILD 2020 632|1001|N|N|N||Preferred Brand|1359134-TiliaFe28DayPack|CHILD 2020 632|1001|N|N|N||Preferred Generic|1094104-Phenazopyridinehydrochloride200MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|898715-pregabalin20MG/MLOralSolution|CHILD 2020 632|1001|N|N|Y||Preferred Generic|241946-84HREstradiol0.00156MG/HRTransdermalSystem|CHILD 2020 632|1001|N|Y|N||Preferred Brand|833149-Milnacipranhydrochloride25MGOralTablet[Savella]|CHILD 2020 632|1001|Y|N|N||Preferred Generic|1988977-24HRpregabalin330MGExtendedReleaseOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|852913-QuinidineSulfate300MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|308078-AluminumHydroxide64MG/MLOralSuspension|CHILD 2020 632|1001|N|N|N||Preferred Generic|895987-Fluticasonepropionate0.5MG/MLTopicalCream|CHILD 2020 632|1001|N|N|N||Preferred Brand|2110516-60ACTUATFluticasonepropionate0.5MG/ACTUAT/salmeterol0.05MG/ACTUATDryPowderInhaler[Wixela]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2047596-1MLepoetinalfa-epbx10000UNT/MLInjection[Retacrit]|CHILD 2020 632|1001|Y|N|N||Preferred Generic|310599-Granisetron1MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|897666-Verapamilhydrochloride120MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|854248-1MLEnoxaparinsodium100MG/MLPrefilledSyringe|CHILD 2020 632|1001|Y|N|N||Preferred Generic|1988980-24HRpregabalin82.5MGExtendedReleaseOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|668606-Vorinostat100MGOralCapsule[Zolinza]|CHILD 2020 632|1001|N|N|N||Preferred Generic|1659263-1MLheparinsodium,porcine5000UNT/MLInjection|CHILD 2020 632|1001|N|N|Y||Preferred Generic|349196-Clonazepam1MGDisintegratingOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Brand|798479-1MLHepatitisAVaccine(Inactivated)StrainHM1751440UNT/MLPrefilledSyringe[Havrix]|CHILD 2020 632|1001|Y|N|N||Preferred Generic|1657160-0.5MLSumatriptan12MG/MLCartridge|CHILD 2020 632|1001|N|Y|N||Preferred Generic|349556-ezetimibe10MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|1599949-60ACTUATTestosterone30MG/ACTUATTopicalSolution|CHILD 2020 632|1001|N|N|N||Preferred Brand|750243-Ogestrel28DayPack|CHILD 2020 632|1001|Y|N|N||Preferred Brand|860898-Vigabatrin500MGPowderforOralSolution[Sabril]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|313570-Vancomycin125MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|198153-Colchicine0.5MG/Probenecid500MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|1234571-PhenylephrineHydrochloride100MG/MLOphthalmicSolution|CHILD 2020 632|1001|N|N|N||Preferred Generic|835564-ImipramineHydrochloride25MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|541363-Amphetamineaspartate7.5MG/AmphetamineSulfate7.5MG/Dextroamphetaminesaccharate7.5MG/DextroamphetamineSulfate7.5MGOralTa|CHILD 2020 632|1001|N|N|N||Preferred Generic|198857-Simethicone66.7MG/MLOralSuspension|CHILD 2020 632|1001|N|N|N||Preferred Generic|898690-Benazeprilhydrochloride20MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Brand|311033-insulin,regular,human100UNT/MLInjectableSolution[NovolinR]|CHILD 2020 632|1001|N|N|N||Preferred Generic|314000-Glyburide1.5MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|896758-Labetalolhydrochloride100MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1734642-elbasvir50MG/grazoprevir100MGOralTablet[Zepatier]|CHILD 2020 632|1001|Y|N|N||Preferred Generic|349253-bosentan62.5MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|896762-Labetalolhydrochloride200MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|312940-Sertraline25MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|993518-12HRBupropionHydrochloride150MGExtendedReleaseOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|197732-Furosemide80MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1300803-24HRmirabegron50MGExtendedReleaseOralTablet[Myrbetriq]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|845488-Ramipril1.25MGOralCapsule|CHILD 2020 632|1001|Y|N|N||Preferred Generic|1299911-Tiagabinehydrochloride2MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|312059-Nystatin500000UNTOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|310796-Hydrochlorothiazide12.5MG/quinapril10MGOralTablet|CHILD 2020 632|1001|N|Y|N||Preferred Generic|810090-Carbidopa18.75MG/entacapone200MG/Levodopa75MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|197590-Diazepam2MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|1359779-Fluticasonepropionate0.1MG/ACTUAT/salmeterol0.05MG/ACTUATDryPowderInhaler|CHILD 2020 632|1001|N|N|N||Preferred Brand|404475-Azathioprine75MGOralTablet[Azasan]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2045959-Doptelet40MGDailyDoseCartonPack|CHILD 2020 632|1001|Y|N|N||Preferred Generic|245134-72HRFentanyl0.025MG/HRTransdermalSystem|CHILD 2020 632|1001|N|N|Y||Preferred Brand|1190916-0.5MLdiphtheriatoxoidvaccine,inactivated4UNT/ML/tetanustoxoidvaccine,inactivated10UNT/MLInjection[Tenivac]|CHILD 2020 632|1001|N|N|N||Preferred Generic|896766-Labetalolhydrochloride300MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|308963-Captopril12.5MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|200328-capecitabine500MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|310364-Fluocinonide0.5MG/MLTopicalSolution|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1855527-HumiraPediatricCrohn'sDiseaseStarterPackage(2count)|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2000013-1.1MLhydroxyprogesteronecaproate(USP)250MG/MLAuto-Injector[Makena]|CHILD 2020 632|1001|Y|N|N||Preferred Generic|1607784-deferasirox180MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1921017-0.2MLadalimumab100MG/MLPrefilledSyringe[Humira]|CHILD 2020 632|1001|N|N|N||Preferred Generic|993536-12HRBupropionHydrochloride200MGExtendedReleaseOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|1085686-TriamcinoloneAcetonide5MG/MLTopicalCream|CHILD 2020 632|1001|N|N|N||Preferred Generic|1049906-DiphenhydramineHydrochloride2.5MG/MLOralSolution|CHILD 2020 632|1001|Y|N|N||Preferred Generic|205316-topiramate15MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Brand|2562995-0.5MLinfluenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Washington/19/2020(H1N1)antigen0.03MG/|CHILD 2020 632|1001|N|N|Y||Preferred Generic|104894-Ondansetron4MGDisintegratingOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|978950-Natazia28DayPack|CHILD 2020 632|1001|N|N|N||Preferred Brand|212373-Estrogens,Esterified(USP)1.25MGOralTablet[Menest]|CHILD 2020 632|1001|N|N|N||Preferred Generic|200371-Citalopram20MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|864706-MethadoneHydrochloride10MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|1000487-Premphase28DayPack|CHILD 2020 632|1001|N|N|Y||Preferred Brand|798428-1MLHepatitisBSurfaceAntigenVaccine0.02MG/MLPrefilledSyringe[Engerix-B]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|349194-Clonazepam0.125MGDisintegratingOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|1797851-CromolynSodium5.2MG/ACTUATMeteredDoseNasalSpray|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1989109-1MLbenralizumab30MG/MLPrefilledSyringe[Fasenra]|CHILD 2020 632|1001|N|N|N||Preferred Brand|751875-Necon0.5/3528DayPack|CHILD 2020 632|1001|N|N|Y||Preferred Generic|993770-Acetaminophen300MG/CodeinePhosphate15MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|106387-Permethrin50MG/MLTopicalCream|CHILD 2020 632|1001|N|N|N||Preferred Generic|308962-Captopril100MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|1607617-24HRdesvenlafaxinesuccinate25MGExtendedReleaseOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1921245-HumiraPen80MG/0.8ML-StarterPackageforCrohn'sDisease,UlcerativeColitisorHidradenitisSuppurativa(3count)|CHILD 2020 632|1001|N|N|N||Preferred Generic|197622-Dipyridamole50MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|1242786-Alyacen1/3528-DayKit|CHILD 2020 632|1001|N|N|N||Preferred Brand|2563004-0.7MLinfluenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.0857MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.085|CHILD 2020 632|1001|N|N|Y||Preferred Generic|198317-Triazolam0.125MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|898350-Amlodipine2.5MG/Benazeprilhydrochloride10MGOralCapsule|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1921468-HumiraPen80MG/0.8MLand40MG/0.4ML-Psoriasis/UveitisStarterPackage(3count)|CHILD 2020 632|1001|N|Y|Y||Preferred Generic|483450-pregabalin75MGOralCapsule|CHILD 2020 632|1001|N|N|Y||Preferred Generic|1115698-Oseltamivir6MG/MLOralSuspension|CHILD 2020 632|1001|N|N|N||Preferred Generic|1738483-ParoxetineHydrochloride10MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|849515-DesmopressinAcetate0.1MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|205324-modafinil200MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|197445-Carbidopa25MG/Levodopa250MGOralTablet|CHILD 2020 632|1001|Y|N|Y||Preferred Brand|1292435-0.65MLVaricella-ZosterVirusVaccineLive(Oka-Merck)strain29800UNT/MLInjection[Zostavax]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|309314-Citalopram40MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Brand|1656356-sacubitril97MG/valsartan103MGOralTablet[Entresto]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|809990-lacosamide100MGOralTablet[Vimpat]|CHILD 2020 632|1001|Y|N|N||Preferred Generic|245135-72HRFentanyl0.05MG/HRTransdermalSystem|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2119391-Spravato56MGDoseKit|CHILD 2020 632|1001|N|N|N||Preferred Generic|252732-Melatonin5MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Brand|847213-3MLInsulinLispro50UNT/ML/insulinlisproprotamine,human50UNT/MLPenInjector[HumalogMix]|CHILD 2020 632|1001|N|Y|N||Preferred Generic|749206-sevelamercarbonate800MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|861834-amylase82000UNT/lipase15000UNT/protease51000UNTDelayedReleaseOralCapsule[Zenpep]|CHILD 2020 632|1001|N|N|N||Preferred Generic|197318-Albuterol4MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|245136-72HRFentanyl0.1MG/HRTransdermalSystem|CHILD 2020 632|1001|Y|N|N||Preferred Generic|313211-temozolomide5MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|198152-Probenecid500MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|198759-Niacin100MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|313988-Furosemide40MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|897649-Verapamilhydrochloride240MGExtendedReleaseOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|1098924-SodiumFluoride11MG/MLOralSolution[Flura-Drops]|CHILD 2020 632|1001|N|N|N||Preferred Generic|476809-Mirtazapine7.5MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Brand|213442-insulinisophane,human70UNT/ML/insulin,regular,human30UNT/MLInjectableSuspension[Novolin]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1925255-0.4MLabatacept125MG/MLPrefilledSyringe[Orencia]|CHILD 2020 632|1001|N|N|N||Preferred Generic|200131-12HRCarbamazepine300MGExtendedReleaseOralCapsule|CHILD 2020 632|1001|N|N|Y||Preferred Brand|2360588-0.5MLNeisseriameningitidisserogroupAcapsularpolysaccharidetetanustoxoidproteinconjugatevaccine0.02MG/ML/Neisseriameni|CHILD 2020 632|1001|Y|N|N||Preferred Generic|864978-MethadoneHydrochloride40MGTabletforOralSuspension|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1002300-nilotinib150MGOralCapsule[Tasigna]|CHILD 2020 632|1001|N|N|N||Preferred Generic|313979-fludrocortisoneacetate0.1MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|313210-temozolomide250MGOralCapsule|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1011715-aliskiren150MG/Hydrochlorothiazide25MGOralTablet[TekturnaHCT]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|349199-valsartan80MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|311678-Metronidazole7.5MG/MLTopicalCream|CHILD 2020 632|1001|N|N|N||Preferred Generic|200064-letrozole2.5MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|197943-Methocarbamol500MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|762675-{21(Methylprednisolone4MGOralTablet)}Pack|CHILD 2020 632|1001|N|N|N||Preferred Generic|1359858-Fluticasonepropionate0.5MG/ACTUAT/salmeterol0.05MG/ACTUATDryPowderInhaler|CHILD 2020 632|1001|Y|N|N||Preferred Generic|283317-Hydrochlorothiazide12.5MG/telmisartan80MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|308512-Bacitracin0.5UNT/MG/PolymyxinB10UNT/MGTopicalOintment|CHILD 2020 632|1001|N|Y|N||Preferred Generic|745791-200ACTUATLevalbuterol0.045MG/ACTUATMeteredDoseInhaler|CHILD 2020 632|1001|N|N|N||Preferred Generic|866419-24HRmetoprololsuccinate200MGExtendedReleaseOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Brand|830263-1MLHepatitisBSurfaceAntigenVaccine0.04MG/MLInjection[Recombivax]|CHILD 2020 632|1001|Y|N|N||Preferred Generic|260218-modafinil100MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|198146-Prednisone2.5MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|197818-Indomethacin50MGOralCapsule|CHILD 2020 632|1001|Y|N|N||Preferred Brand|810079-24HRFesoterodineFumarate8MGExtendedReleaseOralTablet[Toviaz]|CHILD 2020 632|1001|N|N|N||Preferred Generic|598006-Erythromycin250MGOralTablet|CHILD 2020 632|1001|Y|N|Y||Preferred Brand|861821-Metforminhydrochloride500MG/sitagliptin50MGOralTablet[Janumet]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|991486-CodeinePhosphate2MG/ML/PromethazineHydrochloride1.25MG/MLOralSolution|CHILD 2020 632|1001|N|N|N||Preferred Generic|199168-Phenobarbital64.8MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1045408-dasatinib80MGOralTablet[Sprycel]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1544398-0.5MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|CHILD 2020 632|1001|N|N|N||Preferred Generic|312845-ropinirole0.25MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|197316-Albuterol2MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|995599-EthambutolHydrochloride100MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|310437-Galantamine8MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|1595473-amylase63000UNT/lipase15000UNT/protease47000UNTDelayedReleaseOralCapsule[Zenpep]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1946520-3-Month1.5MLLeuprolideAcetate20MG/MLPrefilledSyringe[Lupron]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1927290-infliximab-abda100MGInjection[Renflexis]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1091843-Roflumilast0.5MGOralTablet[Daliresp]|CHILD 2020 632|1001|N|N|Y||Preferred Brand|1658106-0.5MLhepatitisAvirusstrainCR326Fantigen,inactivated50UNT/MLInjection[Vaqta]|CHILD 2020 632|1001|N|N|N||Preferred Generic|848176-AugmentedBetamethasone0.5MG/MLTopicalCream|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1999389-symdeko100MG/150MGand150MGPack|CHILD 2020 632|1001|N|N|Y||Preferred Generic|197589-Diazepam10MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|106351-SilverSulfadiazine10MG/MLTopicalCream|CHILD 2020 632|1001|Y|N|N||Preferred Generic|312835-rivastigmine3MGOralCapsule|CHILD 2020 632|1001|N|N|Y||Preferred Generic|242462-cilostazol50MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|197527-Clonazepam0.5MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|313413-tizanidine4MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|208549-thyroid(USP)240MGOralTablet[ArmourThyroid]|CHILD 2020 632|1001|N|N|N||Preferred Generic|1011852-LidocaineHydrochloride0.02MG/MGTopicalGel|CHILD 2020 632|1001|N|N|N||Preferred Generic|848943-CholestyramineResin4000MGPowderforOralSuspension|CHILD 2020 632|1001|N|N|N||Preferred Generic|198148-Prednisone50MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|1006120-SulfacetamideSodium100MG/MLOphthalmicSolution|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1732157-incobotulinumtoxinA50UNTInjection[Xeomin]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1741049-24HRtofacitinib11MGExtendedReleaseOralTablet[Xeljanz]|CHILD 2020 632|1001|N|N|N||Preferred Brand|1422081-Enskyce28DayPack|CHILD 2020 632|1001|N|N|N||Preferred Generic|1655968-8MLMethotrexate25MG/MLInjection|CHILD 2020 632|1001|N|N|N||Preferred Brand|206978-Ketoconazole20MG/MLMedicatedShampoo[Nizoral]|CHILD 2020 632|1001|N|N|N||Preferred Generic|1085640-TriamcinoloneAcetonide0.005MG/MGTopicalOintment|CHILD 2020 632|1001|N|N|N||Preferred Generic|1923432-dorzolamide20MG/ML/Timolol5MG/MLOphthalmicSolution|CHILD 2020 632|1001|N|N|N||Preferred Generic|897584-24HRVerapamilhydrochloride100MGExtendedReleaseOralCapsule|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1663728-Isotretinoin30MGOralCapsule[Myorisan]|CHILD 2020 632|1001|N|Y|N||Preferred Generic|730988-Carbidopa50MG/entacapone200MG/Levodopa200MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|200132-Acarbose25MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|833008-DesmopressinAcetate0.2MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|349094-Budesonide0.125MG/MLInhalationSuspension|CHILD 2020 632|1001|Y|N|N||Preferred Generic|861370-sevelamercarbonate2400MGPowderforOralSuspension|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2001321-Roflumilast0.25MGOralTablet[Daliresp]|CHILD 2020 632|1001|N|N|N||Preferred Generic|313989-Fluoxetine40MGOralCapsule|CHILD 2020 632|1001|N|N|Y||Preferred Brand|795737-ChantixStartingMonthPAK|CHILD 2020 632|1001|Y|N|N||Preferred Generic|577057-72HRFentanyl0.012MG/HRTransdermalSystem|CHILD 2020 632|1001|N|N|N||Preferred Generic|898346-Amlodipine10MG/Benazeprilhydrochloride40MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Brand|209360-Acetaminophen325MGRectalSuppository[Acephen]|CHILD 2020 632|1001|Y|N|N||Preferred Generic|153822-candesartancilexetil4MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|801961-2MLDiazepam5MG/MLRectalGel|CHILD 2020 632|1001|N|N|Y||Preferred Brand|311026-insulinisophane,human100UNT/MLInjectableSuspension[HumulinN]|CHILD 2020 632|1001|Y|N|N||Preferred Generic|1490065-RaloxifeneHydrochloride60MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|313472-Trientinehydrochloride250MGOralCapsule|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2003767-1.14MLsarilumab175MG/MLAuto-Injector[Kevzara]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|1000126-1MLmedroxyprogesteroneacetate150MG/MLInjection|CHILD 2020 632|1001|N|Y|N||Preferred Generic|810083-Carbidopa31.25MG/entacapone200MG/Levodopa125MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|308508-Bacitracin0.5UNT/MGOphthalmicOintment|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2045638-1MLerenumab-aooe70MG/MLAuto-Injector[Aimovig]|CHILD 2020 632|1001|N|N|N||Preferred Brand|705008-Cefixime40MG/MLOralSuspension[Suprax]|CHILD 2020 632|1001|N|N|N||Preferred Generic|1243585-Flurbiprofensodium0.3MG/MLOphthalmicSolution|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1989085-bosentan32MGTabletforOralSuspension[Tracleer]|CHILD 2020 632|1001|N|N|N||Preferred Brand|201338-Nadolol80MGOralTablet[Corgard]|CHILD 2020 632|1001|N|N|N||Preferred Generic|106258-Hydrocortisone10MG/MLTopicalCream|CHILD 2020 632|1001|Y|N|N||Preferred Generic|348719-Tobramycin60MG/MLInhalationSolution|CHILD 2020 632|1001|N|Y|N||Preferred Generic|1246673-Ivermectin5MG/MLTopicalLotion|CHILD 2020 632|1001|N|N|Y||Preferred Generic|1149632-84HREstradiol0.00313MG/HRTransdermalSystem|CHILD 2020 632|1001|N|N|N||Preferred Generic|200133-12HRCarbamazepine200MGExtendedReleaseOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|198201-Rifampin150MGOralCapsule|CHILD 2020 632|1001|N|N|Y||Preferred Brand|211947-Atovaquone150MG/MLOralSuspension[Mepron]|CHILD 2020 632|1001|N|N|N||Preferred Generic|310965-Ibuprofen200MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2387331-120ACTUATbudesonide0.16MG/ACTUAT/formoterolfumarate0.0048MG/ACTUAT/glycopyrrolate0.009MG/ACTUATMeteredDoseInhaler[Bre|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2045961-Doptelet60MGDailyDoseCartonPack|CHILD 2020 632|1001|N|N|N||Preferred Generic|310798-Hydrochlorothiazide25MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|861495-ClobetasolPropionate0.5MG/MLTopicalCream|CHILD 2020 632|1001|N|N|Y||Preferred Brand|2166928-10ACTUATolodaterol0.0025MG/ACTUAT/tiotropium0.0025MG/ACTUATInhalationSpray[Stiolto]|CHILD 2020 632|1001|Y|N|N||Preferred Generic|1111641-1MLglatirameracetate20MG/MLPrefilledSyringe|CHILD 2020 632|1001|Y|N|N||Preferred Generic|349407-Treprostinil1MG/MLInjectableSolution|CHILD 2020 632|1001|N|N|Y||Preferred Generic|485485-tizanidine4MGOralCapsule|CHILD 2020 632|1001|Y|N|N||Preferred Generic|283316-Hydrochlorothiazide12.5MG/telmisartan40MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|992447-PromethazineHydrochloride25MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|198428-lamotrigine150MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|864761-MethadoneHydrochloride1MG/MLOralSolution|CHILD 2020 632|1001|N|N|Y||Preferred Generic|310792-Hydrochlorothiazide12.5MG/irbesartan150MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|349408-Treprostinil10MG/MLInjectableSolution|CHILD 2020 632|1001|N|N|Y||Preferred Generic|199381-potassiumcitrate10MEQExtendedReleaseOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|313580-venlafaxine100MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|835603-tramadolhydrochloride50MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|898356-Amlodipine5MG/Benazeprilhydrochloride20MGOralCapsule|CHILD 2020 632|1001|N|N|Y||Preferred Generic|897612-24HRVerapamilhydrochloride120MGExtendedReleaseOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|313226-terconazole4MG/MLVaginalCream|CHILD 2020 632|1001|Y|N|N||Preferred Brand|995156-lacosamide10MG/MLOralSolution[Vimpat]|CHILD 2020 632|1001|Y|N|N||Preferred Generic|349409-Treprostinil2.5MG/MLInjectableSolution|CHILD 2020 632|1001|Y|N|N||Preferred Brand|731241-1MLdarbepoetinalfa0.5MG/MLPrefilledSyringe[Aranesp]|CHILD 2020 632|1001|N|Y|N||Preferred Generic|996594-24HRMemantinehydrochloride14MGExtendedReleaseOralCapsule|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1593858-lisdexamfetaminedimesylate10MGOralCapsule[Vyvanse]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1946522-4-Month1.5MLLeuprolideAcetate20MG/MLPrefilledSyringe[Lupron]|CHILD 2020 632|1001|Y|N|N||Preferred Generic|349410-Treprostinil5MG/MLInjectableSolution|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2047614-1MLepoetinalfa-epbx4000UNT/MLInjection[Retacrit]|CHILD 2020 632|1001|N|N|N||Preferred Generic|1012021-Prednisolonesodiumphosphate2.5MG/ML/SulfacetamideSodium100MG/MLOphthalmicSolution|CHILD 2020 632|1001|N|N|N||Preferred Generic|238920-Betamethasone0.5MG/MLTopicalCream|CHILD 2020 632|1001|N|N|N||Preferred Generic|855480-alclometasonedipropionate0.0005MG/MGTopicalOintment|CHILD 2020 632|1001|N|N|Y||Preferred Generic|830861-24HRDiltiazemHydrochloride120MGExtendedReleaseOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|309115-Cephalexin250MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|1242787-Alyacen7/7/7Kit|CHILD 2020 632|1001|N|Y|N||Preferred Generic|855178-tolterodinetartrate1MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|854901-BisoprololFumarate10MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|486146-24HRNitroglycerin0.6MG/HRTransdermalSystem|CHILD 2020 632|1001|N|N|N||Preferred Generic|197583-Dexamethasone6MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|1091497-MethylphenidateHydrochloride5MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|310594-Gramicidin0.025MG/ML/Neomycin1.75MG/ML/PolymyxinB10000UNT/MLOphthalmicSolution|CHILD 2020 632|1001|N|N|N||Preferred Generic|859193-selegilinehydrochloride5MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|207588-Procarbazine50MGOralCapsule[Matulane]|CHILD 2020 632|1001|Y|N|N||Preferred Generic|349435-voriconazole50MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|251322-Ethosuximide50MG/MLOralSolution|CHILD 2020 632|1001|N|N|N||Preferred Generic|1245230-chlorhexidinegluconate20MG/MLMedicatedLiquidSoap|CHILD 2020 632|1001|N|N|N||Preferred Generic|198165-Propantheline15MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|1373503-{7(EthinylEstradiol0.01MGOralTablet)/42(EthinylEstradiol0.02MG/Levonorgestrel0.15MGOralTablet)/21(EthinylEstradiol0.0|CHILD 2020 632|1001|Y|N|N||Preferred Generic|310436-Galantamine4MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|898367-Benazeprilhydrochloride20MG/Hydrochlorothiazide12.5MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1310531-teriflunomide14MGOralTablet[Aubagio]|CHILD 2020 632|1001|Y|N|Y||Preferred Brand|804547-difluprednate0.5MG/MLOphthalmicSuspension[Durezol]|CHILD 2020 632|1001|Y|N|N||Preferred Generic|351114-5MLzoledronicacid0.8MG/MLInjection|CHILD 2020 632|1001|N|N|Y||Preferred Generic|311975-Nicotine4MGChewingGum|CHILD 2020 632|1001|N|N|N||Preferred Generic|898372-Benazeprilhydrochloride20MG/Hydrochlorothiazide25MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|260376-Terazosin10MGOralCapsule|CHILD 2020 632|1001|N|N|Y||Preferred Generic|854245-0.8MLEnoxaparinsodium150MG/MLPrefilledSyringe|CHILD 2020 632|1001|N|N|N||Preferred Generic|308964-Captopril50MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|861156-12HRPropafenoneHydrochloride225MGExtendedReleaseOralCapsule|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1745108-1MLixekizumab80MG/MLAuto-Injector[Taltz]|CHILD 2020 632|1001|N|N|Y||Preferred Brand|1658150-1MLHepatitisBSurfaceAntigenVaccine0.01MG/MLInjection[Recombivax]|CHILD 2020 632|1001|N|N|Y||Preferred Brand|2166204-10ACTUATtiotropium0.0025MG/ACTUATInhalationSpray[Spiriva]|CHILD 2020 632|1001|N|N|N||Preferred Brand|854910-BisoprololFumarate10MG/Hydrochlorothiazide6.25MGOralTablet[Ziac]|CHILD 2020 632|1001|Y|N|N||Preferred Generic|402505-12HRCarbamazepine200MGExtendedReleaseOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Brand|351433-24HRNicotine0.292MG/HRTransdermalSystem[NicodermC-Q]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1551886-lanthanumcarbonate750MGOralPowder[Fosrenol]|CHILD 2020 632|1001|N|N|N||Preferred Generic|855168-levocetirizinedihydrochloride0.5MG/MLOralSolution|CHILD 2020 632|1001|Y|N|N||Preferred Generic|864681-Atovaquone62.5MG/proguanilhydrochloride25MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|898378-Benazeprilhydrochloride5MG/Hydrochlorothiazide6.25MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|748738-Topotecan0.25MGOralCapsule[Hycamtin]|CHILD 2020 632|1001|N|N|N||Preferred Generic|1094107-Phenazopyridinehydrochloride100MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|200256-repaglinide1MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Brand|351859-insulin,regular,human500UNT/MLInjectableSolution[HumulinR]|CHILD 2020 632|1001|Y|N|N||Preferred Generic|1011736-aliskiren150MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2048025-0.6MLpegfilgrastim-jmdb10MG/MLPrefilledSyringe[Fulphila]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|485484-tizanidine6MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|199149-Acarbose50MGOralTablet|CHILD 2020 632|1001|N|Y|N||Preferred Generic|825130-24HRmesalamine375MGExtendedReleaseOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|1376336-prednisoloneacetate10MG/MLOphthalmicSuspension|CHILD 2020 632|1001|Y|N|N||Preferred Generic|403811-aprepitant125MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|855172-levocetirizinedihydrochloride5MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|1046771-12HRHyoscyamineSulfate0.375MGExtendedReleaseOralTablet[Levbid]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|315223-Sumatriptan25MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|205532-DornaseAlfa1MG/MLInhalationSolution[Pulmozyme]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|856940-Acetaminophen21.7MG/ML/HydrocodoneBitartrate0.5MG/MLOralSolution|CHILD 2020 632|1001|N|N|N||Preferred Generic|308493-Bacitracin0.4UNT/MG/Neomycin0.0035MG/MG/PolymyxinB10UNT/MGOphthalmicOintment|CHILD 2020 632|1001|N|N|Y||Preferred Brand|404448-84HRoxybutynin0.162MG/HRTransdermalSystem[Oxytrol]|CHILD 2020 632|1001|N|N|Y||Preferred Brand|864650-Ganciclovir0.0015MG/MGOphthalmicGel[Zirgan]|CHILD 2020 632|1001|N|N|N||Preferred Generic|314203-quinapril40MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2058906-cannabidiol100MG/MLOralSolution[Epidiolex]|CHILD 2020 632|1001|Y|N|N||Preferred Generic|403879-imatinib400MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|242891-84HREstradiol0.00208MG/HRTransdermalSystem|CHILD 2020 632|1001|N|N|N||Preferred Generic|314055-IsosorbideDinitrate5MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|403853-Hydrochlorothiazide12.5MG/Olmesartanmedoxomil20MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|310429-Furosemide20MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1650901-0.5MLInterferonbeta-1a0.06MG/MLAuto-Injector[Avonex]|CHILD 2020 632|1001|N|N|N||Preferred Generic|855818-prasugrel5MGOralTablet|CHILD 2020 632|1001|N|Y|Y||Preferred Generic|860654-epinastinehydrochloride0.5MG/MLOphthalmicSolution|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2056700-1.5MLfremanezumab-vfrm150MG/MLPrefilledSyringe[Ajovy]|CHILD 2020 632|1001|Y|N|N||Preferred Generic|403930-Isotretinoin30MGOralCapsule|CHILD 2020 632|1001|N|N|Y||Preferred Generic|857366-EconazoleNitrate10MG/MLTopicalCream|CHILD 2020 632|1001|N|N|N||Preferred Brand|352210-Mesna400MGOralTablet[Mesnex]|CHILD 2020 632|1001|N|N|N||Preferred Generic|105292-isoniazid10MG/MLOralSolution|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1868020-pirfenidone801MGOralTablet[Esbriet]|CHILD 2020 632|1001|N|N|N||Preferred Generic|313586-venlafaxine75MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|992395-gatifloxacin5MG/MLOphthalmicSolution|CHILD 2020 632|1001|N|N|N||Preferred Generic|1085741-TriamcinoloneAcetonide0.25MG/MLTopicalLotion|CHILD 2020 632|1001|N|Y|Y||Preferred Generic|197519-Clindamycin10MG/MLTopicalLotion|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1482513-eslicarbazepineacetate200MGOralTablet[Aptiom]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1482814-1MLgolimumab100MG/MLPrefilledSyringe[Simponi]|CHILD 2020 632|1001|N|N|N||Preferred Generic|1738511-ParoxetineHydrochloride40MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|993456-1MLdenosumab60MG/MLPrefilledSyringe[Prolia]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|198188-Ramipril2.5MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|1367436-21DAYEthinylEstradiol0.000625MG/HR/Etonogestrel0.005MG/HRVaginalSystem|CHILD 2020 632|1001|Y|N|N||Preferred Generic|477130-Hydrochlorothiazide25MG/telmisartan80MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|477347-lanthanumcarbonate500MGChewableTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|1806187-30/70Release24HRMethylphenidateHydrochloride20MGExtendedReleaseOralCapsule|CHILD 2020 632|1001|Y|N|Y||Preferred Generic|891893-MorphineSulfate60MGExtendedReleaseOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|197388-Azathioprine50MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2058877-1MLgalcanezumab-gnlm120MG/MLAuto-Injector[Emgality]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1666334-Ticagrelor60MGOralTablet[Brilinta]|CHILD 2020 632|1001|N|N|N||Preferred Generic|866924-MetoprololTartrate25MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|830463-1MLrabiesvirusvaccineflury-lepstrain2.5UNT/MLInjection[RabAvert]|CHILD 2020 632|1001|N|N|N||Preferred Generic|1000064-DoxepinHydrochloride150MGOralCapsule|CHILD 2020 632|1001|N|N|Y||Preferred Brand|830253-0.5MLHepatitisBSurfaceAntigenVaccine0.01MG/MLPrefilledSyringe[Recombivax]|CHILD 2020 632|1001|Y|N|N||Preferred Generic|477367-solifenacinsuccinate5MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|861375-sevelamercarbonate800MGPowderforOralSuspension|CHILD 2020 632|1001|N|N|N||Preferred Generic|309313-Citalopram2MG/MLOralSolution|CHILD 2020 632|1001|N|N|Y||Preferred Brand|637190-varenicline1MGOralTablet[Chantix]|CHILD 2020 632|1001|Y|N|N||Preferred Generic|477372-solifenacinsuccinate10MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2054995-lusutrombopag3MGOralTablet[Mulpleta]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|854876-Zolpidemtartrate5MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|310964-Ibuprofen200MGOralCapsule|CHILD 2020 632|1001|N|N|Y||Preferred Generic|861237-24HRAmphetamineaspartate1.25MG/AmphetamineSulfate1.25MG/Dextroamphetaminesaccharate1.25MG/DextroamphetamineSulfate1.25|CHILD 2020 632|1001|N|N|N||Preferred Generic|248109-Ribavirin200MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|199376-potassiumcitrate5MEQExtendedReleaseOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|617309-Amoxicillin200MG/Clavulanate28.5MGChewableTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|997223-Donepezilhydrochloride10MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1544386-0.25MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|CHILD 2020 632|1001|N|N|N||Preferred Generic|312504-PotassiumChloride10MEQExtendedReleaseOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|308867-Calcitriol0.00025MGOralCapsule|CHILD 2020 632|1001|Y|N|N||Preferred Brand|902626-dexlansoprazole60MGDelayedReleaseOralCapsule[Dexilant]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|892582-MorphineSulfate15MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|1734399-1MLGranisetron1MG/MLInjection|CHILD 2020 632|1001|N|N|N||Preferred Brand|748865-Trivora28DayPack|CHILD 2020 632|1001|N|N|Y||Preferred Generic|314285-zonisamide100MGOralCapsule|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2058946-1MLomalizumab150MG/MLPrefilledSyringe[Xolair]|CHILD 2020 632|1001|Y|N|N||Preferred Generic|616749-12HRranolazine500MGExtendedReleaseOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Brand|752388-InsulinLispro25UNT/ML/insulinlisproprotamine,human75UNT/MLInjectableSuspension[HumalogMix]|CHILD 2020 632|1001|N|N|N||Preferred Generic|349401-Olmesartanmedoxomil20MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|198145-Prednisone10MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|485423-24HRdarifenacin7.5MGExtendedReleaseOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|197529-Clonazepam2MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Brand|707566-PolyethyleneGlycol4004MG/ML/Propyleneglycol3MG/MLOphthalmicSolution[Systane]|CHILD 2020 632|1001|Y|N|Y||Preferred Brand|665036-sitagliptin100MGOralTablet[Januvia]|CHILD 2020 632|1001|Y|N|N||Preferred Generic|485434-entecavir0.5MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|855318-WarfarinSodium3MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|884385-DextroamphetamineSulfate10MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|199058-mycophenolatemofetil250MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Brand|750839-erythromycinstearate250MGOralTablet[ErythrocinStearate]|CHILD 2020 632|1001|N|N|N||Preferred Generic|1052760-magnesiumcitrate58.2MG/MLOralSolution|CHILD 2020 632|1001|N|N|N||Preferred Generic|311955-Niacin250MGExtendedReleaseOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|197579-Dexamethasone1MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|967012-POLYETHYLENEGLYCOL3350236000MG/PotassiumChloride2970MG/SodiumBicarbonate6740MG/SodiumChloride5860MG/sodiumsulfate22740|CHILD 2020 632|1001|N|N|N||Preferred Generic|903703-liothyroninesodium0.05MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1653166-1MLgolimumab100MG/MLAuto-Injector[Simponi]|CHILD 2020 632|1001|N|N|N||Preferred Generic|861004-Metforminhydrochloride1000MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1545174-hydrocortisoneacetate100MG/MLRectalFoam[Cortifoam]|CHILD 2020 632|1001|Y|N|N||Preferred Generic|485436-entecavir1MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|204423-Hydrocortisone10MG/ML/Neomycin3.5MG/ML/PolymyxinB10000UNT/MLOticSolution|CHILD 2020 632|1001|N|Y|N||Preferred Generic|996603-24HRMemantinehydrochloride21MGExtendedReleaseOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|103401-Hydrocortisone0.025MG/MGTopicalOintment|CHILD 2020 632|1001|N|N|Y||Preferred Generic|198342-Urea400MG/MLTopicalCream|CHILD 2020 632|1001|N|N|N||Preferred Generic|904481-PravastatinSodium80MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|402698-24HRFelodipine2.5MGExtendedReleaseOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|1094543-Briellyn28DayPack|CHILD 2020 632|1001|Y|N|N||Preferred Generic|725023-24HRrivastigmine0.396MG/HRTransdermalSystem|CHILD 2020 632|1001|N|N|N||Preferred Generic|979485-LosartanPotassium25MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|311192-IsosorbideMononitrate10MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|903884-FluvoxamineMaleate100MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|901614-Aztreonam75MG/MLInhalationSolution[Cayston]|CHILD 2020 632|1001|N|N|N||Preferred Generic|197311-Acyclovir400MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|854921-BisoprololFumarate5MG/Hydrochlorothiazide6.25MGOralTablet[Ziac]|CHILD 2020 632|1001|Y|N|N||Preferred Generic|543218-1MLGranisetron0.1MG/MLInjection|CHILD 2020 632|1001|N|N|N||Preferred Generic|197863-Leucovorin5MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1650004-0.5MLInterferonbeta-1a0.088MG/MLAuto-Injector[Rebif]|CHILD 2020 632|1001|N|N|N||Preferred Generic|856733-PropranololHydrochloride8MG/MLOralSolution|CHILD 2020 632|1001|N|N|N||Preferred Generic|310273-Famotidine20MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|1014314-TriamcinoloneAcetonide1MG/MLTopicalCream|CHILD 2020 632|1001|N|N|N||Preferred Generic|197960-Hydrochlorothiazide25MG/Methyldopa250MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|312515-PotassiumChloride1.33MEQ/MLOralSolution|CHILD 2020 632|1001|Y|N|N||Preferred Generic|545835-LeuprolideAcetate5MG/MLInjectableSolution|CHILD 2020 632|1001|N|N|N||Preferred Generic|617312-atorvastatin10MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1605075-0.8MLFILGRASTIM-SNDZ0.6MG/MLPrefilledSyringe[Zarxio]|CHILD 2020 632|1001|N|Y|Y||Preferred Generic|856535-24HRPropranololHydrochloride60MGExtendedReleaseOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|204844-Azithromycin600MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|1362720-MexiletineHydrochloride250MGOralCapsule|CHILD 2020 632|1001|N|Y|N||Preferred Brand|1992703-ertugliflozin7.5MG/Metforminhydrochloride500MGOralTablet[Segluromet]|CHILD 2020 632|1001|Y|N|N||Preferred Generic|727339-0.5MLSumatriptan12MG/MLPrefilledSyringe|CHILD 2020 632|1001|N|N|Y||Preferred Generic|862013-24HRGuanfacine2MGExtendedReleaseOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|991061-DicyclomineHydrochloride10MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|312055-Nystatin100000UNT/MLOralSuspension|CHILD 2020 632|1001|N|N|N||Preferred Generic|198014-Naproxen500MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|1095725-ClemastineFumarate1.34MGOralTablet[Dayhist-1]|CHILD 2020 632|1001|N|N|N||Preferred Brand|208551-thyroid(USP)300MGOralTablet[ArmourThyroid]|CHILD 2020 632|1001|N|N|N||Preferred Brand|1148646-28ACTUATFluticasonepropionate0.25MG/ACTUATDryPowderInhaler[Flovent]|CHILD 2020 632|1001|N|N|Y||Preferred Brand|211609-hypromellose5MG/MLOphthalmicSolution[IsoptoAlkaline]|CHILD 2020 632|1001|N|N|N||Preferred Generic|311372-Loratadine10MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|207136-Methylprednisolone2MGOralTablet[Medrol]|CHILD 2020 632|1001|N|N|N||Preferred Generic|749783-{6(Azithromycin250MGOralTablet)}Pack|CHILD 2020 632|1001|N|N|Y||Preferred Generic|311237-Ketotifen0.25MG/MLOphthalmicSolution|CHILD 2020 632|1001|N|N|N||Preferred Generic|1731345-deferoxaminemesylate2000MGInjection|CHILD 2020 632|1001|N|N|N||Preferred Generic|855338-WarfarinSodium6MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|198105-Pindolol5MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|313415-Tobramycin3MG/MLOphthalmicSolution|CHILD 2020 632|1001|N|N|N||Preferred Generic|197582-Dexamethasone4MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|309367-Clotrimazole10MG/MLTopicalCream|CHILD 2020 632|1001|N|N|N||Preferred Generic|198222-Spironolactone100MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|310190-estradiolvalerate20MG/MLInjectableSolution|CHILD 2020 632|1001|N|N|N||Preferred Brand|2562996-0.5MLinfluenzaAvirusA/Cambodia/e0826360/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.|CHILD 2020 632|1001|Y|N|N||Preferred Generic|1359861-Budesonide0.16MG/ACTUAT/formoterolfumarate0.0045MG/ACTUATMeteredDoseInhaler|CHILD 2020 632|1001|Y|N|N||Preferred Generic|577348-ramelteon8MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|312357-Phenobarbital15MGOralTablet|CHILD 2020 632|1001|N|Y|N||Preferred Generic|1368403-alogliptin12.5MG/pioglitazone15MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|205924-1MLEpoetinAlfa4000UNT/MLInjection[Procrit]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1921081-1.56MLabaloparatide2MG/MLPenInjector[Tymlos]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|312075-Ofloxacin3MG/MLOphthalmicSolution|CHILD 2020 632|1001|N|N|N||Preferred Generic|205284-leflunomide10MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|897702-HydromorphoneHydrochloride4MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|359817-Nicotine2MGOralLozenge|CHILD 2020 632|1001|N|N|N||Preferred Brand|404492-5MLLaronidase0.58MG/MLInjection[Aldurazyme]|CHILD 2020 632|1001|Y|N|N||Preferred Generic|1013629-{24(drospirenone3MG/EthinylEstradiol0.02MG/levomefolatecalcium0.451MGOralTablet)/4(levomefolatecalcium0.451MGOralTabl|CHILD 2020 632|1001|Y|N|N||Preferred Brand|206791-mesalamine250MGExtendedReleaseOralCapsule[Pentasa]|CHILD 2020 632|1001|N|N|N||Preferred Generic|1648755-NITROFURANTOIN,MACROCRYSTALS25MG/Nitrofurantoin,Monohydrate75MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|238600-seleniumsulfide25MG/MLMedicatedShampoo|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1653144-0.5MLgolimumab100MG/MLAuto-Injector[Simponi]|CHILD 2020 632|1001|N|Y|Y||Preferred Brand|1716223-patiromer25200MGPowderforOralSuspension[Veltassa]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|860244-interferonbeta-1b0.3MGInjection[Extavia]|CHILD 2020 632|1001|N|N|N||Preferred Generic|1797907-Fluticasonepropionate0.05MG/ACTUATMeteredDoseNasalSpray|CHILD 2020 632|1001|N|N|Y||Preferred Generic|830845-24HRDiltiazemHydrochloride180MGExtendedReleaseOralCapsule|CHILD 2020 632|1001|N|N|Y||Preferred Generic|897749-HydromorphoneHydrochloride3MGRectalSuppository|CHILD 2020 632|1001|N|Y|N||Preferred Generic|996609-24HRMemantinehydrochloride28MGExtendedReleaseOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|198223-Spironolactone50MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|863038-bepotastinebesilate15MG/MLOphthalmicSolution|CHILD 2020 632|1001|N|N|N||Preferred Generic|314077-Lisinopril20MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|897590-24HRVerapamilhydrochloride200MGExtendedReleaseOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Brand|1998772-Breath-Actuated120ACTUATBeclomethasoneDipropionate0.08MG/ACTUATMeteredDoseInhaler[Qvar]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|242892-84HREstradiol0.00417MG/HRTransdermalSystem|CHILD 2020 632|1001|N|N|N||Preferred Generic|995607-EthambutolHydrochloride400MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|904431-Alendronicacid70MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|808118-prednisolone5MGOralTablet[MILLIPRED]|CHILD 2020 632|1001|Y|N|N||Preferred Generic|578330-candesartancilexetil32MG/Hydrochlorothiazide12.5MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|855474-alclometasonedipropionate0.5MG/MLTopicalCream|CHILD 2020 632|1001|Y|N|N||Preferred Generic|578325-candesartancilexetil16MG/Hydrochlorothiazide12.5MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|197595-Dicloxacillin250MGOralCapsule|CHILD 2020 632|1001|N|N|Y||Preferred Generic|899548-dexmethylphenidatehydrochloride10MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|310352-Fluconazole10MG/MLOralSuspension|CHILD 2020 632|1001|Y|N|N||Preferred Generic|597768-deferasirox125MGTabletforOralSuspension|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1870950-deflazacort6MGOralTablet[Emflaza]|CHILD 2020 632|1001|N|N|N||Preferred Generic|312641-Progesterone200MGOralCapsule|CHILD 2020 632|1001|Y|N|N||Preferred Generic|579148-Galantamine12MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|349195-Clonazepam0.25MGDisintegratingOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|979480-LosartanPotassium100MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|897710-HydromorphoneHydrochloride8MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|205921-1MLEpoetinAlfa3000UNT/MLInjection[Epogen]|CHILD 2020 632|1001|N|N|N||Preferred Brand|750264-Necon7/7/728DayPack|CHILD 2020 632|1001|N|N|Y||Preferred Generic|904405-Alendronicacid40MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|1358775-MicrogestinFe1/2028DayPack|CHILD 2020 632|1001|N|N|N||Preferred Generic|205285-leflunomide20MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|1095229-FlavoxateHydrochloride100MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|199192-famciclovir125MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|197596-Dicloxacillin500MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Brand|1114041-DextromethorphanHydrobromide1MG/MLOralSolution[DayQuilCough]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2107351-prucalopride1MGOralTablet[Motegrity]|CHILD 2020 632|1001|N|Y|Y||Preferred Generic|1111343-olopatadine2MG/MLOphthalmicSolution|CHILD 2020 632|1001|N|N|N||Preferred Generic|904467-PravastatinSodium20MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1873765-plecanatide3MGOralTablet[Trulance]|CHILD 2020 632|1001|N|Y|N||Preferred Generic|197984-Minocycline100MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Brand|201337-Nadolol40MGOralTablet[Corgard]|CHILD 2020 632|1001|N|N|N||Preferred Generic|197770-Hydrochlorothiazide50MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|855671-Phenytoinsodium100MGExtendedReleaseOralCapsule|CHILD 2020 632|1001|N|N|Y||Preferred Generic|485442-Eszopiclone2MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|830837-24HRDiltiazemHydrochloride240MGExtendedReleaseOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|205304-telmisartan40MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|197512-Ciprofloxacin750MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|1797867-Azelastinehydrochloride0.137MG/ACTUATMeteredDoseNasalSpray|CHILD 2020 632|1001|N|Y|Y||Preferred Generic|1797865-mometasonefuroate0.05MG/ACTUATMeteredDoseNasalSpray|CHILD 2020 632|1001|N|N|N||Preferred Generic|198707-Hydrocortisone5MG/MLTopicalCream|CHILD 2020 632|1001|Y|N|Y||Preferred Generic|891888-MorphineSulfate30MGExtendedReleaseOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|904475-PravastatinSodium40MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|1358780-Junel1/2021DayPack|CHILD 2020 632|1001|N|N|N||Preferred Generic|835593-ImipramineHydrochloride10MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|855664-DiclofenacSodium25MGDelayedReleaseOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|864675-Atovaquone250MG/proguanilhydrochloride100MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Brand|2106334-0.5MLdiphtheriatoxoidvaccine,inactivated4UNT/ML/tetanustoxoidvaccine,inactivated4UNT/MLInjection[Tdvax]|CHILD 2020 632|1001|N|N|N||Preferred Brand|208949-Estrogens,Conjugated(USP)0.9MGOralTablet[Premarin]|CHILD 2020 632|1001|N|N|N||Preferred Generic|402695-24HRFelodipine10MGExtendedReleaseOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|896006-120ACTUATFluticasonepropionate0.22MG/ACTUATMeteredDoseInhaler[Flovent]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|753442-9HRMethylphenidate2.22MG/HRTransdermalSystem[Daytrana]|CHILD 2020 632|1001|N|N|N||Preferred Generic|198232-Sulfasalazine500MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|730046-0.5MLdarbepoetinalfa0.2MG/MLPrefilledSyringe[Aranesp]|CHILD 2020 632|1001|N|N|N||Preferred Brand|1595478-amylase84000UNT/lipase20000UNT/protease63000UNTDelayedReleaseOralCapsule[Zenpep]|CHILD 2020 632|1001|N|Y|Y||Preferred Generic|1806195-50/50Release24HRMethylphenidateHydrochloride10MGExtendedReleaseOralCapsule|CHILD 2020 632|1001|N|N|Y||Preferred Generic|1091150-MethylphenidateHydrochloride10MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|311893-nabumetone750MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|904458-PravastatinSodium10MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|993462-midodrinehydrochloride10MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Brand|1658155-0.5MLHepatitisBSurfaceAntigenVaccine0.01MG/MLInjection[Recombivax]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|351297-insulinaspartprotamine,human70UNT/ML/insulinaspart,human30UNT/MLInjectableSuspension|CHILD 2020 632|1001|N|N|N||Preferred Brand|209002-prednisolone1.2MG/MLOphthalmicSuspension[PredMild]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1431647-4MLgolimumab12.5MG/MLInjection[Simponi]|CHILD 2020 632|1001|N|N|Y||Preferred Brand|208821-Dexamethasone0.001MG/MG/Tobramycin0.003MG/MGOphthalmicOintment[Tobradex]|CHILD 2020 632|1001|N|N|Y||Preferred Brand|1797888-Nicotine0.5MG/ACTUATMeteredDoseNasalSpray[Nicotrol]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|993466-midodrinehydrochloride2.5MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|597770-deferasirox250MGTabletforOralSuspension|CHILD 2020 632|1001|N|N|N||Preferred Brand|1359032-Microgestin1.5/3021DayPack|CHILD 2020 632|1001|Y|N|N||Preferred Brand|795085-certolizumabpegol200MGInjection[Cimzia]|CHILD 2020 632|1001|N|N|N||Preferred Generic|904932-ibandronicacid150MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|212218-EpoetinAlfa20000UNT/MLInjectableSolution[Epogen]|CHILD 2020 632|1001|N|N|N||Preferred Generic|197380-Atenolol25MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|2110513-60ACTUATFluticasonepropionate0.25MG/ACTUAT/salmeterol0.05MG/ACTUATDryPowderInhaler[Wixela]|CHILD 2020 632|1001|N|N|Y||Preferred Brand|830245-1MLHepatitisBSurfaceAntigenVaccine0.01MG/MLPrefilledSyringe[Recombivax]|CHILD 2020 632|1001|Y|N|N||Preferred Generic|860695-24HRgalantaminehydrobromide16MGExtendedReleaseOralCapsule|CHILD 2020 632|1001|N|N|Y||Preferred Generic|485440-Eszopiclone1MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1043582-24HRMetforminhydrochloride500MG/saxagliptin5MGExtendedReleaseOralTablet[Kombiglyze]|CHILD 2020 632|1001|N|N|N||Preferred Brand|205562-Estramustine140MGOralCapsule[Emcyt]|CHILD 2020 632|1001|N|N|N||Preferred Generic|855873-Phenytoinsodium300MGExtendedReleaseOralCapsule|CHILD 2020 632|1001|Y|N|N||Preferred Generic|642452-lanthanumcarbonate750MGChewableTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|1000491-Prempro0.3/1.528DayPack|CHILD 2020 632|1001|N|N|N||Preferred Generic|1298066-Cyclopentolatehydrochloride10MG/MLOphthalmicSolution|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2123314-Mayzent0.25MGStarterPack|CHILD 2020 632|1001|N|N|N||Preferred Generic|1085644-TriamcinoloneAcetonide0.25MG/MLTopicalCream|CHILD 2020 632|1001|N|N|N||Preferred Generic|905158-Sirolimus0.5MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|312899-Salsalate500MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|1989117-0.3MLEpinephrine1MG/MLPrefilledSyringe[Symjepi]|CHILD 2020 632|1001|N|N|N||Preferred Generic|314231-Simvastatin10MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|644088-aprepitant40MGOralCapsule|CHILD 2020 632|1001|N|N|Y||Preferred Generic|242461-cilostazol100MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|992475-PromethazineHydrochloride50MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|656659-bosentan125MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|313850-Amoxicillin40MG/MLOralSuspension|CHILD 2020 632|1001|N|N|N||Preferred Generic|197783-Hydrocortisone20MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|200220-tolcapone100MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|859044-Pramipexoledihydrochloride0.5MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|349201-valsartan160MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|283433-Melatonin10MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|979475-MetaproterenolSulfate20MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|312938-Sertraline100MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|198238-Sulindac150MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|830801-24HRDiltiazemHydrochloride300MGExtendedReleaseOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|251156-ferroussulfate75MG/MLOralSolution|CHILD 2020 632|1001|N|N|Y||Preferred Generic|854241-0.8MLEnoxaparinsodium100MG/MLPrefilledSyringe|CHILD 2020 632|1001|N|N|N||Preferred Generic|197405-Betamethasone0.0005MG/MGTopicalOintment|CHILD 2020 632|1001|Y|N|N||Preferred Generic|700883-temozolomide140MGOralCapsule|CHILD 2020 632|1001|N|N|Y||Preferred Generic|349595-atomoxetine60MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Brand|991233-bexarotene0.01MG/MGTopicalGel[Targretin]|CHILD 2020 632|1001|N|N|N||Preferred Generic|863664-Oxybutyninchloride5MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|616018-abatacept250MGInjection[Orencia]|CHILD 2020 632|1001|Y|N|N||Preferred Generic|700885-temozolomide180MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|313219-Terazosin5MGOralCapsule|CHILD 2020 632|1001|N|N|Y||Preferred Generic|310465-Gentamicin0.001MG/MGTopicalOintment|CHILD 2020 632|1001|N|Y|N||Preferred Brand|1801840-lifitegrast50MG/MLOphthalmicSolution[Xiidra]|CHILD 2020 632|1001|Y|N|N||Preferred Generic|860901-galantaminehydrobromide4MG/MLOralSolution|CHILD 2020 632|1001|N|N|N||Preferred Generic|199047-Famotidine10MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|705824-100MLzoledronicacid0.05MG/MLInjection|CHILD 2020 632|1001|N|N|N||Preferred Generic|995258-HydroxyzineHydrochloride25MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2173822-1MLmepolizumab100MG/MLPrefilledSyringe[Nucala]|CHILD 2020 632|1001|N|N|N||Preferred Generic|686400-ErythromycinEthylsuccinate40MG/MLOralSuspension|CHILD 2020 632|1001|N|N|N||Preferred Generic|197650-Erythromycin500MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|349353-Hydrochlorothiazide25MG/valsartan160MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1871469-lisdexamfetaminedimesylate50MGChewableTablet[Vyvanse]|CHILD 2020 632|1001|Y|N|N||Preferred Generic|722116-ambrisentan10MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|198239-Sulindac200MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|905225-HydralazineHydrochloride25MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|206842-IsosorbideDinitrate20MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|722122-ambrisentan5MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|855205-docosanol100MG/MLTopicalCream[Abreva]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1649495-ivabradine7.5MGOralTablet[Corlanor]|CHILD 2020 632|1001|N|N|N||Preferred Generic|198116-PotassiumChloride20MEQExtendedReleaseOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|1299909-Tiagabinehydrochloride16MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|1860154-Abuse-Deterrent12HROxycodoneHydrochloride15MGExtendedReleaseOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|1298070-Cyclopentolatehydrochloride20MG/MLOphthalmicSolution|CHILD 2020 632|1001|Y|N|N||Preferred Generic|724859-armodafinil150MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|857321-BethanecholChloride10MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2196592-120ACTUATformoterolfumarate0.005MG/ACTUAT/mometasonefuroate0.05MG/ACTUATMeteredDoseInhaler[Dulera]|CHILD 2020 632|1001|N|N|N||Preferred Generic|312997-SodiumChloride9MG/MLInhalationSolution|CHILD 2020 632|1001|N|Y|N||Preferred Brand|1992816-ertugliflozin5MGOralTablet[Steglatro]|CHILD 2020 632|1001|Y|N|Y||Preferred Generic|835809-testosteroneenanthate200MG/MLInjectableSolution|CHILD 2020 632|1001|N|N|N||Preferred Generic|314241-Theophylline450MGExtendedReleaseOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|1923809-thyroid(USP)120MGOralTablet[NPThyroid]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2201540-romiplostim0.125MGInjection[Nplate]|CHILD 2020 632|1001|Y|N|Y||Preferred Generic|313451-Tretinoin0.00025MG/MGTopicalGel|CHILD 2020 632|1001|N|N|N||Preferred Generic|1014676-cetirizinehydrochloride5MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|209890-Acetaminophen500MGOralCapsule[Mapap]|CHILD 2020 632|1001|N|N|N||Preferred Brand|209531-Acetaminophen80MGRectalSuppository[Feverall]|CHILD 2020 632|1001|N|N|N||Preferred Generic|198292-Tolazamide250MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|308212-Ampicillin500MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|311892-nabumetone500MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Brand|1364441-apixaban2.5MGOralTablet[Eliquis]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2359358-24HRempagliflozin5MG/linagliptin2.5MG/metforminhydrochloride1000MGExtendedReleaseOralTablet[Trijardy]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|199206-Riluzole50MGOralTablet|CHILD 2020 632|1001|N|Y|Y||Preferred Generic|244374-BenzoylPeroxide0.05MG/MG/Erythromycin0.03MG/MGTopicalGel|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2203893-sofosbuvir200MGOralTablet[Sovaldi]|CHILD 2020 632|1001|N|N|N||Preferred Generic|314277-venlafaxine50MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1729029-selexipag1.2MGOralTablet[Uptravi]|CHILD 2020 632|1001|N|Y|Y||Preferred Generic|798133-Erythromycin20MG/MLMedicatedPad[Ery]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1729033-selexipag1.4MGOralTablet[Uptravi]|CHILD 2020 632|1001|N|N|N||Preferred Generic|966221-LevothyroxineSodium0.05MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|995666-MeclizineHydrochloride25MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|197698-Fluconazole100MGOralTablet|CHILD 2020 632|1001|Y|N|Y||Preferred Generic|891881-MorphineSulfate15MGExtendedReleaseOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|759473-20ACTUATZanamivir5MG/ACTUATDryPowderInhaler[Relenza]|CHILD 2020 632|1001|N|N|N||Preferred Generic|1099296-DesipramineHydrochloride150MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|856377-TrazodoneHydrochloride50MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2256943-lasmiditan100MGOralTablet[Reyvow]|CHILD 2020 632|1001|N|N|N||Preferred Generic|861430-PropafenoneHydrochloride300MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|198293-Tolazamide500MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|1046985-HyoscyamineSulfate0.125MGDisintegratingOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|198371-torsemide20MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1871467-lisdexamfetaminedimesylate60MGChewableTablet[Vyvanse]|CHILD 2020 632|1001|N|N|N||Preferred Generic|898342-Amlodipine10MG/Benazeprilhydrochloride20MGOralCapsule|CHILD 2020 632|1001|Y|N|N||Preferred Generic|639537-candesartancilexetil32MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|728231-12HRranolazine1000MGExtendedReleaseOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|1193360-100MLLevetiracetam15MG/MLInjection|CHILD 2020 632|1001|N|N|N||Preferred Generic|315090-Erythromycin333MGDelayedReleaseOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2174390-symdeko50MG/75MGand75MGPack|CHILD 2020 632|1001|N|N|Y||Preferred Generic|198052-Ondansetron4MGOralTablet|CHILD 2020 632|1001|N|Y|N||Preferred Brand|213307-Ciprofloxacin0.003MG/MGOphthalmicOintment[Ciloxan]|CHILD 2020 632|1001|N|N|N||Preferred Generic|198427-lamotrigine100MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|995624-MeclizineHydrochloride12.5MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|1049214-Acetaminophen325MG/OxycodoneHydrochloride10MGOralTablet|CHILD 2020 632|1001|N|Y|Y||Preferred Generic|200193-zolmitriptan2.5MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1441407-0.4MLMethotrexate25MG/MLAuto-Injector[Otrexup]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2257013-trikafta100MG/50MG/75MGand150MGPack|CHILD 2020 632|1001|Y|N|N||Preferred Generic|794639-lubiprostone0.008MGOralCapsule|CHILD 2020 632|1001|Y|N|N||Preferred Generic|754508-{1(aprepitant125MGOralCapsule)/2(aprepitant80MGOralCapsule)}Pack|CHILD 2020 632|1001|N|N|Y||Preferred Generic|1918194-60ACTUATfluticasonepropionate0.113MG/ACTUAT/salmeterol0.014MG/ACTUATDryPowderInhaler|CHILD 2020 632|1001|N|N|N||Preferred Generic|211365-chlorhexidinegluconate40MG/MLMedicatedLiquidSoap|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2262713-MicronizedIsotretinoin16MGOralCapsule[Absorica]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|753437-9HRMethylphenidate1.11MG/HRTransdermalSystem[Daytrana]|CHILD 2020 632|1001|N|Y|N||Preferred Generic|313921-calcipotriene0.05MG/MLTopicalCream|CHILD 2020 632|1001|N|N|N||Preferred Generic|856448-PropranololHydrochloride10MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|855861-Phenytoinsodium200MGExtendedReleaseOralCapsule|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2557216-trikafta50MG/37.5MG/25MGand75MGPack|CHILD 2020 632|1001|Y|N|N||Preferred Generic|860715-24HRgalantaminehydrobromide8MGExtendedReleaseOralCapsule|CHILD 2020 632|1001|N|Y|Y||Preferred Generic|314227-Sumatriptan20MG/ACTUATNasalSpray|CHILD 2020 632|1001|N|N|N||Preferred Generic|1801289-SmokingCessation12HRBupropionHydrochloride150MGExtendedReleaseOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|903855-2MLPyridostigmineBromide5MG/MLInjection[Regonol]|CHILD 2020 632|1001|N|N|N||Preferred Brand|404550-Estrogens,Conjugated(USP)0.45MGOralTablet[Premarin]|CHILD 2020 632|1001|N|N|N||Preferred Generic|313142-Sulfasalazine500MGDelayedReleaseOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|857799-Treprostinil0.6MG/MLInhalationSolution[Tyvaso]|CHILD 2020 632|1001|Y|N|N||Preferred Generic|810096-{7(EthinylEstradiol0.01MGOralTablet)/84(EthinylEstradiol0.02MG/Levonorgestrel0.1MGOralTablet)}Pack|CHILD 2020 632|1001|N|N|N||Preferred Generic|861657-24HRNitroglycerin0.1MG/HRTransdermalSystem|CHILD 2020 632|1001|N|N|N||Preferred Generic|313797-Amoxicillin25MG/MLOralSuspension|CHILD 2020 632|1001|N|N|N||Preferred Generic|857336-BethanecholChloride5MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|308194-Amoxicillin875MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1871463-lisdexamfetaminedimesylate20MGChewableTablet[Vyvanse]|CHILD 2020 632|1001|N|N|N||Preferred Generic|904170-PrimaquinePhosphate26.3MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|1099300-DesipramineHydrochloride25MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|1099687-ValproicAcid50MG/MLOralSolution|CHILD 2020 632|1001|Y|N|N||Preferred Generic|198200-Rifabutin150MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|856519-PropranololHydrochloride40MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|748740-Topotecan1MGOralCapsule[Hycamtin]|CHILD 2020 632|1001|N|Y|Y||Preferred Generic|314266-Tacrolimus0.001MG/MGTopicalOintment|CHILD 2020 632|1001|N|N|N||Preferred Brand|207373-Mitotane500MGOralTablet[Lysodren]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2265689-Voxelotor500MGOralTablet[Oxbryta]|CHILD 2020 632|1001|N|N|N||Preferred Generic|198332-Trimethoprim100MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|315134-Levocarnitine100MG/MLOralSolution|CHILD 2020 632|1001|N|N|N||Preferred Generic|996824-MethylergonovineMaleate0.2MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|833234-mesalamine800MGDelayedReleaseOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|197803-Ibuprofen20MG/MLOralSuspension|CHILD 2020 632|1001|N|Y|N||Preferred Brand|833139-Milnacipranhydrochloride100MGOralTablet[Savella]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|106346-Mupirocin0.02MG/MGTopicalOintment|CHILD 2020 632|1001|N|N|N||Preferred Generic|856556-PropranololHydrochloride60MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|996571-Memantinehydrochloride5MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|995232-HydroxyzinePamoate100MGOralCapsule|CHILD 2020 632|1001|Y|N|Y||Preferred Generic|313450-Tretinoin0.0001MG/MGTopicalGel|CHILD 2020 632|1001|Y|N|N||Preferred Brand|603978-nepafenac1MG/MLOphthalmicSuspension[Nevanac]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|802652-1MLEtanercept50MG/MLPrefilledSyringe[Enbrel]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2273115-24HRtofacitinib22MGExtendedReleaseOralTablet[Xeljanz]|CHILD 2020 632|1001|Y|N|N||Preferred Generic|1050493-{21(drospirenone3MG/EthinylEstradiol0.03MG/levomefolatecalcium0.451MGOralTablet)/7(levomefolatecalcium0.451MGOralTabl|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2106362-rifamycinSV194MGDelayedReleaseOralTablet[Aemcolo]|CHILD 2020 632|1001|Y|N|N||Preferred Generic|834241-febuxostat80MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|1724439-thyroid(USP)30MGOralTablet[NPThyroid]|CHILD 2020 632|1001|Y|N|N||Preferred Generic|845515-everolimus5MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|237420-CalciumCarbonate1500MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|897021-12HRdalfampridine10MGExtendedReleaseOralTablet|CHILD 2020 632|1001|N|Y|Y||Preferred Generic|483440-pregabalin150MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|198334-Sulfamethoxazole400MG/Trimethoprim80MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|848131-Amlodipine10MG/Hydrochlorothiazide12.5MG/valsartan160MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|859033-Pramipexoledihydrochloride0.125MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|197701-Fluconazole50MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|828364-hydrocortisoneacetate10MG/ML/Pramoxinehydrochloride10MG/MLRectalFoam[Proctofoam-HC]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2282414-bempedoicacid180MGOralTablet[Nexletol]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|351246-montelukast4MGOralGranules|CHILD 2020 632|1001|N|N|N||Preferred Generic|856853-AmitriptylineHydrochloride75MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|848135-Amlodipine10MG/Hydrochlorothiazide25MG/valsartan320MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|866427-24HRmetoprololsuccinate25MGExtendedReleaseOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|686379-celecoxib50MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|892255-LevothyroxineSodium0.3MGOralTablet|CHILD 2020 632|1001|N|Y|Y||Preferred Generic|483446-pregabalin200MGOralCapsule|CHILD 2020 632|1001|N|N|Y||Preferred Generic|801966-4MLDiazepam5MG/MLRectalGel|CHILD 2020 632|1001|N|N|N||Preferred Generic|198086-Phenobarbital16.2MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|966914-POLYETHYLENEGLYCOL3350240000MG/PotassiumChloride2980MG/SodiumBicarbonate6720MG/SodiumChloride5840MG/sodiumsulfate22720|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2287905-1.5MLfremanezumab-vfrm150MG/MLAuto-Injector[Ajovy]|CHILD 2020 632|1001|N|N|N||Preferred Generic|856720-AmitriptylineHydrochloride10MG/Perphenazine4MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|979464-Hydrochlorothiazide12.5MG/LosartanPotassium100MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|861427-PropafenoneHydrochloride225MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|995241-HydroxyzineHydrochloride2MG/MLOralSolution|CHILD 2020 632|1001|Y|N|N||Preferred Generic|197844-Isotretinoin20MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|317110-24HRIsosorbideMononitrate30MGExtendedReleaseOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|197940-Methazolamide50MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|848145-Amlodipine5MG/Hydrochlorothiazide25MG/valsartan160MGOralTablet|CHILD 2020 632|1001|N|Y|N||Preferred Generic|1797863-flunisolide0.025MG/ACTUATMeteredDoseNasalSpray|CHILD 2020 632|1001|N|N|N||Preferred Generic|966920-POLYETHYLENEGLYCOL3350236000MG/PotassiumChloride2970MG/SodiumBicarbonate6740MG/SodiumChloride5860MG/sodiumsulfate22740|CHILD 2020 632|1001|N|N|N||Preferred Generic|1020477-DiphenhydramineHydrochloride50MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|892251-LevothyroxineSodium0.2MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|349197-Clonazepam2MGDisintegratingOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|636042-Hydrochlorothiazide12.5MG/valsartan320MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|313291-Theophylline400MGExtendedReleaseOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Brand|1597099-0.5MLL1protein,Humanpapillomavirustype11Vaccine0.08MG/ML/L1protein,Humanpapillomavirustype16Vaccine0.12MG/ML/L1protei|CHILD 2020 632|1001|N|N|N||Preferred Generic|197305-AceticAcid20MG/MLOticSolution|CHILD 2020 632|1001|N|N|N||Preferred Generic|1099625-DivalproexSodium125MGDelayedReleaseOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|1190568-AtropineSulfate0.005MG/ML/DiphenoxylateHydrochloride0.5MG/MLOralSolution|CHILD 2020 632|1001|N|Y|Y||Preferred Generic|577127-pregabalin225MGOralCapsule|CHILD 2020 632|1001|Y|N|N||Preferred Brand|902624-dexlansoprazole30MGDelayedReleaseOralCapsule[Dexilant]|CHILD 2020 632|1001|N|N|N||Preferred Generic|1313885-Phenytoin50MGChewableTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|312086-Ondansetron8MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|850087-24HRlamotrigine100MGExtendedReleaseOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|349592-atomoxetine18MGOralCapsule|CHILD 2020 632|1001|Y|N|N||Preferred Brand|731250-0.3MLdarbepoetinalfa0.2MG/MLPrefilledSyringe[Aranesp]|CHILD 2020 632|1001|Y|N|N||Preferred Generic|999996-Amlodipine5MG/Hydrochlorothiazide12.5MG/Olmesartanmedoxomil40MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Brand|2000133-Vancomycin25MG/MLOralSolution[Firvanq]|CHILD 2020 632|1001|Y|N|N||Preferred Generic|850091-24HRlamotrigine50MGExtendedReleaseOralTablet|CHILD 2020 632|1001|N|Y|N||Preferred Generic|197508-Cimetidine800MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|1667916-5MLIsoproterenolHydrochloride0.2MG/MLInjection[Isuprel]|CHILD 2020 632|1001|N|N|N||Preferred Generic|314131-Niacin250MGExtendedReleaseOralCapsule|CHILD 2020 632|1001|Y|N|N||Preferred Brand|864820-Oxybutyninchloride0.1MG/MGTopicalGel[Gelnique]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|313566-valganciclovir450MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2371768-Oriahnn28DayKit|CHILD 2020 632|1001|Y|N|N||Preferred Brand|208083-sargramostim0.25MG/MLInjectableSolution[Leukine]|CHILD 2020 632|1001|N|N|N||Preferred Generic|282755-telmisartan20MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|993943-Acetaminophen325MG/butalbital50MG/Caffeine40MG/CodeinePhosphate30MGOralCapsule|CHILD 2020 632|1001|Y|N|N||Preferred Generic|860103-KetorolacTromethamine4MG/MLOphthalmicSolution|CHILD 2020 632|1001|N|N|N||Preferred Generic|992775-{1(MiconazoleNitrate1200MGVaginalInsert)/1(9000MG)(MiconazoleNitrate20MG/MLVaginalCream)}Pack|CHILD 2020 632|1001|Y|N|N||Preferred Generic|848151-Amlodipine10MG/Hydrochlorothiazide25MG/valsartan160MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|240209-Betamethasone0.5MG/MLTopicalLotion|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1232190-asparaginaseErwiniachrysanthemi10000UNTInjection[Erwinaze]|CHILD 2020 632|1001|N|N|N||Preferred Generic|197443-Carbidopa10MG/Levodopa100MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|854880-Zolpidemtartrate12.5MGExtendedReleaseOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|204135-Desonide0.0005MG/MGTopicalOintment|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2373941-bedaquiline20MGOralTablet[Sirturo]|CHILD 2020 632|1001|N|N|N||Preferred Generic|856762-AmitriptylineHydrochloride100MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|580286-mesalamine500MGExtendedReleaseOralCapsule[Pentasa]|CHILD 2020 632|1001|Y|N|N||Preferred Generic|854894-Zolpidemtartrate6.25MGExtendedReleaseOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|860107-KetorolacTromethamine5MG/MLOphthalmicSolution|CHILD 2020 632|1001|N|N|Y||Preferred Generic|1000153-1MLmedroxyprogesteroneacetate150MG/MLPrefilledSyringe|CHILD 2020 632|1001|N|N|Y||Preferred Generic|403923-168HREstradiol0.0025MG/HRTransdermalSystem|CHILD 2020 632|1001|N|N|N||Preferred Brand|863829-amylase120000UNT/lipase24000UNT/protease76000UNTDelayedReleaseOralCapsule[Creon]|CHILD 2020 632|1001|N|N|N||Preferred Generic|751901-{84(EthinylEstradiol0.03MG/Levonorgestrel0.15MGOralTablet)/7(InertIngredients1MGOralTablet)}Pack|CHILD 2020 632|1001|N|N|N||Preferred Generic|1362706-MexiletineHydrochloride150MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|309594-vitaminB121MG/MLInjectableSolution|CHILD 2020 632|1001|N|N|N||Preferred Generic|313584-venlafaxine37.5MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Brand|106892-insulinisophane,human70UNT/ML/insulin,regular,human30UNT/MLInjectableSuspension[Humulin]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1114096-Vandetanib300MGOralTablet[Caprelsa]|CHILD 2020 632|1001|Y|N|N||Preferred Generic|855626-Twice-Dailydiclofenacepolamine0.013MG/MGMedicatedPatch|CHILD 2020 632|1001|N|N|N||Preferred Generic|1099316-DesipramineHydrochloride75MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|198335-Sulfamethoxazole800MG/Trimethoprim160MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|855642-DiclofenacSodium0.03MG/MGTopicalGel|CHILD 2020 632|1001|N|N|N||Preferred Generic|199884-Levofloxacin250MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|311353-Lisinopril2.5MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|861424-PropafenoneHydrochloride150MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|751890-Portia28DayPack|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2256947-lasmiditan50MGOralTablet[Reyvow]|CHILD 2020 632|1001|N|N|N||Preferred Generic|992528-Terbinafinehydrochloride10MG/MLTopicalCream|CHILD 2020 632|1001|N|N|N||Preferred Generic|1366116-bacitracinzinc0.5UNT/MGTopicalOintment|CHILD 2020 632|1001|N|N|N||Preferred Generic|200033-carvedilol25MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1858833-12HRTreprostinil5MGExtendedReleaseOralTablet[Orenitram]|CHILD 2020 632|1001|N|N|N||Preferred Generic|349420-desloratadine5MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|359601-Guaifenesin400MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|310537-Glyburide5MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|238006-Estrogens,Esterified(USP)0.625MG/Methyltestosterone1.25MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2463733-epoetinalfa-epbx10000UNT/MLInjectableSolution[Retacrit]|CHILD 2020 632|1001|N|Y|Y||Preferred Generic|998675-168HRClonidine0.00833MG/HRTransdermalSystem|CHILD 2020 632|1001|Y|N|N||Preferred Generic|1923826-deferasirox360MGOralGranules|CHILD 2020 632|1001|Y|N|N||Preferred Generic|857224-Sevelamerhydrochloride800MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|1087012-thyroid(USP)32.5MGOralTablet[Westhroid]|CHILD 2020 632|1001|N|N|N||Preferred Generic|1367410-Ergocalciferol1.25MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|857169-FosinoprilSodium10MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|979471-Hydrochlorothiazide25MG/LosartanPotassium100MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|2563020-influenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Washington/19/2020(H1N1)antigen0.03MG/ML/in|CHILD 2020 632|1001|N|N|N||Preferred Generic|979444-MetaproterenolSulfate2MG/MLOralSolution|CHILD 2020 632|1001|N|N|Y||Preferred Generic|1049225-Acetaminophen325MG/OxycodoneHydrochloride7.5MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1000089-alcaftadine2.5MG/MLOphthalmicSolution[Lastacaft]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|847917-60ACTUATexenatide0.005MG/ACTUATPenInjector[Byetta]|CHILD 2020 632|1001|N|N|N||Preferred Brand|616450-MycophenolicAcid180MGDelayedReleaseOralTablet[Myfortic]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2473042-ponatinib10MGOralTablet[Iclusig]|CHILD 2020 632|1001|N|N|Y||Preferred Brand|1667882-60ACTUATtiotropium0.00125MG/ACTUATInhalationSpray[Spiriva]|CHILD 2020 632|1001|N|N|N||Preferred Generic|310459-Gemfibrozil600MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|1918042-abirateroneacetate500MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|198250-tetracyclinehydrochloride250MGOralCapsule|CHILD 2020 632|1001|Y|N|N||Preferred Generic|403878-imatinib100MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|979092-HydroxychloroquineSulfate200MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1148502-crizotinib200MGOralCapsule[Xalkori]|CHILD 2020 632|1001|N|N|N||Preferred Generic|856797-AmitriptylineHydrochloride25MG/Perphenazine2MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|978006-LoperamideHydrochloride2MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Brand|2045958-avatrombopag20MGOralTablet[Doptelet]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|897126-3MLliraglutide6MG/MLPenInjector[Victoza]|CHILD 2020 632|1001|N|N|N||Preferred Generic|884189-ClonidineHydrochloride0.3MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1011712-aliskiren150MG/Hydrochlorothiazide12.5MGOralTablet[TekturnaHCT]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2463737-epoetinalfa-epbx20000UNT/MLInjectableSolution[Retacrit]|CHILD 2020 632|1001|N|Y|Y||Preferred Generic|998679-168HRClonidine0.0125MG/HRTransdermalSystem|CHILD 2020 632|1001|N|N|Y||Preferred Brand|1364447-apixaban5MGOralTablet[Eliquis]|CHILD 2020 632|1001|N|N|N||Preferred Generic|284245-Famotidine40MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|311668-Metoclopramide5MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|197987-Minoxidil2.5MGOralTablet|CHILD 2020 632|1001|N|Y|Y||Preferred Generic|856569-24HRPropranololHydrochloride80MGExtendedReleaseOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|722131-Amlodipine10MG/valsartan320MGOralTablet|CHILD 2020 632|1001|N|Y|N||Preferred Generic|349590-Levalbuterol0.103MG/MLInhalationSolution|CHILD 2020 632|1001|N|N|N||Preferred Generic|198104-Pindolol10MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|1440184-hydrocortisoneacetate0.01MG/MGTopicalOintment|CHILD 2020 632|1001|N|N|N||Preferred Generic|856825-AmitriptylineHydrochloride25MG/Perphenazine4MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1011752-aliskiren300MG/Hydrochlorothiazide12.5MGOralTablet[TekturnaHCT]|CHILD 2020 632|1001|N|N|N||Preferred Generic|351136-Albuterol0.417MG/MLInhalationSolution|CHILD 2020 632|1001|N|N|N||Preferred Generic|1806181-30/70Release24HRMethylphenidateHydrochloride10MGExtendedReleaseOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|197409-Betamethasone0.001MG/MGTopicalOintment|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2475856-vericiguat2.5MGOralTablet[Verquvo]|CHILD 2020 632|1001|N|N|N||Preferred Generic|311354-Lisinopril5MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Brand|1992169-InsulinLispro100UNT/MLInjectableSolution[Admelog]|CHILD 2020 632|1001|N|N|N||Preferred Generic|966224-LevothyroxineSodium0.125MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|1298072-Cyclopentolatehydrochloride5MG/MLOphthalmicSolution|CHILD 2020 632|1001|Y|N|N||Preferred Generic|1799212-sofosbuvir400MG/velpatasvir100MGOralTablet|CHILD 2020 632|1001|Y|N|Y||Preferred Generic|198300-Tretinoin1MG/MLTopicalCream|CHILD 2020 632|1001|N|Y|N||Preferred Brand|1992691-ertugliflozin2.5MG/Metforminhydrochloride1000MGOralTablet[Segluromet]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1145932-1MLabatacept125MG/MLPrefilledSyringe[Orencia]|CHILD 2020 632|1001|Y|N|N||Preferred Generic|999967-Amlodipine5MG/Hydrochlorothiazide12.5MG/Olmesartanmedoxomil20MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2475860-vericiguat5MGOralTablet[Verquvo]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1012899-fingolimod0.5MGOralCapsule[Gilenya]|CHILD 2020 632|1001|N|N|N||Preferred Generic|311290-Levetiracetam750MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|966220-LevothyroxineSodium0.025MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|313160-Sumatriptan100MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1599797-1MLsecukinumab150MG/MLPrefilledSyringe[Cosentyx]|CHILD 2020 632|1001|N|N|Y||Preferred Brand|1723478-dabigatranetexilate110MGOralCapsule[Pradaxa]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1040058-DextromethorphanHydrobromide20MG/QuinidineSulfate10MGOralCapsule[Nuedexta]|CHILD 2020 632|1001|N|N|Y||Preferred Brand|2000136-Vancomycin50MG/MLOralSolution[Firvanq]|CHILD 2020 632|1001|N|N|N||Preferred Brand|1595457-amylase24000UNT/lipase5000UNT/protease17000UNTDelayedReleaseOralCapsule[Zenpep]|CHILD 2020 632|1001|N|N|Y||Preferred Brand|1046920-Nicotine4MGInhalationSolution[Nicotrol]|CHILD 2020 632|1001|N|N|N||Preferred Brand|748859-Zovia1/35E28DayPack|CHILD 2020 632|1001|N|N|N||Preferred Generic|905222-HydralazineHydrochloride100MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|310442-Ganciclovir500MGInjection|CHILD 2020 632|1001|N|N|N||Preferred Generic|198370-torsemide100MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|197407-Betamethasone1MG/MLTopicalCream|CHILD 2020 632|1001|N|N|N||Preferred Generic|856840-AmitriptylineHydrochloride50MG/Perphenazine4MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|1048452-ColestipolHydrochloride5000MGGranulesforOralSuspension[Colestid]|CHILD 2020 632|1001|N|Y|N||Preferred Generic|562806-Pimecrolimus10MG/MLTopicalCream|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2536752-24HRviloxazine150MGExtendedReleaseOralCapsule[Qelbree]|CHILD 2020 632|1001|N|N|N||Preferred Generic|198861-SodiumBicarbonate650MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|832909-CalciumCarbonate1250MG/Cholecalciferol100UNTChewableTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|197303-Acetazolamide125MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|404059-Isotretinoin10MGOralCapsule[Claravis]|CHILD 2020 632|1001|N|N|N||Preferred Generic|310169-Estradiol0.1MG/MLVaginalCream|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1045404-dasatinib140MGOralTablet[Sprycel]|CHILD 2020 632|1001|N|N|N||Preferred Generic|199890-topiramate200MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|687043-Amphetamineaspartate3.125MG/AmphetamineSulfate3.125MG/Dextroamphetaminesaccharate3.125MG/DextroamphetamineSulfate3.125|CHILD 2020 632|1001|N|N|N||Preferred Generic|198372-torsemide5MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|1091225-8HRMethylphenidateHydrochloride20MGExtendedReleaseOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|1359135-Tri-LegestFe28DayPack|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1799230-1MLabatacept125MG/MLAuto-Injector[Orencia]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|349593-atomoxetine25MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|237723-Ergocalciferol0.2MG/MLOralSolution|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1112687-Amethia91DayPack|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1046402-1.7MLdenosumab70MG/MLInjection[Xgeva]|CHILD 2020 632|1001|N|N|N||Preferred Generic|198546-CalciumGluconate500MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|310324-ferroussulfate325MGDelayedReleaseOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|857297-ClomipramineHydrochloride25MGOralCapsule|CHILD 2020 632|1001|Y|N|N||Preferred Generic|2198370-pretomanid200MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2550713-0.5MLsecukinumab150MG/MLPrefilledSyringe[Cosentyx]|CHILD 2020 632|1001|N|N|N||Preferred Generic|903887-FluvoxamineMaleate25MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|283407-Mirtazapine30MGDisintegratingOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|896245-120ACTUATFluticasonepropionate0.115MG/ACTUAT/salmeterol0.021MG/ACTUATMeteredDoseInhaler[Advair]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|198252-tetracyclinehydrochloride500MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|314072-latanoprost0.05MG/MLOphthalmicSolution|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2559707-1.14MLdupilumab175MG/MLAuto-Injector[Dupixent]|CHILD 2020 632|1001|N|N|N||Preferred Generic|897596-24HRVerapamilhydrochloride300MGExtendedReleaseOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|1099569-24HRDivalproexSodium500MGExtendedReleaseOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|1860148-Abuse-Deterrent12HROxycodoneHydrochloride80MGExtendedReleaseOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|313428-Toremifene60MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|583170-Salsalate750MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|858824-EnalaprilMaleate5MG/Hydrochlorothiazide12.5MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|198102-vitaminK15MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|197320-Allopurinol300MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2107355-prucalopride2MGOralTablet[Motegrity]|CHILD 2020 632|1001|N|N|N||Preferred Generic|1245468-DocusateSodium250MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|259255-atorvastatin80MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|647121-5MLLevetiracetam100MG/MLInjection|CHILD 2020 632|1001|N|N|N||Preferred Generic|314076-Lisinopril10MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1115449-1MLLeuprolideAcetate11.25MG/MLPrefilledSyringe[Lupron]|CHILD 2020 632|1001|N|N|N||Preferred Generic|898687-Benazeprilhydrochloride10MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|210000-AluminumHydroxide80MG/ML/MagnesiumHydroxide80MG/ML/Simethicone8MG/MLOralSuspension[Almacone]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|731235-0.4MLdarbepoetinalfa0.5MG/MLPrefilledSyringe[Aranesp]|CHILD 2020 632|1001|N|N|N||Preferred Generic|351137-Albuterol0.21MG/MLInhalationSolution|CHILD 2020 632|1001|N|N|N||Preferred Generic|311960-Niacin500MGExtendedReleaseOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|197853-Ketoconazole200MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1796091-24HRLinagliptin2.5MG/Metforminhydrochloride1000MGExtendedReleaseOralTablet[Jentadueto]|CHILD 2020 632|1001|N|Y|Y||Preferred Brand|1716215-patiromer8400MGPowderforOralSuspension[Veltassa]|CHILD 2020 632|1001|N|N|N||Preferred Brand|759469-Quasense91DayPack|CHILD 2020 632|1001|N|N|N||Preferred Generic|884308-Nystatin100UNT/MGTopicalOintment|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1484296-sucroferricoxyhydroxide500MGChewableTablet[Velphoro]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1660934-60ACTUATformoterolfumarate0.005MG/ACTUAT/mometasonefuroate0.1MG/ACTUATMeteredDoseInhaler[Dulera]|CHILD 2020 632|1001|N|N|N||Preferred Brand|351750-podofilox0.005MG/MGTopicalGel[Condylox]|CHILD 2020 632|1001|N|N|N||Preferred Generic|197854-Ketoprofen25MGOralCapsule|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1114074-Vandetanib100MGOralTablet[Caprelsa]|CHILD 2020 632|1001|N|Y|Y||Preferred Brand|2200650-semaglutide14MGOralTablet[Rybelsus]|CHILD 2020 632|1001|Y|N|Y||Preferred Generic|106302-Tretinoin0.25MG/MLTopicalCream|CHILD 2020 632|1001|N|N|N||Preferred Generic|857183-FosinoprilSodium20MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|198034-24HRNifedipine30MGExtendedReleaseOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|261362-alosetron1MGOralTablet[Lotronex]|CHILD 2020 632|1001|Y|N|N||Preferred Generic|313165-0.5MLSumatriptan12MG/MLInjection|CHILD 2020 632|1001|Y|N|N||Preferred Brand|731231-0.3MLdarbepoetinalfa0.5MG/MLPrefilledSyringe[Aranesp]|CHILD 2020 632|1001|N|N|N||Preferred Generic|310434-gabapentin800MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|861200-Brimonidinetartrate2MG/MLOphthalmicSolution|CHILD 2020 632|1001|Y|N|N||Preferred Brand|731229-0.6MLdarbepoetinalfa0.5MG/MLPrefilledSyringe[Aranesp]|CHILD 2020 632|1001|Y|N|N||Preferred Generic|311204-Itraconazole100MGOralCapsule|CHILD 2020 632|1001|N|N|Y||Preferred Generic|310288-Fenofibrate134MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|897683-Verapamilhydrochloride80MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|881341-adefovirdipivoxil10MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|1797880-Nafarelin0.2MG/ACTUATMeteredDoseNasalSpray[Synarel]|CHILD 2020 632|1001|N|N|N||Preferred Generic|857187-FosinoprilSodium40MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|884619-eltrombopag75MGOralTablet[Promacta]|CHILD 2020 632|1001|N|Y|N||Preferred Brand|1190334-24HRFexofenadinehydrochloride180MG/PseudoephedrineHydrochloride240MGExtendedReleaseOralTablet[Wal-FexD]|CHILD 2020 632|1001|N|N|N||Preferred Brand|312018-Nitroglycerin6.5MGExtendedReleaseOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Brand|749151-Tri-Norinyl28DayPack|CHILD 2020 632|1001|N|N|N||Preferred Generic|991086-DicyclomineHydrochloride20MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|352047-1MLdarbepoetinalfa0.1MG/MLInjection[Aranesp]|CHILD 2020 632|1001|N|N|N||Preferred Brand|1359020-Microgestin1/2021DayPack|CHILD 2020 632|1001|N|N|N||Preferred Generic|351249-Escitalopram5MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|199159-Tretinoin10MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|200060-mycophenolatemofetil500MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1115464-1MLLeuprolideAcetate7.5MG/MLPrefilledSyringe[Lupron]|CHILD 2020 632|1001|N|N|N||Preferred Generic|198045-Nortriptyline10MGOralCapsule|CHILD 2020 632|1001|Y|N|N||Preferred Brand|352262-1MLdarbepoetinalfa0.3MG/MLInjection[Aranesp]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|261962-Ramipril10MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|244967-PolymyxinB10000UNT/ML/Trimethoprim1MG/MLOphthalmicSolution|CHILD 2020 632|1001|N|N|N||Preferred Generic|1665188-1MLLorazepam2MG/MLInjection|CHILD 2020 632|1001|N|N|N||Preferred Generic|198377-Tacrolimus1MGOralCapsule|CHILD 2020 632|1001|Y|N|N||Preferred Generic|968766-PhentermineHydrochloride15MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|309110-Cephalexin25MG/MLOralSuspension|CHILD 2020 632|1001|Y|N|N||Preferred Brand|352046-1MLdarbepoetinalfa0.06MG/MLInjection[Aranesp]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|541892-Amphetamineaspartate2.5MG/AmphetamineSulfate2.5MG/Dextroamphetaminesaccharate2.5MG/DextroamphetamineSulfate2.5MGOralTa|CHILD 2020 632|1001|N|N|N||Preferred Generic|309371-Clotrimazole10MGOralLozenge|CHILD 2020 632|1001|N|N|N||Preferred Generic|861743-Glyburide1.25MG/Metforminhydrochloride250MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|351250-Escitalopram20MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|1426881-Levonorgestrel1.5MGOralTablet[MyWay]|CHILD 2020 632|1001|N|N|N||Preferred Generic|1099596-DivalproexSodium125MGDelayedReleaseOralCapsule|CHILD 2020 632|1001|Y|N|Y||Preferred Generic|197634-dronabinol10MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|1193358-100MLLevetiracetam10MG/MLInjection|CHILD 2020 632|1001|N|N|N||Preferred Generic|860975-24HRMetforminhydrochloride500MGExtendedReleaseOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|896209-60ACTUATFluticasonepropionate0.25MG/ACTUAT/salmeterol0.05MG/ACTUATDryPowderInhaler|CHILD 2020 632|1001|N|N|N||Preferred Generic|858817-EnalaprilMaleate10MGOralTablet|CHILD 2020 632|1001|N|Y|Y||Preferred Generic|2001565-BXRating24HRMethylphenidateHydrochloride27MGExtendedReleaseOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|853354-0.5MLustekinumab90MG/MLPrefilledSyringe[Stelara]|CHILD 2020 632|1001|N|N|N||Preferred Generic|197855-Ketoprofen50MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|198089-Phenobarbital60MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|197304-Acetazolamide250MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|1806189-30/70Release24HRMethylphenidateHydrochloride30MGExtendedReleaseOralCapsule|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1649491-ivabradine5MGOralTablet[Corlanor]|CHILD 2020 632|1001|Y|N|N||Preferred Generic|861960-armodafinil200MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|1193362-100MLLevetiracetam5MG/MLInjection|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1116639-Ticagrelor90MGOralTablet[Brilinta]|CHILD 2020 632|1001|N|N|N||Preferred Brand|617333-Amoxicillin25MG/ML/Clavulanate6.25MG/MLOralSuspension[Augmentin]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|197738-Glycopyrrolate1MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1091650-azilsartanmedoxomil40MGOralTablet[Edarbi]|CHILD 2020 632|1001|N|N|N||Preferred Generic|1923426-SotalolHydrochloride80MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|197686-Etodolac400MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|308973-Carbamazepine100MGChewableTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|1298088-FlurazepamHydrochloride15MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|359296-calciumacetate667MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|197499-Chlorthalidone25MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|199889-topiramate100MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|2563032-0.5MLinfluenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.03MG/|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1796096-24HRLinagliptin5MG/Metforminhydrochloride1000MGExtendedReleaseOralTablet[Jentadueto]|CHILD 2020 632|1001|N|Y|N||Preferred Generic|239239-Griseofulvin250MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|404449-Thalidomide100MGOralCapsule[Thalomid]|CHILD 2020 632|1001|Y|N|N||Preferred Generic|603206-erlotinib150MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|404450-Thalidomide200MGOralCapsule[Thalomid]|CHILD 2020 632|1001|N|N|N||Preferred Generic|886662-FlecainideAcetate50MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2282320-Rimegepant75MGDisintegratingOralTablet[Nurtec]|CHILD 2020 632|1001|N|N|N||Preferred Generic|686418-ErythromycinEthylsuccinate80MG/MLOralSuspension|CHILD 2020 632|1001|N|N|N||Preferred Generic|197856-Ketoprofen75MGOralCapsule|CHILD 2020 632|1001|N|N|Y||Preferred Generic|728113-Oseltamivir45MGOralCapsule|CHILD 2020 632|1001|N|N|Y||Preferred Generic|252559-Budesonide0.5MG/MLInhalationSuspension|CHILD 2020 632|1001|N|N|Y||Preferred Generic|314135-naratriptan2.5MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1149667-Camrese91DayPack|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1596778-14ACTUATBudesonide2MG/ACTUATRectalFoam[Uceris]|CHILD 2020 632|1001|N|N|N||Preferred Generic|103951-Tolnaftate10MG/MLTopicalCream|CHILD 2020 632|1001|N|Y|N||Preferred Brand|539789-rifaximin200MGOralTablet[XIFAXAN]|CHILD 2020 632|1001|N|N|N||Preferred Generic|1053697-Nystatin100UNT/MG/TriamcinoloneAcetonide0.001MG/MGTopicalOintment|CHILD 2020 632|1001|Y|N|N||Preferred Generic|465355-voriconazole40MG/MLOralSuspension|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1149617-COLLAGENASE0.25UNT/MGTopicalOintment[Santyl]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|540181-alosetron0.5MGOralTablet[Lotronex]|CHILD 2020 632|1001|Y|N|N||Preferred Generic|317160-temozolomide100MGOralCapsule|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1801519-Methylnaltrexonebromide150MGOralTablet[Relistor]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|867506-pazopanib200MGOralTablet[Votrient]|CHILD 2020 632|1001|N|N|N||Preferred Generic|311726-Mirtazapine45MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|903456-liothyroninesodium0.005MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|360110-Sirolimus2MGOralTablet|CHILD 2020 632|1001|Y|N|Y||Preferred Generic|106303-Tretinoin0.5MG/MLTopicalCream|CHILD 2020 632|1001|N|N|N||Preferred Generic|1665050-Cefazolin1000MGInjection|CHILD 2020 632|1001|N|N|N||Preferred Generic|199703-cabergoline0.5MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|646456-Nystatin100UNT/MGTopicalPowder|CHILD 2020 632|1001|N|N|N||Preferred Generic|831054-DiltiazemHydrochloride120MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|582595-Iloprost0.01MG/MLInhalationSolution[Ventavis]|CHILD 2020 632|1001|N|Y|N||Preferred Generic|204119-Malathion5MG/MLTopicalLotion|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1605071-0.5MLFILGRASTIM-SNDZ0.6MG/MLPrefilledSyringe[Zarxio]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1790546-infliximab-dyyb100MGInjection[Inflectra]|CHILD 2020 632|1001|N|N|N||Preferred Generic|381056-IsosorbideDinitrate10MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|866511-MetoprololTartrate100MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|315183-PotassiumChloride8MEQExtendedReleaseOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Brand|1233850-Vestura28DayPack|CHILD 2020 632|1001|N|N|N||Preferred Generic|310489-24HRGlipizide2.5MGExtendedReleaseOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|251872-pantoprazole20MGDelayedReleaseOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|861043-2.7MLpramlintideacetate1MG/MLPenInjector[Symlin]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|198035-24HRNifedipine60MGExtendedReleaseOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1191128-EdrophoniumChloride10MG/MLInjectableSolution[Enlon]|CHILD 2020 632|1001|N|N|N||Preferred Generic|198380-tioconazole0.065MG/MGVaginalOintment|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1232204-Zolpidemtartrate3.5MGSublingualTablet[Intermezzo]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|602862-magnesiumaminoacidchelate133MGOralTablet[MGPlusProtein]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1232200-Zolpidemtartrate1.75MGSublingualTablet[Intermezzo]|CHILD 2020 632|1001|Y|N|N||Preferred Generic|1299917-Tiagabinehydrochloride4MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|993755-Acetaminophen24MG/ML/CodeinePhosphate2.4MG/MLOralSolution|CHILD 2020 632|1001|N|N|N||Preferred Generic|197319-Allopurinol100MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|1085636-TriamcinoloneAcetonide0.001MG/MGTopicalOintment|CHILD 2020 632|1001|N|N|N||Preferred Generic|387003-Levetiracetam1000MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|999613-SulfacetamideSodium100MG/ML/Sulfur50MG/MLMedicatedLiquidSoap|CHILD 2020 632|1001|N|Y|N||Preferred Generic|198373-calcipotriene0.00005MG/MGTopicalOintment|CHILD 2020 632|1001|N|N|Y||Preferred Generic|349200-valsartan320MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|199351-trandolapril2MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|1855086-thyroid(USP)15MGOralTablet[NPThyroid]|CHILD 2020 632|1001|N|N|N||Preferred Generic|835913-MefloquineHydrochloride250MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|607579-entecavir0.05MG/MLOralSolution[Baraclude]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1235157-azilsartanmedoxomil40MG/Chlorthalidone25MGOralTablet[Edarbyclor]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|1009145-Amphetamineaspartate1.875MG/AmphetamineSulfate1.875MG/Dextroamphetaminesaccharate1.875MG/DextroamphetamineSulfate1.87|CHILD 2020 632|1001|N|N|N||Preferred Generic|198382-famciclovir500MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|1737461-PamidronateDisodium90MGInjection|CHILD 2020 632|1001|N|N|N||Preferred Brand|762334-Velivet28DayPack|CHILD 2020 632|1001|N|N|N||Preferred Generic|866090-buspironehydrochloride30MGOralTablet|CHILD 2020 632|1001|N|Y|Y||Preferred Generic|483442-pregabalin25MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|1150836-LevobunololHydrochloride5MG/MLOphthalmicSolution|CHILD 2020 632|1001|N|N|N||Preferred Generic|1191013-Proparacainehydrochloride5MG/MLOphthalmicSolution|CHILD 2020 632|1001|N|N|N||Preferred Generic|866083-buspironehydrochloride10MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1596023-ferriccitrate1000MGOralTablet[Auryxia]|CHILD 2020 632|1001|N|N|N||Preferred Generic|1043690-hydrocortisoneacetate10MG/MLTopicalCream|CHILD 2020 632|1001|N|Y|N||Preferred Generic|1368438-alogliptin25MG/pioglitazone45MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|1293639-Caffeine100MG/ErgotamineTartrate2MGRectalSuppository[Migergot]|CHILD 2020 632|1001|N|N|N||Preferred Generic|858813-EnalaprilMaleate5MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|577961-Amphetamineaspartate5MG/AmphetamineSulfate5MG/Dextroamphetaminesaccharate5MG/DextroamphetamineSulfate5MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|199885-Levofloxacin500MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|313582-venlafaxine25MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|245314-Albuterol5MG/MLInhalationSolution|CHILD 2020 632|1001|Y|N|Y||Preferred Generic|197636-dronabinol5MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|857340-BethanecholChloride50MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|311277-lansoprazole30MGDelayedReleaseOralCapsule|CHILD 2020 632|1001|N|N|Y||Preferred Generic|199370-Ciprofloxacin100MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|1923428-Timolol2.5MG/MLOphthalmicSolution|CHILD 2020 632|1001|N|N|Y||Preferred Generic|248478-84HREstradiol0.00104MG/HRTransdermalSystem|CHILD 2020 632|1001|N|N|N||Preferred Generic|317173-Captopril25MGOralTablet|CHILD 2020 632|1001|Y|N|Y||Preferred Generic|197635-dronabinol2.5MGOralCapsule|CHILD 2020 632|1001|N|Y|Y||Preferred Generic|797274-Clindamycin10MG/MLMedicatedPad|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1242615-Isotretinoin40MGOralCapsule[Myorisan]|CHILD 2020 632|1001|N|N|N||Preferred Generic|197832-isoniazid300MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1242611-Isotretinoin10MGOralCapsule[Myorisan]|CHILD 2020 632|1001|N|N|N||Preferred Generic|317573-pioglitazone15MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|856845-AmitriptylineHydrochloride50MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|861164-12HRPropafenoneHydrochloride325MGExtendedReleaseOralCapsule|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1747181-0.4MLMethotrexate31.3MG/MLAuto-Injector[Otrexup]|CHILD 2020 632|1001|Y|N|N||Preferred Generic|616578-lubiprostone0.024MGOralCapsule|CHILD 2020 632|1001|Y|N|N||Preferred Brand|731227-0.4MLdarbepoetinalfa0.1MG/MLPrefilledSyringe[Aranesp]|CHILD 2020 632|1001|N|N|N||Preferred Brand|544597-PotassiumIodide1000MG/MLOralSolution[SSKIbrandofPotassiumIodide]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1242968-exenatide2MGInjection[Bydureon]|CHILD 2020 632|1001|N|N|Y||Preferred Brand|1986830-0.5MLVaricellazostervirusglycoproteinE,recombinant0.1MG/MLInjection[Shingrix]|CHILD 2020 632|1001|N|N|N||Preferred Generic|310431-gabapentin300MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|197862-Leucovorin25MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|892342-24HRMorphineSulfate30MGExtendedReleaseOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|393245-Digoxin0.05MG/MLOralSolution|CHILD 2020 632|1001|Y|N|N||Preferred Brand|616116-lenalidomide5MGOralCapsule[Revlimid]|CHILD 2020 632|1001|N|N|N||Preferred Generic|748961-{28(Norethindrone0.35MGOralTablet)}Pack|CHILD 2020 632|1001|Y|N|N||Preferred Brand|758027-0.5MLInterferonbeta-1a0.088MG/MLPrefilledSyringe[Rebif]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|728109-Oseltamivir30MGOralCapsule|CHILD 2020 632|1001|N|N|Y||Preferred Brand|1658157-1MLHepatitisBSurfaceAntigenVaccine0.02MG/MLInjection[Engerix-B]|CHILD 2020 632|1001|N|N|N||Preferred Brand|2563039-0.5MLinfluenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.03MG/|CHILD 2020 632|1001|Y|N|N||Preferred Generic|1728055-5MLpalonosetron0.05MG/MLInjection|CHILD 2020 632|1001|N|N|N||Preferred Brand|206216-2MLIron-DextranComplex50MG/MLInjection[InFed]|CHILD 2020 632|1001|Y|N|N||Preferred Generic|577776-candesartancilexetil16MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|830882-24HRDiltiazemHydrochloride300MGExtendedReleaseOralTablet|CHILD 2020 632|1001|N|Y|N||Preferred Generic|197551-Cycloserine250MGOralCapsule|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1242233-lenalidomide2.5MGOralCapsule[Revlimid]|CHILD 2020 632|1001|Y|N|N||Preferred Generic|1426600-{24(EthinylEstradiol0.02MG/norethindroneacetate1MGChewableTablet)/4(Ferrousfumarate75MGOralTablet)}Pack|CHILD 2020 632|1001|N|N|N||Preferred Generic|318272-Aspirin81MGChewableTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|311666-Metoclopramide10MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|349373-Olmesartanmedoxomil5MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1745114-1MLixekizumab80MG/MLPrefilledSyringe[Taltz]|CHILD 2020 632|1001|N|N|N||Preferred Generic|1191315-FluocinoloneAcetonide0.25MG/MLTopicalCream|CHILD 2020 632|1001|Y|N|N||Preferred Brand|616283-sunitinib12.5MGOralCapsule[Sutent]|CHILD 2020 632|1001|N|N|N||Preferred Generic|283077-prednisolone3MG/MLOralSolution|CHILD 2020 632|1001|N|N|N||Preferred Generic|692783-Loratadine1MG/MLOralSolution|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1811182-icosapentethyl500MGOralCapsule[Vascepa]|CHILD 2020 632|1001|N|N|N||Preferred Generic|313217-Terazosin2MGOralCapsule|CHILD 2020 632|1001|Y|N|Y||Preferred Generic|312084-Ondansetron24MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1243033-Linagliptin2.5MG/Metforminhydrochloride500MGOralTablet[Jentadueto]|CHILD 2020 632|1001|N|N|Y||Preferred Brand|1049216-Acetaminophen325MG/OxycodoneHydrochloride10MGOralTablet[Endocet]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|309309-Ciprofloxacin500MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|861487-ClobetasolPropionate0.5MG/MLTopicalSolution|CHILD 2020 632|1001|N|N|N||Preferred Brand|688242-Estrogens,Conjugated(USP)0.625MG/MLVaginalCream[Premarin]|CHILD 2020 632|1001|N|N|N||Preferred Brand|707333-SodiumChloride0.111MEQ/MLNasalSolution[AyrSalineNasal]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|861045-1.5MLpramlintideacetate1MG/MLPenInjector[Symlin]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|854228-0.3MLEnoxaparinsodium100MG/MLPrefilledSyringe|CHILD 2020 632|1001|N|N|N||Preferred Generic|885857-Balsalazidedisodium750MGOralCapsule|CHILD 2020 632|1001|N|N|Y||Preferred Generic|1649990-DoxycyclineMonohydrate100MGOralCapsule|CHILD 2020 632|1001|Y|N|N||Preferred Brand|731245-0.42MLdarbepoetinalfa0.06MG/MLPrefilledSyringe[Aranesp]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|616287-sunitinib25MGOralCapsule[Sutent]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1037185-LoLoestrinFe28DayPack|CHILD 2020 632|1001|N|N|N||Preferred Generic|1099648-5MLValproicAcid100MG/MLInjection|CHILD 2020 632|1001|N|N|N||Preferred Generic|205305-telmisartan80MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1243052-ivacaftor150MGOralTablet[Kalydeco]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1601373-naloxegol25MGOralTablet[Movantik]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|541878-Amphetamineaspartate1.25MG/AmphetamineSulfate1.25MG/Dextroamphetaminesaccharate1.25MG/DextroamphetamineSulfate1.25MGOr|CHILD 2020 632|1001|N|N|N||Preferred Generic|1047881-HyoscyamineSulfate0.025MG/MLOralSolution|CHILD 2020 632|1001|N|N|N||Preferred Generic|103403-Hydrocortisone10MG/MLTopicalLotion|CHILD 2020 632|1001|Y|N|N||Preferred Generic|1087964-hydroxyprogesteronecaproate(USP)250MG/MLInjectableSolution|CHILD 2020 632|1001|N|N|N||Preferred Generic|307730-Acyclovir40MG/MLOralSuspension|CHILD 2020 632|1001|N|N|N||Preferred Generic|198509-Bisacodyl10MGRectalSuppository|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1243026-Linagliptin2.5MG/Metforminhydrochloride1000MGOralTablet[Jentadueto]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|854238-0.6MLEnoxaparinsodium100MG/MLPrefilledSyringe|CHILD 2020 632|1001|N|N|N||Preferred Generic|311194-IsosorbideDinitrate40MGExtendedReleaseOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|198242-Temazepam30MGOralCapsule|CHILD 2020 632|1001|Y|N|N||Preferred Brand|615979-sorafenib200MGOralTablet[Nexavar]|CHILD 2020 632|1001|N|N|N||Preferred Generic|197860-Leucovorin10MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|1020155-Introvale91DayPack|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1243843-24HRMetforminhydrochloride1000MG/sitagliptin50MGExtendedReleaseOralTablet[Janumet]|CHILD 2020 632|1001|N|N|N||Preferred Generic|857683-TerbutalineSulfate5MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|577957-Amphetamineaspartate3.75MG/AmphetamineSulfate3.75MG/Dextroamphetaminesaccharate3.75MG/DextroamphetamineSulfate3.75MGOr|CHILD 2020 632|1001|N|N|N||Preferred Brand|208513-Estrogens,Conjugated(USP)0.3MGOralTablet[Premarin]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|993781-Acetaminophen300MG/CodeinePhosphate30MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|992438-PromethazineHydrochloride12.5MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Brand|1300378-0.5MLBordetellapertussisfilamentoushemagglutininvaccine,inactivated0.016MG/ML/Bordetellapertussispertactinvaccine,ina|CHILD 2020 632|1001|N|N|N||Preferred Generic|309098-Cefuroxime500MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|643173-dasatinib20MGOralTablet[Sprycel]|CHILD 2020 632|1001|N|N|N||Preferred Generic|1437702-Albuterol0.833MG/ML/IpratropiumBromide0.167MG/MLInhalationSolution|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1243848-24HRMetforminhydrochloride500MG/sitagliptin50MGExtendedReleaseOralTablet[Janumet]|CHILD 2020 632|1001|N|N|N||Preferred Generic|199150-Acarbose100MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|977880-AmilorideHydrochloride5MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|616292-sunitinib50MGOralCapsule[Sutent]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|1918209-60ACTUATfluticasonepropionate0.055MG/ACTUAT/salmeterol0.014MG/ACTUATDryPowderInhaler|CHILD 2020 632|1001|N|N|N||Preferred Brand|102250-Hydrocortisone1.67MG/MLEnema[Cortenema]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|858366-KetorolacTromethamine4.5MG/MLOphthalmicSolution[Acuvail]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1244062-0.6MLMethylnaltrexonebromide20MG/MLPrefilledSyringe[Relistor]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1593835-24HRdapagliflozin10MG/Metforminhydrochloride500MGExtendedReleaseOralTablet[Xigduo]|CHILD 2020 632|1001|N|N|N||Preferred Generic|1116758-chloroquinephosphate500MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|1860151-Abuse-Deterrent12HROxycodoneHydrochloride30MGExtendedReleaseOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|1874553-24HRdesvenlafaxinesuccinate100MGExtendedReleaseOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|153183-adapalene0.001MG/MGTopicalGel[Differin]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1813112-Rajani28DayPack|CHILD 2020 632|1001|N|N|N||Preferred Generic|828320-Cyclobenzaprinehydrochloride5MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|1363309-ChlorpheniramineMaleate4MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|854844-lisdexamfetaminedimesylate70MGOralCapsule[Vyvanse]|CHILD 2020 632|1001|N|N|N||Preferred Generic|866514-MetoprololTartrate50MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|198467-Aspirin325MGDelayedReleaseOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|313412-tizanidine2MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|403855-Hydrochlorothiazide25MG/Olmesartanmedoxomil40MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|727816-0.5MLInterferonbeta-1a0.06MG/MLPrefilledSyringe[Avonex]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1244632-AmethiaLo91DayPack|CHILD 2020 632|1001|N|N|N||Preferred Generic|349208-Sirolimus1MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|643177-dasatinib70MGOralTablet[Sprycel]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1148506-crizotinib250MGOralCapsule[Xalkori]|CHILD 2020 632|1001|N|N|N||Preferred Generic|103457-Fluocinonide0.0005MG/MGTopicalOintment|CHILD 2020 632|1001|N|N|Y||Preferred Generic|351133-Fenofibrate54MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|861171-12HRPropafenoneHydrochloride425MGExtendedReleaseOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Brand|213282-hydroxyurea200MGOralCapsule[Droxia]|CHILD 2020 632|1001|Y|N|N||Preferred Generic|876524-Amlodipine5MG/telmisartan40MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|643488-Isotretinoin30MGOralCapsule[Claravis]|CHILD 2020 632|1001|N|N|N||Preferred Brand|616449-MycophenolicAcid360MGDelayedReleaseOralTablet[Myfortic]|CHILD 2020 632|1001|N|N|N||Preferred Generic|997501-Fexofenadinehydrochloride60MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|200095-irbesartan150MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|197885-Hydrochlorothiazide12.5MG/Lisinopril10MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|860805-Azelastinehydrochloride0.5MG/MLOphthalmicSolution|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1245003-eltrombopag12.5MGOralTablet[Promacta]|CHILD 2020 632|1001|N|N|N||Preferred Brand|1000497-Prempro0.45/1.528DayPack|CHILD 2020 632|1001|N|N|N||Preferred Generic|197448-Levocarnitine330MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|999991-Amlodipine10MG/Hydrochlorothiazide25MG/Olmesartanmedoxomil40MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|199163-Melatonin3MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|860225-MegestrolAcetate40MG/MLOralSuspension|CHILD 2020 632|1001|Y|N|N||Preferred Generic|857700-DiclofenacSodium15MG/MLTopicalSolution|CHILD 2020 632|1001|N|N|N||Preferred Generic|831109-CromolynSodium40MG/MLOphthalmicSolution|CHILD 2020 632|1001|Y|N|N||Preferred Brand|404065-Isotretinoin40MGOralCapsule[Claravis]|CHILD 2020 632|1001|N|N|N||Preferred Generic|403966-zonisamide25MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|1801298-MicroencapsulatedPotassiumChloride10MEQExtendedReleaseOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1115473-1.5MLLeuprolideAcetate7.5MG/MLPrefilledSyringe[Lupron]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1291092-hydrocortisoneacetate30MGRectalSuppository[Proctocort]|CHILD 2020 632|1001|N|N|N||Preferred Generic|858616-Nicardipinehydrochloride30MGOralCapsule|CHILD 2020 632|1001|N|N|Y||Preferred Generic|608139-atomoxetine100MGOralCapsule|CHILD 2020 632|1001|Y|N|N||Preferred Generic|199378-12HRCarbamazepine100MGExtendedReleaseOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|403922-168HREstradiol0.00156MG/HRTransdermalSystem|CHILD 2020 632|1001|N|N|N||Preferred Generic|860215-MegestrolAcetate20MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|1304979-icosapentethyl1000MGOralCapsule|CHILD 2020 632|1001|Y|N|N||Preferred Brand|828696-Zolpidemtartrate5MG/ACTUATOralSpray[Zolpimist]|CHILD 2020 632|1001|N|N|N||Preferred Generic|199390-Etodolac500MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|343033-Dexamethasone0.75MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|858613-Nicardipinehydrochloride20MGOralCapsule|CHILD 2020 632|1001|Y|N|N||Preferred Brand|825429-eltrombopag50MGOralTablet[Promacta]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|825425-eltrombopag25MGOralTablet[Promacta]|CHILD 2020 632|1001|N|N|N||Preferred Generic|905395-HydralazineHydrochloride50MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|1607990-{24(EthinylEstradiol0.025MG/Norethindrone0.8MGChewableTablet)/4(Ferrousfumarate75MGChewableTablet)}Pack|CHILD 2020 632|1001|N|Y|Y||Preferred Generic|197978-Metolazone10MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|349594-atomoxetine40MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|308345-apraclonidine5MG/MLOphthalmicSolution|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1654079-0.5MLustekinumab90MG/MLInjection[Stelara]|CHILD 2020 632|1001|N|N|N||Preferred Generic|858625-Pramipexoledihydrochloride0.75MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|643722-lenalidomide25MGOralCapsule[Revlimid]|CHILD 2020 632|1001|N|N|N||Preferred Generic|197886-Hydrochlorothiazide12.5MG/Lisinopril20MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|200329-Omeprazole40MGDelayedReleaseOralCapsule|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1115259-1.5MLLeuprolideAcetate30MG/MLPrefilledSyringe[Lupron]|CHILD 2020 632|1001|N|N|N||Preferred Generic|643102-Ibuprofen200MGOralTablet[Wal-Profen]|CHILD 2020 632|1001|N|N|N||Preferred Generic|995281-HydroxyzineHydrochloride50MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|1000054-DoxepinHydrochloride10MG/MLOralSolution|CHILD 2020 632|1001|Y|N|N||Preferred Generic|802749-candesartancilexetil32MG/Hydrochlorothiazide25MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1605172-0.4MLdarbepoetinalfa0.025MG/MLPrefilledSyringe[Aranesp]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1657976-4MLtocilizumab20MG/MLInjection[Actemra]|CHILD 2020 632|1001|N|N|N||Preferred Generic|1099678-DivalproexSodium250MGDelayedReleaseOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|429503-Hydrochlorothiazide12.5MGOralTablet|CHILD 2020 632|1001|N|Y|N||Preferred Generic|1085816-spinosad9MG/MLMedicatedShampoo|CHILD 2020 632|1001|N|N|N||Preferred Generic|996561-Memantinehydrochloride10MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|198741-MagnesiumOxide400MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|313161-Sumatriptan50MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|859186-selegilinehydrochloride5MGOralCapsule|CHILD 2020 632|1001|N|Y|N||Preferred Generic|1368392-alogliptin12.5MG/Metforminhydrochloride500MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|197454-Cephalexin500MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|314165-prednisolone10MG/MLOphthalmicSolution|CHILD 2020 632|1001|N|N|N||Preferred Brand|1358765-JunelFe1/2028DayPack|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1115456-1MLLeuprolideAcetate15MG/MLPrefilledSyringe[Lupron]|CHILD 2020 632|1001|N|N|N||Preferred Generic|197604-Digoxin0.125MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1300797-24HRmirabegron25MGExtendedReleaseOralTablet[Myrbetriq]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|636045-Hydrochlorothiazide25MG/valsartan320MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|859048-Pramipexoledihydrochloride1.5MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|284551-nilutamide150MGOralTablet[Nilandron]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|1812015-Osmotic24HRNifedipine90MGExtendedReleaseOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1801322-3.5MLevolocumab120MG/MLCartridge[Repatha]|CHILD 2020 632|1001|N|N|N||Preferred Brand|854918-BisoprololFumarate2.5MG/Hydrochlorothiazide6.25MGOralTablet[Ziac]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|896237-120ACTUATFluticasonepropionate0.045MG/ACTUAT/salmeterol0.021MG/ACTUATMeteredDoseInhaler[Advair]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|753443-9HRMethylphenidate3.33MG/HRTransdermalSystem[Daytrana]|CHILD 2020 632|1001|N|N|N||Preferred Generic|309291-ciclopirox80MG/MLTopicalSolution|CHILD 2020 632|1001|Y|N|Y||Preferred Brand|861771-Metforminhydrochloride1000MG/sitagliptin50MGOralTablet[Janumet]|CHILD 2020 632|1001|N|N|N||Preferred Generic|966249-LevothyroxineSodium0.175MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|207864-crotamiton100MG/MLTopicalCream[Eurax]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1492746-apremilast30MGOralTablet[Otezla]|CHILD 2020 632|1001|N|N|N||Preferred Generic|432400-cinacalcet90MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|311681-Metronidazole500MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|763185-{21(Prednisone10MGOralTablet)}Pack|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1307630-bosutinib100MGOralTablet[Bosulif]|CHILD 2020 632|1001|N|N|N||Preferred Generic|858828-EnalaprilMaleate10MG/Hydrochlorothiazide25MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|727316-NDA0194300.3MLEpinephrine0.5MG/MLAuto-Injector|CHILD 2020 632|1001|N|N|N||Preferred Generic|198440-Acetaminophen500MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|727714-0.67MLanakinra149MG/MLPrefilledSyringe[Kineret]|CHILD 2020 632|1001|N|N|N||Preferred Generic|197887-Hydrochlorothiazide25MG/Lisinopril20MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1732161-incobotulinumtoxinA100UNTInjection[Xeomin]|CHILD 2020 632|1001|N|N|N||Preferred Generic|866436-24HRmetoprololsuccinate50MGExtendedReleaseOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|993541-24HRBupropionHydrochloride150MGExtendedReleaseOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|242438-montelukast5MGChewableTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|1860100-ferroussulfate324MGDelayedReleaseOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|198369-torsemide10MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|1099681-ValproicAcid250MGOralCapsule|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1307635-bosutinib500MGOralTablet[Bosulif]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|727705-0.8MLadalimumab50MG/MLPrefilledSyringe[Humira]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1243833-24HRMetforminhydrochloride1000MG/sitagliptin100MGExtendedReleaseOralTablet[Janumet]|CHILD 2020 632|1001|N|N|N||Preferred Generic|1047905-HyoscyamineSulfate0.125MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1648789-30ACTUATfluticasonefuroate0.2MG/ACTUAT/vilanterol0.025MG/ACTUATDryPowderInhaler[Breo]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1043574-24HRMetforminhydrochloride1000MG/saxagliptin5MGExtendedReleaseOralTablet[Kombiglyze]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|351109-Budesonide0.25MG/MLInhalationSuspension|CHILD 2020 632|1001|N|N|N||Preferred Generic|198049-Ofloxacin300MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1593833-24HRdapagliflozin5MG/Metforminhydrochloride1000MGExtendedReleaseOralTablet[Xigduo]|CHILD 2020 632|1001|N|N|N||Preferred Generic|199353-trandolapril1MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|1812013-Osmotic24HRNifedipine60MGExtendedReleaseOralTablet|CHILD 2020 632|1001|Y|N|Y||Preferred Brand|665044-sitagliptin50MGOralTablet[Januvia]|CHILD 2020 632|1001|N|N|N||Preferred Generic|432402-cinacalcet30MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|858804-EnalaprilMaleate2.5MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|861132-24HRAlfuzosinhydrochloride10MGExtendedReleaseOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|213510-Auranofin3MGOralCapsule[Ridaura]|CHILD 2020 632|1001|N|N|N||Preferred Generic|858747-Ursodiol300MGOralCapsule|CHILD 2020 632|1001|Y|N|N||Preferred Brand|700418-Thalidomide150MGOralCapsule[Thalomid]|CHILD 2020 632|1001|Y|N|N||Preferred Generic|824301-rufinamide400MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|197973-Methylprednisolone8MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|349198-Clonazepam0.5MGDisintegratingOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1806942-carfilzomib60MGInjection[Kyprolis]|CHILD 2020 632|1001|N|N|N||Preferred Generic|198429-lamotrigine200MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|1992303-12HRTimolol5MG/MLOphthalmicSolution|CHILD 2020 632|1001|N|N|Y||Preferred Brand|1992171-3MLInsulinLispro100UNT/MLPenInjector[Admelog]|CHILD 2020 632|1001|N|N|N||Preferred Generic|312748-quinapril10MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|260243-Progesterone100MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|992441-PromethazineHydrochloride12.5MGRectalSuppository|CHILD 2020 632|1001|Y|N|N||Preferred Brand|352045-1MLdarbepoetinalfa0.04MG/MLInjection[Aranesp]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|643175-dasatinib50MGOralTablet[Sprycel]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|853356-1MLustekinumab90MG/MLPrefilledSyringe[Stelara]|CHILD 2020 632|1001|N|N|N||Preferred Generic|391937-Lactulose667MG/MLOralSolution|CHILD 2020 632|1001|N|N|Y||Preferred Generic|1806191-30/70Release24HRMethylphenidateHydrochloride40MGExtendedReleaseOralCapsule|CHILD 2020 632|1001|N|N|Y||Preferred Generic|807832-24HRLevetiracetam500MGExtendedReleaseOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|857677-TerbutalineSulfate2.5MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|2563031-influenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.03MG/ML/in|CHILD 2020 632|1001|Y|N|N||Preferred Generic|1923822-deferasirox90MGOralGranules|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1313061-24HRPhentermine11.25MG/topiramate69MGExtendedReleaseOralCapsule[Qsymia]|CHILD 2020 632|1001|N|N|N||Preferred Generic|857461-ClemastineFumarate2.68MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|616114-lenalidomide10MGOralCapsule[Revlimid]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1310144-everolimus3MGTabletforOralSuspension[Afinitor]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|242333-168HREstradiol0.00104MG/HRTransdermalSystem|CHILD 2020 632|1001|N|N|Y||Preferred Generic|596930-duloxetine30MGDelayedReleaseOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|1359117-{24(EthinylEstradiol0.02MG/norethindroneacetate1MGOralTablet)/4(Ferrousfumarate75MGOralTablet)}Pack|CHILD 2020 632|1001|N|N|N||Preferred Generic|834061-PenicillinVPotassium250MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1357547-tofacitinib5MGOralTablet[Xeljanz]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|861966-Iloprost0.02MG/MLInhalationSolution[Ventavis]|CHILD 2020 632|1001|N|N|N||Preferred Generic|197904-Lovastatin20MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|197971-Methylprednisolone32MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|309362-clopidogrel75MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2170613-1MLgalcanezumab-gnlm100MG/MLPrefilledSyringe[Emgality]|CHILD 2020 632|1001|N|N|N||Preferred Generic|857328-BethanecholChloride25MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|310410-FolicAcid1MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|616444-mycophenolatemofetil200MG/MLOralSuspension[Cellcept]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1729065-selexipag0.8MGOralTablet[Uptravi]|CHILD 2020 632|1001|N|N|N||Preferred Generic|328160-Cyclosporine100MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|197815-Indapamide1.25MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|310433-gabapentin600MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|206208-aluminumchloride200MG/MLTopicalSolution[Drysol]|CHILD 2020 632|1001|N|N|N||Preferred Generic|857305-ClomipramineHydrochloride75MGOralCapsule|CHILD 2020 632|1001|Y|N|N||Preferred Generic|892349-24HRMorphineSulfate60MGExtendedReleaseOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|486131-BenzoylPeroxide0.1MG/MGTopicalGel|CHILD 2020 632|1001|N|N|N||Preferred Generic|979409-MetaproterenolSulfate10MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|857301-ClomipramineHydrochloride50MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|198024-Niacin500MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|404062-Isotretinoin20MGOralCapsule[Claravis]|CHILD 2020 632|1001|Y|N|N||Preferred Generic|1591943-ledipasvir90MG/sofosbuvir400MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|1597123-2500MGTestosterone0.01MG/MGTopicalGel|CHILD 2020 632|1001|N|N|N||Preferred Generic|314234-Sucralfate1000MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|198365-Prochlorperazine10MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|104884-Metoclopramide1MG/MLOralSolution|CHILD 2020 632|1001|N|N|N||Preferred Generic|197670-Estrogens,Esterified(USP)1.25MG/Methyltestosterone2.5MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|197735-Gentamicin1MG/MLTopicalCream|CHILD 2020 632|1001|N|N|N||Preferred Generic|993687-BupropionHydrochloride100MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|310534-Glyburide2.5MGOralTablet|CHILD 2020 632|1001|N|Y|N||Preferred Generic|197419-Bumetanide2MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|997491-Fexofenadinehydrochloride6MG/MLOralSuspension|CHILD 2020 632|1001|N|N|Y||Preferred Generic|311918-naratriptan1MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|1014678-cetirizinehydrochloride10MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|198012-Naproxen375MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|352044-1MLdarbepoetinalfa0.025MG/MLInjection[Aranesp]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|834022-KetorolacTromethamine10MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|1870230-NDA0208000.3MLEpinephrine1MG/MLAuto-Injector|CHILD 2020 632|1001|Y|N|N||Preferred Generic|672149-lapatinib250MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|239238-Griseofulvin25MG/MLOralSuspension|CHILD 2020 632|1001|N|N|N||Preferred Generic|993691-BupropionHydrochloride75MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|1918203-60ACTUATfluticasonepropionate0.232MG/ACTUAT/salmeterol0.014MG/ACTUATDryPowderInhaler|CHILD 2020 632|1001|N|N|Y||Preferred Generic|349287-Fenofibrate160MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|903891-FluvoxamineMaleate50MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|1112715-Amethyst28DayPack|CHILD 2020 632|1001|N|N|N||Preferred Generic|197905-Lovastatin40MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|153473-Altretamine50MGOralCapsule[Hexalen]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2395775-30ACTUATfluticasonefuroate0.2MG/ACTUAT/umeclidinium0.0625MG/ACTUAT/vilanterol0.025MG/ACTUATDryPowderInhaler[Trelegy]|CHILD 2020 632|1001|N|N|N||Preferred Generic|307675-Acetaminophen32MG/MLOralSolution|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2536758-24HRviloxazine200MGExtendedReleaseOralCapsule[Qelbree]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1729061-selexipag0.6MGOralTablet[Uptravi]|CHILD 2020 632|1001|N|N|N||Preferred Generic|311727-Misoprostol0.1MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|486148-24HRNitroglycerin0.2MG/HRTransdermalSystem|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2536554-24HRviloxazine100MGExtendedReleaseOralCapsule[Qelbree]|CHILD 2020 632|1001|N|N|N||Preferred Generic|311196-24HRIsosorbideMononitrate120MGExtendedReleaseOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2531134-HumiraPen80MG/0.8ML-StarterPackageforPediatricUlcerativeColitis(4count)|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1593775-24HRdapagliflozin10MG/Metforminhydrochloride1000MGExtendedReleaseOralTablet[Xigduo]|CHILD 2020 632|1001|N|N|N||Preferred Generic|856834-AmitriptylineHydrochloride25MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|1099563-24HRDivalproexSodium250MGExtendedReleaseOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1728099-romiplostim0.5MGInjection[Nplate]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|241527-168HREstradiol0.00312MG/HRTransdermalSystem|CHILD 2020 632|1001|N|N|N||Preferred Generic|860981-24HRMetforminhydrochloride750MGExtendedReleaseOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1729057-selexipag0.4MGOralTablet[Uptravi]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|801957-0.5MLDiazepam5MG/MLRectalGel|CHILD 2020 632|1001|N|Y|N||Preferred Generic|311345-linezolid20MG/MLOralSuspension|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1653243-1MLsecukinumab150MG/MLAuto-Injector[Cosentyx]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1373335-Isotretinoin20MGOralCapsule[Zenatane]|CHILD 2020 632|1001|N|N|N||Preferred Generic|348472-Theophylline600MGExtendedReleaseOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|403967-zonisamide50MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|1099292-DesipramineHydrochloride100MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1373337-Isotretinoin40MGOralCapsule[Zenatane]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|1812011-Osmotic24HRNifedipine30MGExtendedReleaseOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|486152-24HRNitroglycerin0.4MG/HRTransdermalSystem|CHILD 2020 632|1001|N|N|N||Preferred Generic|856773-AmitriptylineHydrochloride150MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1302833-24HRPhentermine7.5MG/topiramate46MGExtendedReleaseOralCapsule[Qsymia]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2392142-0.5MLetanercept50MG/MLInjection[Enbrel]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1374574-TOBIPodhalerKit,224|CHILD 2020 632|1001|Y|N|Y||Preferred Generic|310140-eprosartan600MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|900038-PhentermineHydrochloride30MGOralCapsule|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1541928-sunitinib37.5MGOralCapsule[Sutent]|CHILD 2020 632|1001|N|Y|N||Preferred Generic|197418-Bumetanide1MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|861064-Sertraline20MG/MLOralSolution|CHILD 2020 632|1001|N|N|N||Preferred Brand|762007-Nortrel7/7/728DayPack|CHILD 2020 632|1001|N|N|N||Preferred Generic|197919-Melphalan2MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2359353-24HRempagliflozin25MG/linagliptin5MG/metforminhydrochloride1000MGExtendedReleaseOralTablet[Trijardy]|CHILD 2020 632|1001|N|N|N||Preferred Generic|856724-PropranololHydrochloride4MG/MLOralSolution|CHILD 2020 632|1001|N|N|N||Preferred Generic|543546-Nystatin100000UNT/MLTopicalCream|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2359290-24HRempagliflozin12.5MG/linagliptin2.5MG/metforminhydrochloride1000MGExtendedReleaseOralTablet[Trijardy]|CHILD 2020 632|1001|N|N|N||Preferred Generic|310362-Fluocinonide0.0005MG/MGTopicalGel|CHILD 2020 632|1001|N|N|N||Preferred Generic|242446-Ofloxacin3MG/MLOticSolution|CHILD 2020 632|1001|N|N|N||Preferred Generic|310386-Fluoxetine4MG/MLOralSolution|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1747187-0.4MLMethotrexate43.8MG/MLAuto-Injector[Otrexup]|CHILD 2020 632|1001|N|N|N||Preferred Generic|1049167-PseudoephedrineHydrochloride60MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|856706-AmitriptylineHydrochloride10MG/Perphenazine2MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|997420-Fexofenadinehydrochloride180MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|855926-DiclofenacSodium75MGDelayedReleaseOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|313521-Tropicamide5MG/MLOphthalmicSolution|CHILD 2020 632|1001|N|N|Y||Preferred Generic|1926331-0.5UNTDoses3MLInsulinLispro100UNT/MLPenInjector|CHILD 2020 632|1001|N|Y|Y||Preferred Generic|856481-24HRPropranololHydrochloride160MGExtendedReleaseOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|311288-Levetiracetam250MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|197449-Cefaclor500MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|866412-24HRmetoprololsuccinate100MGExtendedReleaseOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|403818-moxifloxacin5MG/MLOphthalmicSolution|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1605455-Otezla28-DayStarterPack|CHILD 2020 632|1001|N|N|N||Preferred Generic|197807-Ibuprofen800MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|197900-Lorazepam0.5MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1429284-NeostigmineMethylsulfate1MG/MLInjectableSolution[Bloxiverz]|CHILD 2020 632|1001|N|N|N||Preferred Generic|866144-Cyproheptadinehydrochloride4MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|1724481-thyroid(USP)60MGOralTablet[NPThyroid]|CHILD 2020 632|1001|N|N|N||Preferred Generic|197557-Dapsone100MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|200224-montelukast10MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1100706-Linagliptin5MGOralTablet[Tradjenta]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|261105-Etanercept25MG/MLInjectableSolution[Enbrel]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1310535-teriflunomide7MGOralTablet[Aubagio]|CHILD 2020 632|1001|N|N|N||Preferred Generic|856457-PropranololHydrochloride20MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|858040-saxagliptin5MGOralTablet[Onglyza]|CHILD 2020 632|1001|N|Y|Y||Preferred Generic|856460-24HRPropranololHydrochloride120MGExtendedReleaseOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|892246-LevothyroxineSodium0.1MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|756209-Zidovudine10MG/MLOralSolution|CHILD 2020 632|1001|N|N|N||Preferred Generic|1115005-DocusateSodium100MGOralCapsule|CHILD 2020 632|1001|N|N|Y||Preferred Generic|197511-Ciprofloxacin250MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Brand|1994352-0.5MLHepatitisBSurfaceAntigenVaccine0.04MG/MLInjection[Heplisav-B]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1729047-selexipag1.6MGOralTablet[Uptravi]|CHILD 2020 632|1001|Y|N|N||Preferred Generic|857216-Sevelamerhydrochloride400MGOralTablet|CHILD 2020 632|1001|N|Y|N||Preferred Generic|197417-Bumetanide0.5MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|315107-24HRGlipizide10MGExtendedReleaseOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Brand|798482-0.5MLHepatitisAVaccine(Inactivated)StrainHM1751440UNT/MLPrefilledSyringe[Havrix]|CHILD 2020 632|1001|N|N|N||Preferred Generic|856783-AmitriptylineHydrochloride10MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|1100457-PyridoxineHydrochloride25MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|198046-Nortriptyline50MGOralCapsule|CHILD 2020 632|1001|Y|N|N||Preferred Generic|153823-candesartancilexetil8MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|854848-lisdexamfetaminedimesylate60MGOralCapsule[Vyvanse]|CHILD 2020 632|1001|N|N|N||Preferred Generic|197383-Atenolol50MG/Chlorthalidone25MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|105590-Thioguanine40MGOralTablet[Tabloid]|CHILD 2020 632|1001|N|N|Y||Preferred Brand|1597103-0.5MLL1protein,Humanpapillomavirustype11Vaccine0.08MG/ML/L1protein,Humanpapillomavirustype16Vaccine0.12MG/ML/L1protei|CHILD 2020 632|1001|N|N|N||Preferred Generic|237776-vitaminB121MGExtendedReleaseOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|849599-1MLcertolizumabpegol200MG/MLPrefilledSyringe[Cimzia]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1606866-ivacaftor50MGOralGranules[Kalydeco]|CHILD 2020 632|1001|N|N|N||Preferred Generic|856373-TrazodoneHydrochloride100MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|200031-carvedilol6.25MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|1191256-FluocinoloneAcetonide0.00025MG/MGTopicalOintment|CHILD 2020 632|1001|N|N|N||Preferred Generic|562251-Amoxicillin250MG/Clavulanate125MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|261353-Trimethoprim10MG/MLOralSolution[Primsol]|CHILD 2020 632|1001|N|N|N||Preferred Generic|313585-24HRvenlafaxine75MGExtendedReleaseOralCapsule|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1364515-Bedaquiline100MGOralTablet[Sirturo]|CHILD 2020 632|1001|N|N|N||Preferred Generic|309113-Cephalexin50MG/MLOralSuspension|CHILD 2020 632|1001|N|N|N||Preferred Generic|993503-12HRBupropionHydrochloride100MGExtendedReleaseOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|993804-Gianvi28-DayPack|CHILD 2020 632|1001|N|N|N||Preferred Generic|755497-Albuterol0.4MG/MLOralSolution|CHILD 2020 632|1001|N|N|N||Preferred Generic|310539-Glyburide6MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|702249-ferroussulfate44MG/MLOralSolution|CHILD 2020 632|1001|N|N|Y||Preferred Generic|857002-Acetaminophen325MG/HydrocodoneBitartrate5MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|1000500-Prempro0.625/528DayPack|CHILD 2020 632|1001|N|N|N||Preferred Brand|542059-Didanosine10MG/MLOralSolution[Videx]|CHILD 2020 632|1001|N|N|N||Preferred Generic|855911-2MLPhenytoinsodium50MG/MLCartridge|CHILD 2020 632|1001|N|N|N||Preferred Generic|314208-ropinirole1MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|197939-Methazolamide25MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|1648759-NITROFURANTOIN,MACROCRYSTALS100MGOralCapsule|CHILD 2020 632|1001|Y|N|N||Preferred Brand|213475-1MLEpoetinAlfa40000UNT/MLInjection[Procrit]|CHILD 2020 632|1001|N|N|N||Preferred Generic|855906-DiclofenacSodium50MGDelayedReleaseOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|404509-CalciumCarbonate1000MG/Simethicone60MGChewableTablet[MaaloxMaxQuickDissolve]|CHILD 2020 632|1001|N|N|N||Preferred Generic|1923424-SotalolHydrochloride160MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|861748-Glyburide2.5MG/Metforminhydrochloride500MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1439901-riociguat2MGOralTablet[Adempas]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1539893-30ACTUATfluticasonefuroate0.1MG/ACTUAT/vilanterol0.025MG/ACTUATDryPowderInhaler[Breo]|CHILD 2020 632|1001|N|N|N||Preferred Generic|1049630-DiphenhydramineHydrochloride25MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|1099288-DesipramineHydrochloride10MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|199521-Vigabatrin500MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|858044-saxagliptin2.5MGOralTablet[Onglyza]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1732165-incobotulinumtoxinA200UNTInjection[Xeomin]|CHILD 2020 632|1001|N|N|N||Preferred Generic|993557-24HRBupropionHydrochloride300MGExtendedReleaseOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|995253-HydroxyzinePamoate25MGOralCapsule|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1721690-1MLEpoetinAlfa10000UNT/MLInjection[Procrit]|CHILD 2020 632|1001|N|N|N||Preferred Generic|996520-DextromethorphanHydrobromide2MG/ML/Guaifenesin20MG/MLOralSolution|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2119389-Spravato84MGDoseKit|CHILD 2020 632|1001|Y|N|N||Preferred Generic|1435115-28ACTUATTeriparatide0.02MG/ACTUATPenInjector|CHILD 2020 632|1001|Y|N|N||Preferred Generic|903843-PyridostigmineBromide12MG/MLOralSolution|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1429367-lenalidomide20MGOralCapsule[Revlimid]|CHILD 2020 632|1001|N|N|N||Preferred Generic|309112-Cephalexin250MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|198352-Zidovudine100MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|866111-buspironehydrochloride7.5MGOralTablet|CHILD 2020 632|1001|N|Y|N||Preferred Generic|284008-travoprost0.04MG/MLOphthalmicSolution|CHILD 2020 632|1001|N|N|N||Preferred Generic|197558-Dapsone25MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|198224-Hydrochlorothiazide25MG/Spironolactone25MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|562524-12HRAcetazolamide500MGExtendedReleaseOralCapsule|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2106075-0.9MLtocilizumab180MG/MLAuto-Injector[Actemra]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1653225-1MLEtanercept50MG/MLAuto-Injector[Enbrel]|CHILD 2020 632|1001|N|N|N||Preferred Generic|197806-Ibuprofen600MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|198555-Capsaicin0.25MG/MLTopicalCream|CHILD 2020 632|1001|N|Y|N||Preferred Generic|311787-moxifloxacin400MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|197433-calciumacetate667MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2102705-0.6MLpegfilgrastim-cbqv10MG/MLPrefilledSyringe[Udenyca]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2359285-24HRempagliflozin10MG/linagliptin5MG/metforminhydrochloride1000MGExtendedReleaseOralTablet[Trijardy]|CHILD 2020 632|1001|N|N|N||Preferred Generic|997220-Donepezilhydrochloride10MGDisintegratingOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|2123111-NDA020503200ACTUATAlbuterol0.09MG/ACTUATMeteredDoseInhaler|CHILD 2020 632|1001|N|N|N||Preferred Generic|562508-Amoxicillin875MG/Clavulanate125MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|1092357-rufinamide40MG/MLOralSuspension|CHILD 2020 632|1001|Y|N|N||Preferred Brand|758032-0.5MLInterferonbeta-1a0.044MG/MLPrefilledSyringe[Rebif]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1441413-0.4MLMethotrexate37.5MG/MLAuto-Injector[Otrexup]|CHILD 2020 632|1001|N|N|N||Preferred Brand|1998774-Breath-Actuated120ACTUATBeclomethasoneDipropionate0.04MG/ACTUATMeteredDoseInhaler[Qvar]|CHILD 2020 632|1001|N|N|N||Preferred Generic|197699-Fluconazole150MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Generic|834235-febuxostat40MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|310687-Hydrocortisone10MG/ML/Neomycin3.5MG/ML/PolymyxinB10000UNT/MLOticSuspension|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1441418-0.4MLMethotrexate50MG/MLAuto-Injector[Otrexup]|CHILD 2020 632|1001|N|N|Y||Preferred Generic|197528-Clonazepam1MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|861010-Metforminhydrochloride850MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1606870-ivacaftor75MGOralGranules[Kalydeco]|CHILD 2020 632|1001|N|N|N||Preferred Generic|855332-WarfarinSodium5MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|2564406-influenzaAvirusA/Tasmania/503/2020(H3N2)antigen158000000UNT/ML/influenzaAvirusA/Victoria/1/2020(H1N1)antigen158000000|CHILD 2020 632|1001|N|N|N||Preferred Brand|855871-Phenytoinsodium30MGExtendedReleaseOralCapsule[Dilantin]|CHILD 2020 632|1001|N|N|N||Preferred Generic|311725-Mirtazapine15MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|855324-WarfarinSodium4MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|312138-oxcarbazepine600MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1441424-0.4MLMethotrexate62.5MG/MLAuto-Injector[Otrexup]|CHILD 2020 632|1001|Y|N|N||Preferred Generic|1487361-1MLglatirameracetate40MG/MLPrefilledSyringe|CHILD 2020 632|1001|Y|N|N||Preferred Brand|205913-EpoetinAlfa10000UNT/MLInjectableSolution[Procrit]|CHILD 2020 632|1001|N|N|N||Preferred Brand|208547-thyroid(USP)180MGOralTablet[ArmourThyroid]|CHILD 2020 632|1001|N|N|N||Preferred Generic|197408-Betamethasone1MG/MLTopicalLotion|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2058950-0.5MLomalizumab150MG/MLPrefilledSyringe[Xolair]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1544388-0.3MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|CHILD 2020 632|1001|N|N|N||Preferred Generic|284215-Clindamycin300MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|1099304-DesipramineHydrochloride50MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|855312-WarfarinSodium2.5MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1441530-0.9MLtocilizumab180MG/MLPrefilledSyringe[Actemra]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|854852-lisdexamfetaminedimesylate50MGOralCapsule[Vyvanse]|CHILD 2020 632|1001|N|N|N||Preferred Generic|855302-WarfarinSodium2MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|200284-Hydrochlorothiazide12.5MG/valsartan80MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|617993-Amoxicillin120MG/ML/Clavulanate8.58MG/MLOralSuspension|CHILD 2020 632|1001|N|N|N||Preferred Generic|866094-buspironehydrochloride5MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|310812-Hydrochlorothiazide25MG/Triamterene37.5MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|404476-Azathioprine100MGOralTablet[Azasan]|CHILD 2020 632|1001|N|N|N||Preferred Generic|995278-HydroxyzinePamoate50MGOralCapsule|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2057205-0.5MLfilgrastim-aafi0.6MG/MLPrefilledSyringe[Nivestym]|CHILD 2020 632|1001|N|N|N||Preferred Generic|238151-mesalamine66.7MG/MLEnema|CHILD 2020 632|1001|N|N|N||Preferred Generic|313477-Trifluridine10MG/MLOphthalmicSolution|CHILD 2020 632|1001|N|N|N||Preferred Generic|142034-BenzoylPeroxide100MG/MLMedicatedLiquidSoap|CHILD 2020 632|1001|N|Y|Y||Preferred Generic|483448-pregabalin50MGOralCapsule|CHILD 2020 632|1001|N|N|N||Preferred Generic|855288-WarfarinSodium1MGOralTablet|CHILD 2020 632|1001|N|N|Y||Preferred Generic|1091145-8HRMethylphenidateHydrochloride10MGExtendedReleaseOralTablet|CHILD 2020 632|1001|N|Y|Y||Preferred Generic|200194-zolmitriptan5MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|2532159-PMDDfluoxetine10MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|199143-Niacin250MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|238154-Acetaminophen325MG/butalbital50MG/Caffeine40MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Generic|308988-Carbidopa25MG/Levodopa100MGExtendedReleaseOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|1359025-JunelFe28DayPack|CHILD 2020 632|1001|N|N|N||Preferred Generic|1053753-Nystatin100000UNT/ML/TriamcinoloneAcetonide1MG/MLTopicalCream|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1870968-deflazacort22.75MG/MLOralSuspension[Emflaza]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2053512-ivacaftor125MG/lumacaftor100MGOralGranules[ORKAMBI]|CHILD 2020 632|1001|Y|N|N||Preferred Generic|903857-PyridostigmineBromide60MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1429282-NeostigmineMethylsulfate0.5MG/MLInjectableSolution[Bloxiverz]|CHILD 2020 632|1001|N|Y|Y||Preferred Generic|311671-Metolazone5MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|2048568-tofacitinib10MGOralTablet[Xeljanz]|CHILD 2020 632|1001|N|Y|N||Preferred Generic|317094-entacapone200MGOralTablet|CHILD 2020 632|1001|N|N|N||Preferred Brand|351901-Sirolimus1MG/MLOralSolution[Rapamune]|CHILD 2020 632|1001|N|N|N||Preferred Generic|198039-Nitroglycerin0.4MGSublingualTablet|CHILD 2020 632|1001|N|N|Y||Preferred Brand|1596445-7ACTUATumeclidinium0.0625MG/ACTUATDryPowderInhaler[Incruse]|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1871465-lisdexamfetaminedimesylate10MGChewableTablet[Vyvanse]|CHILD 2020 632|1001|N|N|N||Preferred Generic|198760-Niacin50MGOralTablet|CHILD 2020 632|1001|Y|N|N||Preferred Brand|1439903-riociguat2.5MGOralTablet[Adempas]|CHILD 2020 632|1001|N|N|N||Preferred Generic|582926-podofilox5MG/MLTopicalSolution|CHILD 2020 632|1001|N|N|N||Preferred Generic|854901-BisoprololFumarate10MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|2047614-1MLepoetinalfa-epbx4000UNT/MLInjection[Retacrit]|EXPANSION 632|1001|N|N|N||Preferred Generic|198741-MagnesiumOxide400MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|351133-Fenofibrate54MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|2564406-influenzaAvirusA/Tasmania/503/2020(H3N2)antigen158000000UNT/ML/influenzaAvirusA/Victoria/1/2020(H1N1)antigen158000000|EXPANSION 632|1001|Y|N|N||Preferred Brand|1484296-sucroferricoxyhydroxide500MGChewableTablet[Velphoro]|EXPANSION 632|1001|N|N|N||Preferred Generic|852877-QuinidineSulfate200MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|2003767-1.14MLsarilumab175MG/MLAuto-Injector[Kevzara]|EXPANSION 632|1001|N|N|N||Preferred Generic|198152-Probenecid500MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|2003757-1.14MLsarilumab132MG/MLAuto-Injector[Kevzara]|EXPANSION 632|1001|Y|N|N||Preferred Brand|2001321-Roflumilast0.25MGOralTablet[Daliresp]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1990869-0.85MLexenatide2.35MG/MLAuto-Injector[Bydureon]|EXPANSION 632|1001|N|N|N||Preferred Generic|252732-Melatonin5MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|205322-celecoxib100MGOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Brand|1482814-1MLgolimumab100MG/MLPrefilledSyringe[Simponi]|EXPANSION 632|1001|N|N|N||Preferred Brand|1358775-MicrogestinFe1/2028DayPack|EXPANSION 632|1001|Y|N|N||Preferred Brand|1989085-bosentan32MGTabletforOralSuspension[Tracleer]|EXPANSION 632|1001|N|N|N||Preferred Generic|1923426-SotalolHydrochloride80MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|1085741-TriamcinoloneAcetonide0.25MG/MLTopicalLotion|EXPANSION 632|1001|N|N|N||Preferred Generic|617430-Amoxicillin80MG/ML/Clavulanate11.4MG/MLOralSuspension|EXPANSION 632|1001|N|N|Y||Preferred Generic|846378-24HRLevetiracetam750MGExtendedReleaseOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|197388-Azathioprine50MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|859419-Rosuvastatincalcium40MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|847191-3MLinsulinaspartprotamine,human70UNT/ML/insulinaspart,human30UNT/MLPenInjector|EXPANSION 632|1001|N|N|N||Preferred Generic|198145-Prednisone10MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1925255-0.4MLabatacept125MG/MLPrefilledSyringe[Orencia]|EXPANSION 632|1001|N|N|N||Preferred Generic|1362720-MexiletineHydrochloride250MGOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Brand|1923347-1.14MLsarilumab175MG/MLPrefilledSyringe[Kevzara]|EXPANSION 632|1001|N|N|N||Preferred Generic|197411-Bromocriptine2.5MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|866090-buspironehydrochloride30MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1921245-HumiraPen80MG/0.8ML-StarterPackageforCrohn'sDisease,UlcerativeColitisorHidradenitisSuppurativa(3count)|EXPANSION 632|1001|N|N|Y||Preferred Generic|197590-Diazepam2MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|1806197-30/70Release24HRMethylphenidateHydrochloride60MGExtendedReleaseOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|198141-Prazosin5MGOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Brand|1726846-0.4MLadalimumab100MG/MLPrefilledSyringe[Humira]|EXPANSION 632|1001|N|N|N||Preferred Brand|1087012-thyroid(USP)32.5MGOralTablet[Westhroid]|EXPANSION 632|1001|N|Y|N||Preferred Generic|1368424-alogliptin25MG/pioglitazone15MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|1367436-21DAYEthinylEstradiol0.000625MG/HR/Etonogestrel0.005MG/HRVaginalSystem|EXPANSION 632|1001|N|N|N||Preferred Generic|198759-Niacin100MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|597852-anagrelide1MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|284215-Clindamycin300MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|197518-Clindamycin150MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|198116-PotassiumChloride20MEQExtendedReleaseOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1873087-HumiraPrefilledSyringe80MG/0.8MLStarterPack-PediatricCrohn'sDisease(3count)|EXPANSION 632|1001|Y|N|N||Preferred Brand|1872980-0.4MLadalimumab100MG/MLAuto-Injector[Humira]|EXPANSION 632|1001|N|N|N||Preferred Brand|105590-Thioguanine40MGOralTablet[Tabloid]|EXPANSION 632|1001|N|N|N||Preferred Brand|351901-Sirolimus1MG/MLOralSolution[Rapamune]|EXPANSION 632|1001|N|N|N||Preferred Generic|197943-Methocarbamol500MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|834102-PenicillinVPotassium500MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1871465-lisdexamfetaminedimesylate10MGChewableTablet[Vyvanse]|EXPANSION 632|1001|N|N|N||Preferred Brand|201337-Nadolol40MGOralTablet[Corgard]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1871461-lisdexamfetaminedimesylate30MGChewableTablet[Vyvanse]|EXPANSION 632|1001|N|N|N||Preferred Generic|995624-MeclizineHydrochloride12.5MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|834040-PenicillinVPotassium50MG/MLOralSolution|EXPANSION 632|1001|N|N|Y||Preferred Generic|349594-atomoxetine40MGOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Brand|1488675-12HRTreprostinil1MGExtendedReleaseOralTablet[Orenitram]|EXPANSION 632|1001|N|N|N||Preferred Generic|749784-{7(EthinylEstradiol0.035MG/norgestimate0.18MGOralTablet)/7(EthinylEstradiol0.035MG/norgestimate0.215MGOralTablet)/7(Et|EXPANSION 632|1001|Y|N|N||Preferred Brand|1870952-deflazacort30MGOralTablet[Emflaza]|EXPANSION 632|1001|N|N|N||Preferred Generic|198105-Pindolol5MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1488679-12HRTreprostinil2.5MGExtendedReleaseOralTablet[Orenitram]|EXPANSION 632|1001|N|N|N||Preferred Generic|966249-LevothyroxineSodium0.175MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1868020-pirfenidone801MGOralTablet[Esbriet]|EXPANSION 632|1001|N|N|N||Preferred Generic|598006-Erythromycin250MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1868016-pirfenidone267MGOralTablet[Esbriet]|EXPANSION 632|1001|N|N|N||Preferred Generic|833008-DesmopressinAcetate0.2MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1855527-HumiraPediatricCrohn'sDiseaseStarterPackage(2count)|EXPANSION 632|1001|N|N|N||Preferred Generic|598025-Amoxicillin250MGChewableTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|825425-eltrombopag25MGOralTablet[Promacta]|EXPANSION 632|1001|N|N|N||Preferred Generic|1366116-bacitracinzinc0.5UNT/MGTopicalOintment|EXPANSION 632|1001|Y|N|N||Preferred Brand|1812470-ivacaftor125MG/lumacaftor100MGOralTablet[ORKAMBI]|EXPANSION 632|1001|N|N|N||Preferred Generic|1049909-DiphenhydramineHydrochloride25MGOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Brand|1806942-carfilzomib60MGInjection[Kyprolis]|EXPANSION 632|1001|Y|N|N||Preferred Generic|1373491-dimethylfumarate240MGDelayedReleaseOralCapsule|EXPANSION 632|1001|N|N|Y||Preferred Generic|854252-1MLEnoxaparinsodium150MG/MLPrefilledSyringe|EXPANSION 632|1001|N|N|N||Preferred Generic|198089-Phenobarbital60MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1799230-1MLabatacept125MG/MLAuto-Injector[Orencia]|EXPANSION 632|1001|Y|N|N||Preferred Brand|825429-eltrombopag50MGOralTablet[Promacta]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1796096-24HRLinagliptin5MG/Metforminhydrochloride1000MGExtendedReleaseOralTablet[Jentadueto]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1796091-24HRLinagliptin2.5MG/Metforminhydrochloride1000MGExtendedReleaseOralTablet[Jentadueto]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1747194-0.4MLMethotrexate56.3MG/MLAuto-Injector[Otrexup]|EXPANSION 632|1001|N|N|N||Preferred Brand|1020155-Introvale91DayPack|EXPANSION 632|1001|Y|N|N||Preferred Brand|854840-lisdexamfetaminedimesylate40MGOralCapsule[Vyvanse]|EXPANSION 632|1001|N|N|N||Preferred Generic|253059-Levocarnitine500MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|198049-Ofloxacin300MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1541928-sunitinib37.5MGOralCapsule[Sutent]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1732165-incobotulinumtoxinA200UNTInjection[Xeomin]|EXPANSION 632|1001|N|N|Y||Preferred Generic|856940-Acetaminophen21.7MG/ML/HydrocodoneBitartrate0.5MG/MLOralSolution|EXPANSION 632|1001|Y|N|N||Preferred Brand|1732161-incobotulinumtoxinA100UNTInjection[Xeomin]|EXPANSION 632|1001|N|N|N||Preferred Brand|1998774-Breath-Actuated120ACTUATBeclomethasoneDipropionate0.04MG/ACTUATMeteredDoseInhaler[Qvar]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1732157-incobotulinumtoxinA50UNTInjection[Xeomin]|EXPANSION 632|1001|N|N|N||Preferred Generic|763181-{21(Prednisone5MGOralTablet)}Pack|EXPANSION 632|1001|Y|N|N||Preferred Brand|1729065-selexipag0.8MGOralTablet[Uptravi]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1729057-selexipag0.4MGOralTablet[Uptravi]|EXPANSION 632|1001|N|N|Y||Preferred Generic|198036-24HRNifedipine90MGExtendedReleaseOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1654079-0.5MLustekinumab90MG/MLInjection[Stelara]|EXPANSION 632|1001|N|N|N||Preferred Generic|312136-oxcarbazepine150MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1729047-selexipag1.6MGOralTablet[Uptravi]|EXPANSION 632|1001|N|N|N||Preferred Brand|1358765-JunelFe1/2028DayPack|EXPANSION 632|1001|N|N|N||Preferred Generic|755497-Albuterol0.4MG/MLOralSolution|EXPANSION 632|1001|N|N|N||Preferred Generic|197381-Atenolol50MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1544383-0.2MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|EXPANSION 632|1001|Y|N|N||Preferred Brand|828703-1.2MLPlerixafor20MG/MLInjection[Mozobil]|EXPANSION 632|1001|N|N|N||Preferred Generic|198045-Nortriptyline10MGOralCapsule|EXPANSION 632|1001|N|N|Y||Preferred Generic|636042-Hydrochlorothiazide12.5MG/valsartan320MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|310380-Fluorouracil50MG/MLTopicalSolution|EXPANSION 632|1001|Y|N|N||Preferred Brand|1544386-0.25MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|EXPANSION 632|1001|N|N|N||Preferred Brand|312020-Nitroglycerin9MGExtendedReleaseOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|617310-atorvastatin20MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|856448-PropranololHydrochloride10MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1721690-1MLEpoetinAlfa10000UNT/MLInjection[Procrit]|EXPANSION 632|1001|N|N|N||Preferred Generic|1052760-magnesiumcitrate58.2MG/MLOralSolution|EXPANSION 632|1001|N|N|N||Preferred Generic|309313-Citalopram2MG/MLOralSolution|EXPANSION 632|1001|Y|N|N||Preferred Brand|1720606-mepolizumab100MGInjection[Nucala]|EXPANSION 632|1001|N|N|Y||Preferred Generic|857366-EconazoleNitrate10MG/MLTopicalCream|EXPANSION 632|1001|N|N|Y||Preferred Generic|861221-24HRAmphetamineaspartate2.5MG/AmphetamineSulfate2.5MG/Dextroamphetaminesaccharate2.5MG/DextroamphetamineSulfate2.5MGEx|EXPANSION 632|1001|N|N|Y||Preferred Generic|197877-Lidocaine25MG/ML/Prilocaine25MG/MLTopicalCream|EXPANSION 632|1001|N|N|N||Preferred Generic|997223-Donepezilhydrochloride10MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1721685-1MLEpoetinAlfa10000UNT/MLInjection[Epogen]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1660934-60ACTUATformoterolfumarate0.005MG/ACTUAT/mometasonefuroate0.1MG/ACTUATMeteredDoseInhaler[Dulera]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1544388-0.3MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1657982-20MLtocilizumab20MG/MLInjection[Actemra]|EXPANSION 632|1001|N|N|N||Preferred Generic|748800-{21(drospirenone3MG/EthinylEstradiol0.03MGOralTablet)/7(InertIngredients1MGOralTablet)}Pack|EXPANSION 632|1001|Y|N|N||Preferred Brand|1657976-4MLtocilizumab20MG/MLInjection[Actemra]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1544394-0.4MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|EXPANSION 632|1001|N|N|N||Preferred Brand|312018-Nitroglycerin6.5MGExtendedReleaseOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Brand|759469-Quasense91DayPack|EXPANSION 632|1001|N|N|N||Preferred Generic|860225-MegestrolAcetate40MG/MLOralSuspension|EXPANSION 632|1001|N|N|N||Preferred Generic|617311-atorvastatin40MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|1050077-DiphenhydramineHydrochloride20MG/MLTopicalCream|EXPANSION 632|1001|N|N|Y||Preferred Brand|901644-0.5MLStreptococcuspneumoniaeserotype1capsularantigendiphtheriaCRM197proteinconjugatevaccine0.0044MG/ML/Streptococcuspn|EXPANSION 632|1001|N|N|N||Preferred Generic|312289-Naloxone0.5MG/Pentazocine50MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|198861-SodiumBicarbonate650MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1546198-PlegridyStarterPack|EXPANSION 632|1001|N|N|N||Preferred Brand|1998772-Breath-Actuated120ACTUATBeclomethasoneDipropionate0.08MG/ACTUATMeteredDoseInhaler[Qvar]|EXPANSION 632|1001|N|N|N||Preferred Generic|198024-Niacin500MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|197958-Methyldopa500MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1653166-1MLgolimumab100MG/MLAuto-Injector[Simponi]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1653144-0.5MLgolimumab100MG/MLAuto-Injector[Simponi]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1606870-ivacaftor75MGOralGranules[Kalydeco]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1650004-0.5MLInterferonbeta-1a0.088MG/MLAuto-Injector[Rebif]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1649605-PlegridyPenStarterPack|EXPANSION 632|1001|N|N|Y||Preferred Generic|311918-naratriptan1MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|1053753-Nystatin100000UNT/ML/TriamcinoloneAcetonide1MG/MLTopicalCream|EXPANSION 632|1001|Y|N|N||Preferred Brand|1546189-0.5MLpeginterferonbeta-1a0.25MG/MLPrefilledSyringe[Plegridy]|EXPANSION 632|1001|N|N|N||Preferred Generic|686924-carvedilol3.125MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|1293864-ErgotamineTartrate2MGSublingualTablet[Ergomar]|EXPANSION 632|1001|N|N|N||Preferred Generic|1923432-dorzolamide20MG/ML/Timolol5MG/MLOphthalmicSolution|EXPANSION 632|1001|N|N|N||Preferred Generic|198012-Naproxen375MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|854832-lisdexamfetaminedimesylate20MGOralCapsule[Vyvanse]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1606866-ivacaftor50MGOralGranules[Kalydeco]|EXPANSION 632|1001|Y|N|N||Preferred Brand|849599-1MLcertolizumabpegol200MG/MLPrefilledSyringe[Cimzia]|EXPANSION 632|1001|N|N|N||Preferred Generic|722137-Amlodipine5MG/valsartan320MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1605455-Otezla28-DayStarterPack|EXPANSION 632|1001|Y|N|N||Preferred Brand|1544398-0.5MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1605071-0.5MLFILGRASTIM-SNDZ0.6MG/MLPrefilledSyringe[Zarxio]|EXPANSION 632|1001|N|N|Y||Preferred Generic|862013-24HRGuanfacine2MGExtendedReleaseOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|1116150-bacitracinzinc0.4UNT/MG/hydrocortisoneacetate0.01MG/MG/NeomycinSulfate0.0035MG/MG/PolymyxinBSulfate10UNT/MGOphthalmic|EXPANSION 632|1001|N|N|N||Preferred Generic|996824-MethylergonovineMaleate0.2MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|853354-0.5MLustekinumab90MG/MLPrefilledSyringe[Stelara]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1599797-1MLsecukinumab150MG/MLPrefilledSyringe[Cosentyx]|EXPANSION 632|1001|N|N|N||Preferred Generic|197986-Minoxidil10MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1596023-ferriccitrate1000MGOralTablet[Auryxia]|EXPANSION 632|1001|N|N|Y||Preferred Generic|854876-Zolpidemtartrate5MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|311668-Metoclopramide5MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|646333-Capsaicin1MG/MLTopicalCream|EXPANSION 632|1001|Y|N|N||Preferred Generic|727339-0.5MLSumatriptan12MG/MLPrefilledSyringe|EXPANSION 632|1001|N|N|N||Preferred Generic|617423-Amoxicillin40MG/ML/Clavulanate5.7MG/MLOralSuspension|EXPANSION 632|1001|N|N|N||Preferred Generic|141963-Azithromycin40MG/MLOralSuspension|EXPANSION 632|1001|N|N|N||Preferred Generic|197973-Methylprednisolone8MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1593833-24HRdapagliflozin5MG/Metforminhydrochloride1000MGExtendedReleaseOralTablet[Xigduo]|EXPANSION 632|1001|Y|N|N||Preferred Brand|853356-1MLustekinumab90MG/MLPrefilledSyringe[Stelara]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1593831-24HRdapagliflozin5MG/Metforminhydrochloride500MGExtendedReleaseOralTablet[Xigduo]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1593775-24HRdapagliflozin10MG/Metforminhydrochloride1000MGExtendedReleaseOralTablet[Xigduo]|EXPANSION 632|1001|N|N|N||Preferred Brand|261353-Trimethoprim10MG/MLOralSolution[Primsol]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1545174-hydrocortisoneacetate100MG/MLRectalFoam[Cortifoam]|EXPANSION 632|1001|N|N|N||Preferred Generic|628953-PotassiumChloride10MEQExtendedReleaseOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1592748-nintedanib100MGOralCapsule[Ofev]|EXPANSION 632|1001|N|N|N||Preferred Generic|617322-Amoxicillin50MG/ML/Clavulanate12.5MG/MLOralSuspension|EXPANSION 632|1001|N|N|N||Preferred Brand|1995479-amylase168000UNT/lipase40000UNT/protease126000UNTDelayedReleaseOralCapsule[Zenpep]|EXPANSION 632|1001|N|N|N||Preferred Generic|312362-Phenobarbital30MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1551923-naloxegol12.5MGOralTablet[Movantik]|EXPANSION 632|1001|N|N|Y||Preferred Generic|866042-NeomycinSulfate500MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|259966-Methylprednisolone4MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|722134-Amlodipine5MG/valsartan160MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|198039-Nitroglycerin0.4MGSublingualTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|197960-Hydrochlorothiazide25MG/Methyldopa250MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1544918-0.65MLexenatide3.08MG/MLPenInjector[Bydureon]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1544404-0.15MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|EXPANSION 632|1001|N|N|N||Preferred Generic|617316-Amoxicillin400MG/Clavulanate57MGChewableTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|311679-Metronidazole0.0075MG/MGTopicalGel|EXPANSION 632|1001|Y|N|N||Preferred Brand|1544402-0.6MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|EXPANSION 632|1001|N|N|N||Preferred Generic|749780-{3(Azithromycin500MGOralTablet)}Pack|EXPANSION 632|1001|N|N|N||Preferred Generic|617312-atorvastatin10MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1666334-Ticagrelor60MGOralTablet[Brilinta]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1544396-0.45MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|EXPANSION 632|1001|N|N|N||Preferred Generic|310157-Erythromycin500MGDelayedReleaseOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|260409-prednisolone1MG/MLOralSolution[Pediapred]|EXPANSION 632|1001|N|N|N||Preferred Generic|199058-mycophenolatemofetil250MGOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Brand|1544390-0.35MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|EXPANSION 632|1001|N|N|N||Preferred Generic|197956-Methyldopa250MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|209890-Acetaminophen500MGOralCapsule[Mapap]|EXPANSION 632|1001|N|N|N||Preferred Generic|617309-Amoxicillin200MG/Clavulanate28.5MGChewableTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1551886-lanthanumcarbonate750MGOralPowder[Fosrenol]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1539893-30ACTUATfluticasonefuroate0.1MG/ACTUAT/vilanterol0.025MG/ACTUATDryPowderInhaler[Breo]|EXPANSION 632|1001|N|N|N||Preferred Generic|197944-Methocarbamol750MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|312504-PotassiumChloride10MEQExtendedReleaseOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Brand|153324-Interferonbeta-1a0.03MGInjection[Avonex]|EXPANSION 632|1001|N|N|N||Preferred Generic|2532159-PMDDfluoxetine10MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1492746-apremilast30MGOralTablet[Otezla]|EXPANSION 632|1001|N|N|N||Preferred Generic|861004-Metforminhydrochloride1000MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1654955-1MLdarbepoetinalfa0.2MG/MLInjection[Aranesp]|EXPANSION 632|1001|N|N|N||Preferred Generic|198038-Nitroglycerin0.3MGSublingualTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|309044-Cefaclor25MG/MLOralSuspension|EXPANSION 632|1001|Y|N|N||Preferred Brand|1488671-12HRTreprostinil0.25MGExtendedReleaseOralTablet[Orenitram]|EXPANSION 632|1001|N|N|N||Preferred Generic|197963-Hydrochlorothiazide15MG/Methyldopa250MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|260243-Progesterone100MGOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Brand|1660938-60ACTUATformoterolfumarate0.005MG/ACTUAT/mometasonefuroate0.2MG/ACTUATMeteredDoseInhaler[Dulera]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1488667-12HRTreprostinil0.125MGExtendedReleaseOralTablet[Orenitram]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1487076-DiclofenacSodium20MG/MLTopicalSolution[Pennsaid]|EXPANSION 632|1001|N|N|N||Preferred Generic|197942-Methimazole5MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|1923809-thyroid(USP)120MGOralTablet[NPThyroid]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1486977-dapagliflozin10MGOralTablet[Farxiga]|EXPANSION 632|1001|N|N|N||Preferred Generic|1049906-DiphenhydramineHydrochloride2.5MG/MLOralSolution|EXPANSION 632|1001|N|N|Y||Preferred Generic|349483-valsartan40MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|583170-Salsalate750MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1665906-1MLevolocumab140MG/MLPrefilledSyringe[Repatha]|EXPANSION 632|1001|N|Y|N||Preferred Generic|1368034-alogliptin12.5MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|892672-MorphineSulfate30MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|861007-Metforminhydrochloride500MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|197941-Methimazole10MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1442143-Macitentan10MGOralTablet[Opsumit]|EXPANSION 632|1001|N|N|N||Preferred Generic|992528-Terbinafinehydrochloride10MG/MLTopicalCream|EXPANSION 632|1001|N|N|N||Preferred Generic|577040-CalciumCarbonate648MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|1989117-0.3MLEpinephrine1MG/MLPrefilledSyringe[Symjepi]|EXPANSION 632|1001|N|Y|Y||Preferred Generic|200194-zolmitriptan5MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|1376336-prednisoloneacetate10MG/MLOphthalmicSuspension|EXPANSION 632|1001|N|N|N||Preferred Generic|313227-terconazole8MG/MLVaginalCream|EXPANSION 632|1001|N|N|N||Preferred Generic|617993-Amoxicillin120MG/ML/Clavulanate8.58MG/MLOralSuspension|EXPANSION 632|1001|N|N|Y||Preferred Brand|1549683-Xarelto30-DayStarterPackKit|EXPANSION 632|1001|Y|N|N||Preferred Brand|1441413-0.4MLMethotrexate37.5MG/MLAuto-Injector[Otrexup]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1592285-pirfenidone267MGOralCapsule[Esbriet]|EXPANSION 632|1001|N|N|Y||Preferred Generic|198052-Ondansetron4MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|861010-Metforminhydrochloride850MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1439903-riociguat2.5MGOralTablet[Adempas]|EXPANSION 632|1001|N|N|Y||Preferred Generic|897612-24HRVerapamilhydrochloride120MGExtendedReleaseOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|197939-Methazolamide25MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|2174390-symdeko50MG/75MGand75MGPack|EXPANSION 632|1001|N|N|N||Preferred Generic|142034-BenzoylPeroxide100MG/MLMedicatedLiquidSoap|EXPANSION 632|1001|Y|N|N||Preferred Brand|1728095-romiplostim0.25MGInjection[Nplate]|EXPANSION 632|1001|N|N|N||Preferred Generic|199143-Niacin250MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|197658-Estradiol1MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1439894-riociguat0.5MGOralTablet[Adempas]|EXPANSION 632|1001|N|N|N||Preferred Generic|863669-Tamsulosinhydrochloride0.4MGOralCapsule|EXPANSION 632|1001|N|N|Y||Preferred Generic|198051-Omeprazole20MGDelayedReleaseOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Brand|2110516-60ACTUATFluticasonepropionate0.5MG/ACTUAT/salmeterol0.05MG/ACTUATDryPowderInhaler[Wixela]|EXPANSION 632|1001|N|N|N||Preferred Generic|197931-mercaptopurine50MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1429367-lenalidomide20MGOralCapsule[Revlimid]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1728099-romiplostim0.5MGInjection[Nplate]|EXPANSION 632|1001|N|N|N||Preferred Brand|207949-Succimer100MGOralCapsule[Chemet]|EXPANSION 632|1001|N|N|N||Preferred Generic|312593-Prazosin1MGOralCapsule|EXPANSION 632|1001|N|N|Y||Preferred Brand|847189-3MLinsulinisophane,human70UNT/ML/insulin,regular,human30UNT/MLPenInjector[Humulin]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1429284-NeostigmineMethylsulfate1MG/MLInjectableSolution[Bloxiverz]|EXPANSION 632|1001|N|N|N||Preferred Brand|2564038-influenzaAvirusA/Cambodia/e0826360/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.03MG/|EXPANSION 632|1001|N|N|N||Preferred Generic|1801289-SmokingCessation12HRBupropionHydrochloride150MGExtendedReleaseOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|543546-Nystatin100000UNT/MLTopicalCream|EXPANSION 632|1001|Y|N|N||Preferred Brand|1374574-TOBIPodhalerKit,224|EXPANSION 632|1001|N|N|N||Preferred Generic|997220-Donepezilhydrochloride10MGDisintegratingOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1373335-Isotretinoin20MGOralCapsule[Zenatane]|EXPANSION 632|1001|N|N|N||Preferred Generic|997420-Fexofenadinehydrochloride180MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|197905-Lovastatin40MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Brand|901518-0.5MLNeisseriameningitidisserogroupAoligosaccharidediphtheriaCRM197proteinconjugatevaccine0.02MG/ML/Neisseriameningiti|EXPANSION 632|1001|N|N|N||Preferred Generic|486146-24HRNitroglycerin0.6MG/HRTransdermalSystem|EXPANSION 632|1001|N|N|Y||Preferred Generic|897659-Verapamilhydrochloride120MGExtendedReleaseOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|106258-Hydrocortisone10MG/MLTopicalCream|EXPANSION 632|1001|N|N|N||Preferred Generic|308989-Carbidopa50MG/Levodopa200MGExtendedReleaseOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1364362-ponatinib45MGOralTablet[Iclusig]|EXPANSION 632|1001|N|N|N||Preferred Generic|197904-Lovastatin20MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|313226-terconazole4MG/MLVaginalCream|EXPANSION 632|1001|Y|N|N||Preferred Brand|1364358-ponatinib15MGOralTablet[Iclusig]|EXPANSION 632|1001|N|N|N||Preferred Generic|310155-Erythromycin250MGDelayedReleaseOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1655934-ivacaftor125MG/lumacaftor200MGOralTablet[ORKAMBI]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1357547-tofacitinib5MGOralTablet[Xeljanz]|EXPANSION 632|1001|N|N|N||Preferred Generic|476809-Mirtazapine7.5MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|197582-Dexamethasone4MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|476576-cefdinir50MG/MLOralSuspension|EXPANSION 632|1001|N|N|N||Preferred Generic|197449-Cefaclor500MGOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Brand|1310531-teriflunomide14MGOralTablet[Aubagio]|EXPANSION 632|1001|N|N|N||Preferred Brand|2564021-0.5MLinfluenzaAvirusA/Cambodia/e0826360/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.|EXPANSION 632|1001|Y|N|N||Preferred Brand|860244-interferonbeta-1b0.3MGInjection[Extavia]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1310144-everolimus3MGTabletforOralSuspension[Afinitor]|EXPANSION 632|1001|N|N|N||Preferred Generic|639566-VitaminB650MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|105292-isoniazid10MG/MLOralSolution|EXPANSION 632|1001|N|N|N||Preferred Generic|1190655-AtropineSulfate10MG/MLOphthalmicSolution|EXPANSION 632|1001|N|N|N||Preferred Generic|197887-Hydrochlorothiazide25MG/Lisinopril20MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1307635-bosutinib500MGOralTablet[Bosulif]|EXPANSION 632|1001|N|N|N||Preferred Brand|861834-amylase82000UNT/lipase15000UNT/protease51000UNTDelayedReleaseOralCapsule[Zenpep]|EXPANSION 632|1001|N|N|N||Preferred Brand|198467-Aspirin325MGDelayedReleaseOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1302833-24HRPhentermine7.5MG/topiramate46MGExtendedReleaseOralCapsule[Qsymia]|EXPANSION 632|1001|Y|N|N||Preferred Brand|860898-Vigabatrin500MGPowderforOralSolution[Sabril]|EXPANSION 632|1001|Y|N|N||Preferred Generic|1308569-24HRrivastigmine0.554MG/HRTransdermalSystem|EXPANSION 632|1001|Y|N|N||Preferred Generic|1307427-sildenafil10MG/MLOralSuspension|EXPANSION 632|1001|N|N|N||Preferred Generic|828320-Cyclobenzaprinehydrochloride5MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|312617-Prednisone5MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|897749-HydromorphoneHydrochloride3MGRectalSuppository|EXPANSION 632|1001|Y|N|N||Preferred Brand|1300797-24HRmirabegron25MGExtendedReleaseOralTablet[Myrbetriq]|EXPANSION 632|1001|Y|N|N||Preferred Generic|990982-2MLphysostigminesalicylate1MG/MLInjection|EXPANSION 632|1001|N|N|N||Preferred Generic|311277-lansoprazole30MGDelayedReleaseOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Brand|1245003-eltrombopag12.5MGOralTablet[Promacta]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1593835-24HRdapagliflozin10MG/Metforminhydrochloride500MGExtendedReleaseOralTablet[Xigduo]|EXPANSION 632|1001|N|N|N||Preferred Generic|859747-Rosuvastatincalcium10MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1244064-0.4MLMethylnaltrexonebromide20MG/MLPrefilledSyringe[Relistor]|EXPANSION 632|1001|N|N|N||Preferred Generic|197884-Lisinopril40MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|1047881-HyoscyamineSulfate0.025MG/MLOralSolution|EXPANSION 632|1001|N|N|N||Preferred Generic|403853-Hydrochlorothiazide12.5MG/Olmesartanmedoxomil20MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|282401-lamotrigine25MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|899548-dexmethylphenidatehydrochloride10MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|996572-{21(Memantinehydrochloride10MGOralTablet)/28(Memantinehydrochloride5MGOralTablet)}Pack|EXPANSION 632|1001|N|N|N||Preferred Generic|197863-Leucovorin5MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1243040-Linagliptin2.5MG/Metforminhydrochloride850MGOralTablet[Jentadueto]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1243033-Linagliptin2.5MG/Metforminhydrochloride500MGOralTablet[Jentadueto]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1663728-Isotretinoin30MGOralCapsule[Myorisan]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1243026-Linagliptin2.5MG/Metforminhydrochloride1000MGOralTablet[Jentadueto]|EXPANSION 632|1001|N|N|Y||Preferred Generic|200224-montelukast10MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|402695-24HRFelodipine10MGExtendedReleaseOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|309273-cholinesalicylate58.6MG/ML/MagnesiumSalicylate72.4MG/MLOralSolution|EXPANSION 632|1001|N|N|Y||Preferred Generic|349201-valsartan160MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1242615-Isotretinoin40MGOralCapsule[Myorisan]|EXPANSION 632|1001|N|N|N||Preferred Brand|1000497-Prempro0.45/1.528DayPack|EXPANSION 632|1001|N|N|N||Preferred Generic|310273-Famotidine20MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|904405-Alendronicacid40MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|199150-Acarbose100MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1242611-Isotretinoin10MGOralCapsule[Myorisan]|EXPANSION 632|1001|N|N|N||Preferred Generic|197861-Leucovorin15MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1235267-CamreseLo91DayPack|EXPANSION 632|1001|N|N|N||Preferred Generic|312036-Nortriptyline2MG/MLOralSolution|EXPANSION 632|1001|N|N|N||Preferred Generic|387003-Levetiracetam1000MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|967012-POLYETHYLENEGLYCOL3350236000MG/PotassiumChloride2970MG/SodiumBicarbonate6740MG/SodiumChloride5860MG/sodiumsulfate22740|EXPANSION 632|1001|Y|N|N||Preferred Brand|1235150-azilsartanmedoxomil40MG/Chlorthalidone12.5MGOralTablet[Edarbyclor]|EXPANSION 632|1001|Y|N|N||Preferred Brand|861966-Iloprost0.02MG/MLInhalationSolution[Ventavis]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1232204-Zolpidemtartrate3.5MGSublingualTablet[Intermezzo]|EXPANSION 632|1001|N|N|N||Preferred Generic|197860-Leucovorin10MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1232200-Zolpidemtartrate1.75MGSublingualTablet[Intermezzo]|EXPANSION 632|1001|Y|N|N||Preferred Brand|864820-Oxybutyninchloride0.1MG/MGTopicalGel[Gelnique]|EXPANSION 632|1001|N|N|N||Preferred Generic|1043690-hydrocortisoneacetate10MG/MLTopicalCream|EXPANSION 632|1001|Y|N|N||Preferred Brand|1232190-asparaginaseErwiniachrysanthemi10000UNTInjection[Erwinaze]|EXPANSION 632|1001|N|N|N||Preferred Generic|646456-Nystatin100UNT/MGTopicalPowder|EXPANSION 632|1001|N|N|N||Preferred Brand|2563032-0.5MLinfluenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.03MG/|EXPANSION 632|1001|N|N|N||Preferred Generic|359601-Guaifenesin400MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|608139-atomoxetine100MGOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Brand|1596778-14ACTUATBudesonide2MG/ACTUATRectalFoam[Uceris]|EXPANSION 632|1001|N|N|N||Preferred Brand|351750-podofilox0.005MG/MGTopicalGel[Condylox]|EXPANSION 632|1001|N|N|N||Preferred Generic|312748-quinapril10MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|1797880-Nafarelin0.2MG/ACTUATMeteredDoseNasalSpray[Synarel]|EXPANSION 632|1001|N|N|N||Preferred Generic|1437702-Albuterol0.833MG/ML/IpratropiumBromide0.167MG/MLInhalationSolution|EXPANSION 632|1001|N|N|Y||Preferred Generic|198250-tetracyclinehydrochloride250MGOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Brand|1148502-crizotinib200MGOralCapsule[Xalkori]|EXPANSION 632|1001|N|N|N||Preferred Generic|197855-Ketoprofen50MGOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Brand|1116639-Ticagrelor90MGOralTablet[Brilinta]|EXPANSION 632|1001|N|N|N||Preferred Generic|313219-Terazosin5MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|351250-Escitalopram20MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|861171-12HRPropafenoneHydrochloride425MGExtendedReleaseOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|197854-Ketoprofen25MGOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Brand|1870950-deflazacort6MGOralTablet[Emflaza]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1115459-1MLLeuprolideAcetate3.75MG/MLPrefilledSyringe[Lupron]|EXPANSION 632|1001|Y|N|N||Preferred Generic|1373497-{14(dimethylfumarate120MGDelayedReleaseOralCapsule)/46(dimethylfumarate240MGDelayedReleaseOralCapsule)}Pack|EXPANSION 632|1001|Y|N|N||Preferred Brand|1115456-1MLLeuprolideAcetate15MG/MLPrefilledSyringe[Lupron]|EXPANSION 632|1001|N|N|N||Preferred Generic|351172-Dutasteride0.5MGOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Brand|867506-pazopanib200MGOralTablet[Votrient]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1115449-1MLLeuprolideAcetate11.25MG/MLPrefilledSyringe[Lupron]|EXPANSION 632|1001|N|N|Y||Preferred Generic|905369-ChlordiazepoxideHydrochloride10MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|351137-Albuterol0.21MG/MLInhalationSolution|EXPANSION 632|1001|N|N|N||Preferred Generic|860221-MegestrolAcetate40MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|1806193-30/70Release24HRMethylphenidateHydrochloride50MGExtendedReleaseOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Brand|1114096-Vandetanib300MGOralTablet[Caprelsa]|EXPANSION 632|1001|N|N|N||Preferred Generic|647121-5MLLevetiracetam100MG/MLInjection|EXPANSION 632|1001|N|N|N||Preferred Brand|2563031-influenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.03MG/ML/in|EXPANSION 632|1001|N|N|Y||Preferred Generic|1650142-DoxycyclineMonohydrate100MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1112687-Amethia91DayPack|EXPANSION 632|1001|Y|N|N||Preferred Brand|1601373-naloxegol25MGOralTablet[Movantik]|EXPANSION 632|1001|N|N|N||Preferred Generic|311264-lamotrigine25MGChewableTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|310793-Hydrochlorothiazide12.5MG/irbesartan300MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|197839-IsosorbideDinitrate30MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|1000862-PilocarpineHydrochloride20MG/MLOphthalmicSolution|EXPANSION 632|1001|N|N|N||Preferred Generic|197380-Atenolol25MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|349405-Olmesartanmedoxomil40MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|199159-Tretinoin10MGOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Generic|999986-Amlodipine10MG/Hydrochlorothiazide12.5MG/Olmesartanmedoxomil40MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|896237-120ACTUATFluticasonepropionate0.045MG/ACTUAT/salmeterol0.021MG/ACTUATMeteredDoseInhaler[Advair]|EXPANSION 632|1001|N|N|N||Preferred Generic|197832-isoniazid300MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1045408-dasatinib80MGOralTablet[Sprycel]|EXPANSION 632|1001|N|N|N||Preferred Generic|197604-Digoxin0.125MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|1000487-Premphase28DayPack|EXPANSION 632|1001|Y|N|N||Preferred Brand|1654630-1MLglatirameracetate20MG/MLPrefilledSyringe[Glatopa]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1043567-24HRMetforminhydrochloride1000MG/saxagliptin2.5MGExtendedReleaseOralTablet[Kombiglyze]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1037185-LoLoestrinFe28DayPack|EXPANSION 632|1001|N|N|N||Preferred Generic|197817-Indomethacin25MGOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Brand|2121096-siponimod0.25MGOralTablet[Mayzent]|EXPANSION 632|1001|N|N|N||Preferred Generic|103403-Hydrocortisone10MG/MLTopicalLotion|EXPANSION 632|1001|N|N|N||Preferred Generic|343033-Dexamethasone0.75MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|197303-Acetazolamide125MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|197816-Indapamide2.5MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|992668-homatropinemethylbromide0.3MG/ML/HydrocodoneBitartrate1MG/MLOralSolution|EXPANSION 632|1001|N|N|N||Preferred Generic|596843-lansoprazole15MGDelayedReleaseOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|328160-Cyclosporine100MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|686418-ErythromycinEthylsuccinate80MG/MLOralSuspension|EXPANSION 632|1001|Y|N|Y||Preferred Generic|883826-TranexamicAcid650MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|1667916-5MLIsoproterenolHydrochloride0.2MG/MLInjection[Isuprel]|EXPANSION 632|1001|N|N|N||Preferred Generic|318272-Aspirin81MGChewableTablet|EXPANSION 632|1001|N|Y|N||Preferred Generic|1368438-alogliptin25MG/pioglitazone45MGOralTablet|EXPANSION 632|1001|N|Y|Y||Preferred Generic|998671-168HRClonidine0.00417MG/HRTransdermalSystem|EXPANSION 632|1001|N|N|Y||Preferred Brand|106892-insulinisophane,human70UNT/ML/insulin,regular,human30UNT/MLInjectableSuspension[Humulin]|EXPANSION 632|1001|N|N|N||Preferred Generic|311994-NITROFURANTOIN,MACROCRYSTALS25MGOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Brand|901614-Aztreonam75MG/MLInhalationSolution[Cayston]|EXPANSION 632|1001|N|Y|Y||Preferred Generic|856569-24HRPropranololHydrochloride80MGExtendedReleaseOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|992780-MiconazoleNitrate100MGVaginalInsert|EXPANSION 632|1001|N|N|N||Preferred Generic|197807-Ibuprofen800MGOralTablet|EXPANSION 632|1001|N|Y|Y||Preferred Generic|856481-24HRPropranololHydrochloride160MGExtendedReleaseOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Brand|1250090-Nonoxynol-90.03MG/MGVaginalGel[GynolII]|EXPANSION 632|1001|N|N|N||Preferred Generic|200032-carvedilol12.5MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Brand|1049216-Acetaminophen325MG/OxycodoneHydrochloride10MGOralTablet[Endocet]|EXPANSION 632|1001|N|N|Y||Preferred Generic|993466-midodrinehydrochloride2.5MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|861424-PropafenoneHydrochloride150MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|1440184-hydrocortisoneacetate0.01MG/MGTopicalOintment|EXPANSION 632|1001|N|N|N||Preferred Generic|197806-Ibuprofen600MGOralTablet|EXPANSION 632|1001|N|Y|Y||Preferred Generic|483440-pregabalin150MGOralCapsule|EXPANSION 632|1001|N|Y|Y||Preferred Generic|797274-Clindamycin10MG/MLMedicatedPad|EXPANSION 632|1001|Y|N|N||Preferred Brand|902624-dexlansoprazole30MGDelayedReleaseOralCapsule[Dexilant]|EXPANSION 632|1001|N|Y|Y||Preferred Generic|606726-Esomeprazole20MGDelayedReleaseOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|835894-cyclosporine,modified25MGOralCapsule|EXPANSION 632|1001|N|Y|Y||Preferred Generic|577127-pregabalin225MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Brand|2563004-0.7MLinfluenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.0857MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.085|EXPANSION 632|1001|N|N|N||Preferred Generic|317110-24HRIsosorbideMononitrate30MGExtendedReleaseOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|312849-ropinirole5MGOralTablet|EXPANSION 632|1001|N|Y|Y||Preferred Generic|483448-pregabalin50MGOralCapsule|EXPANSION 632|1001|N|N|Y||Preferred Generic|311237-Ketotifen0.25MG/MLOphthalmicSolution|EXPANSION 632|1001|N|Y|Y||Preferred Generic|483444-pregabalin300MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|197803-Ibuprofen20MG/MLOralSuspension|EXPANSION 632|1001|N|N|N||Preferred Generic|1014678-cetirizinehydrochloride10MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|197622-Dipyridamole50MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|315134-Levocarnitine100MG/MLOralSolution|EXPANSION 632|1001|N|N|N||Preferred Brand|284551-nilutamide150MGOralTablet[Nilandron]|EXPANSION 632|1001|N|N|N||Preferred Generic|283406-Mirtazapine15MGDisintegratingOralTablet|EXPANSION 632|1001|N|Y|Y||Preferred Generic|351134-zolmitriptan5MGDisintegratingOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1486981-dapagliflozin5MGOralTablet[Farxiga]|EXPANSION 632|1001|N|N|N||Preferred Generic|197797-hydroxyurea500MGOralCapsule|EXPANSION 632|1001|N|Y|Y||Preferred Generic|314227-Sumatriptan20MG/ACTUATNasalSpray|EXPANSION 632|1001|N|Y|Y||Preferred Generic|313189-Tacrolimus0.0003MG/MGTopicalOintment|EXPANSION 632|1001|N|N|N||Preferred Generic|315102-SodiumFluoride1.1MG/MLOralSolution|EXPANSION 632|1001|N|N|Y||Preferred Brand|836634-1MLhepatitisAvirusstrainCR326Fantigen,inactivated50UNT/MLPrefilledSyringe[Vaqta]|EXPANSION 632|1001|N|N|N||Preferred Brand|2562996-0.5MLinfluenzaAvirusA/Cambodia/e0826360/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.|EXPANSION 632|1001|N|Y|Y||Preferred Generic|313159-Sumatriptan5MG/ACTUATNasalSpray|EXPANSION 632|1001|N|N|N||Preferred Generic|315090-Erythromycin333MGDelayedReleaseOralTablet|EXPANSION 632|1001|N|Y|Y||Preferred Generic|309333-Clindamycin10MG/MLTopicalSolution|EXPANSION 632|1001|N|N|N||Preferred Generic|311197-IsosorbideMononitrate20MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|199164-Phenobarbital97.2MGOralTablet|EXPANSION 632|1001|N|Y|Y||Preferred Generic|284201-zolmitriptan2.5MGDisintegratingOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Brand|1190916-0.5MLdiphtheriatoxoidvaccine,inactivated4UNT/ML/tetanustoxoidvaccine,inactivated10UNT/MLInjection[Tenivac]|EXPANSION 632|1001|N|N|N||Preferred Generic|313215-Terazosin1MGOralCapsule|EXPANSION 632|1001|N|N|Y||Preferred Generic|845488-Ramipril1.25MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|197785-Hydrocortisone25MG/MLTopicalLotion|EXPANSION 632|1001|Y|N|N||Preferred Brand|1946520-3-Month1.5MLLeuprolideAcetate20MG/MLPrefilledSyringe[Lupron]|EXPANSION 632|1001|N|N|N||Preferred Generic|314238-Tropicamide10MG/MLOphthalmicSolution|EXPANSION 632|1001|N|N|Y||Preferred Generic|197902-Lorazepam2MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|1595478-amylase84000UNT/lipase20000UNT/protease63000UNTDelayedReleaseOralCapsule[Zenpep]|EXPANSION 632|1001|N|Y|Y||Preferred Generic|2001566-BXRating24HRMethylphenidateHydrochloride36MGExtendedReleaseOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|197783-Hydrocortisone20MGOralTablet|EXPANSION 632|1001|N|Y|Y||Preferred Generic|2001565-BXRating24HRMethylphenidateHydrochloride27MGExtendedReleaseOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|596934-duloxetine60MGDelayedReleaseOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|1014673-cetirizinehydrochloride1MG/MLOralSolution|EXPANSION 632|1001|N|Y|Y||Preferred Generic|2001564-BXRating24HRMethylphenidateHydrochloride18MGExtendedReleaseOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1649593-0.5MLpeginterferonbeta-1a0.25MG/MLAuto-Injector[Plegridy]|EXPANSION 632|1001|N|Y|Y||Preferred Generic|197978-Metolazone10MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|314208-ropinirole1MGOralTablet|EXPANSION 632|1001|N|Y|Y||Preferred Generic|197519-Clindamycin10MG/MLTopicalLotion|EXPANSION 632|1001|N|N|N||Preferred Generic|283433-Melatonin10MGOralCapsule|EXPANSION 632|1001|N|Y|Y||Preferred Generic|1806195-50/50Release24HRMethylphenidateHydrochloride10MGExtendedReleaseOralCapsule|EXPANSION 632|1001|N|Y|Y||Preferred Generic|1806185-50/50Release24HRMethylphenidateHydrochloride60MGExtendedReleaseOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|197304-Acetazolamide250MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|312940-Sertraline25MGOralTablet|EXPANSION 632|1001|N|Y|Y||Preferred Generic|1111343-olopatadine2MG/MLOphthalmicSolution|EXPANSION 632|1001|N|N|N||Preferred Generic|1014571-12HRcetirizinehydrochloride5MG/PseudoephedrineHydrochloride120MGExtendedReleaseOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|314165-prednisolone10MG/MLOphthalmicSolution|EXPANSION 632|1001|N|N|N||Preferred Generic|310964-Ibuprofen200MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|861448-ClobetasolPropionate0.0005MG/MGTopicalOintment|EXPANSION 632|1001|N|N|N||Preferred Generic|197746-Guanfacine2MGOralTablet|EXPANSION 632|1001|N|Y|Y||Preferred Brand|2200650-semaglutide14MGOralTablet[Rybelsus]|EXPANSION 632|1001|Y|N|N||Preferred Brand|995156-lacosamide10MG/MLOralSolution[Vimpat]|EXPANSION 632|1001|N|N|Y||Preferred Brand|1300378-0.5MLBordetellapertussisfilamentoushemagglutininvaccine,inactivated0.016MG/ML/Bordetellapertussispertactinvaccine,ina|EXPANSION 632|1001|N|Y|Y||Preferred Brand|1716223-patiromer25200MGPowderforOralSuspension[Veltassa]|EXPANSION 632|1001|N|N|N||Preferred Generic|314111-Mirtazapine30MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|993456-1MLdenosumab60MG/MLPrefilledSyringe[Prolia]|EXPANSION 632|1001|Y|N|N||Preferred Brand|2047602-1MLepoetinalfa-epbx2000UNT/MLInjection[Retacrit]|EXPANSION 632|1001|N|N|N||Preferred Generic|314106-Metronidazole250MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|1362712-MexiletineHydrochloride200MGOralCapsule|EXPANSION 632|1001|N|Y|N||Preferred Brand|1551300-0.5MLdulaglutide1.5MG/MLAuto-Injector[Trulicity]|EXPANSION 632|1001|N|Y|N||Preferred Generic|997406-12HRFexofenadinehydrochloride60MG/PseudoephedrineHydrochloride120MGExtendedReleaseOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|199376-potassiumcitrate5MEQExtendedReleaseOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|310796-Hydrochlorothiazide12.5MG/quinapril10MGOralTablet|EXPANSION 632|1001|N|Y|N||Preferred Generic|996609-24HRMemantinehydrochloride28MGExtendedReleaseOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|197741-Guaifenesin200MGOralTablet|EXPANSION 632|1001|N|Y|N||Preferred Generic|996594-24HRMemantinehydrochloride14MGExtendedReleaseOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|863628-24HROxybutyninchloride15MGExtendedReleaseOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|314072-latanoprost0.05MG/MLOphthalmicSolution|EXPANSION 632|1001|N|N|N||Preferred Generic|199167-Phenobarbital32.4MGOralTablet|EXPANSION 632|1001|N|Y|N||Preferred Generic|857560-trospiumchloride20MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|199370-Ciprofloxacin100MGOralTablet|EXPANSION 632|1001|N|Y|N||Preferred Brand|833143-Milnacipranhydrochloride12.5MGOralTablet[Savella]|EXPANSION 632|1001|N|N|N||Preferred Generic|197737-Glyburide1.25MGOralTablet|EXPANSION 632|1001|N|Y|N||Preferred Generic|855189-24HRtolterodinetartrate4MGExtendedReleaseOralCapsule|EXPANSION 632|1001|N|Y|N||Preferred Brand|1801840-lifitegrast50MG/MLOphthalmicSolution[Xiidra]|EXPANSION 632|1001|N|Y|N||Preferred Generic|855182-24HRtolterodinetartrate2MGExtendedReleaseOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Brand|2562995-0.5MLinfluenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Washington/19/2020(H1N1)antigen0.03MG/|EXPANSION 632|1001|N|N|N||Preferred Generic|309362-clopidogrel75MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|314000-Glyburide1.5MGOralTablet|EXPANSION 632|1001|N|Y|N||Preferred Generic|810090-Carbidopa18.75MG/entacapone200MG/Levodopa75MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|861960-armodafinil200MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|1595473-amylase63000UNT/lipase15000UNT/protease47000UNTDelayedReleaseOralCapsule[Zenpep]|EXPANSION 632|1001|N|N|N||Preferred Generic|310982-imiquimod50MG/MLTopicalCream|EXPANSION 632|1001|N|Y|N||Preferred Generic|749206-sevelamercarbonate800MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Brand|1300206-0.5MLBordetellapertussisfilamentoushemagglutininvaccine,inactivated0.01MG/ML/Bordetellapertussisfimbriae2/3vaccine,in|EXPANSION 632|1001|N|Y|N||Preferred Brand|1991317-1MGDose1.5MLsemaglutide1.34MG/MLPenInjector[Ozempic]|EXPANSION 632|1001|N|N|N||Preferred Generic|312962-Simvastatin5MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|1011852-LidocaineHydrochloride0.02MG/MGTopicalGel|EXPANSION 632|1001|N|N|N||Preferred Generic|313979-fludrocortisoneacetate0.1MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|310191-estradiolvalerate40MG/MLInjectableSolution|EXPANSION 632|1001|N|Y|N||Preferred Generic|562806-Pimecrolimus10MG/MLTopicalCream|EXPANSION 632|1001|N|N|N||Preferred Generic|197701-Fluconazole50MGOralTablet|EXPANSION 632|1001|N|Y|N||Preferred Generic|403852-Carbidopa37.5MG/entacapone200MG/Levodopa150MGOralTablet|EXPANSION 632|1001|N|Y|N||Preferred Generic|403851-Carbidopa25MG/entacapone200MG/Levodopa100MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|259255-atorvastatin80MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|313888-Cefaclor50MG/MLOralSuspension|EXPANSION 632|1001|N|Y|N||Preferred Generic|403850-Carbidopa12.5MG/entacapone200MG/Levodopa50MGOralTablet|EXPANSION 632|1001|N|Y|N||Preferred Generic|349590-Levalbuterol0.103MG/MLInhalationSolution|EXPANSION 632|1001|N|N|N||Preferred Generic|313850-Amoxicillin40MG/MLOralSuspension|EXPANSION 632|1001|N|Y|N||Preferred Generic|349556-ezetimibe10MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|105583-Fluorouracil50MG/MLTopicalCream|EXPANSION 632|1001|N|N|N||Preferred Brand|2561275-0.5MLinfluenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.03MG/|EXPANSION 632|1001|Y|N|N||Preferred Generic|1050493-{21(drospirenone3MG/EthinylEstradiol0.03MG/levomefolatecalcium0.451MGOralTablet)/7(levomefolatecalcium0.451MGOralTabl|EXPANSION 632|1001|N|Y|N||Preferred Brand|1992695-ertugliflozin2.5MG/Metforminhydrochloride500MGOralTablet[Segluromet]|EXPANSION 632|1001|Y|N|N||Preferred Brand|2106075-0.9MLtocilizumab180MG/MLAuto-Injector[Actemra]|EXPANSION 632|1001|N|N|Y||Preferred Generic|200094-irbesartan75MGOralTablet|EXPANSION 632|1001|N|Y|N||Preferred Generic|313921-calcipotriene0.05MG/MLTopicalCream|EXPANSION 632|1001|N|Y|N||Preferred Generic|311347-linezolid600MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|283858-ropinirole3MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|861657-24HRNitroglycerin0.1MG/HRTransdermalSystem|EXPANSION 632|1001|N|N|N||Preferred Generic|197698-Fluconazole100MGOralTablet|EXPANSION 632|1001|N|Y|N||Preferred Generic|308865-calcipotriene0.05MG/MLTopicalSolution|EXPANSION 632|1001|Y|N|N||Preferred Generic|1087964-hydroxyprogesteronecaproate(USP)250MG/MLInjectableSolution|EXPANSION 632|1001|N|Y|N||Preferred Generic|284008-travoprost0.04MG/MLOphthalmicSolution|EXPANSION 632|1001|N|Y|N||Preferred Generic|242831-Griseofulvin125MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|313583-24HRvenlafaxine37.5MGExtendedReleaseOralCapsule|EXPANSION 632|1001|N|Y|N||Preferred Generic|239239-Griseofulvin250MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|198014-Naproxen500MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|1013629-{24(drospirenone3MG/EthinylEstradiol0.02MG/levomefolatecalcium0.451MGOralTablet)/4(levomefolatecalcium0.451MGOralTabl|EXPANSION 632|1001|N|N|N||Preferred Generic|197625-Doxazosin1MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|997226-Donepezilhydrochloride5MGDisintegratingOralTablet|EXPANSION 632|1001|N|Y|N||Preferred Generic|198373-calcipotriene0.00005MG/MGTopicalOintment|EXPANSION 632|1001|N|N|N||Preferred Generic|197685-Etodolac300MGOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Brand|1653243-1MLsecukinumab150MG/MLAuto-Injector[Cosentyx]|EXPANSION 632|1001|Y|N|N||Preferred Generic|1299903-Tiagabinehydrochloride12MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|1006120-SulfacetamideSodium100MG/MLOphthalmicSolution|EXPANSION 632|1001|N|Y|N||Preferred Brand|1992821-ertugliflozin15MGOralTablet[Steglatro]|EXPANSION 632|1001|N|N|N||Preferred Generic|283523-gabapentin50MG/MLOralSolution|EXPANSION 632|1001|Y|N|N||Preferred Generic|1146690-24HRlamotrigine250MGExtendedReleaseOralTablet|EXPANSION 632|1001|N|Y|N||Preferred Generic|197507-Cimetidine400MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|205922-1MLEpoetinAlfa3000UNT/MLInjection[Procrit]|EXPANSION 632|1001|N|N|N||Preferred Generic|313096-Spironolactone25MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|205923-1MLEpoetinAlfa4000UNT/MLInjection[Epogen]|EXPANSION 632|1001|N|N|N||Preferred Generic|197684-Etodolac200MGOralCapsule|EXPANSION 632|1001|N|Y|N||Preferred Generic|197505-Cimetidine200MGOralTablet|EXPANSION 632|1001|N|Y|N||Preferred Brand|212381-aminosalicylicacid4000MGOralGranules[PaserD/R]|EXPANSION 632|1001|N|Y|N||Preferred Generic|197419-Bumetanide2MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|1595462-amylase42000UNT/lipase10000UNT/protease32000UNTDelayedReleaseOralCapsule[Zenpep]|EXPANSION 632|1001|N|N|N||Preferred Generic|197305-AceticAcid20MG/MLOticSolution|EXPANSION 632|1001|N|Y|N||Preferred Generic|197418-Bumetanide1MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|313521-Tropicamide5MG/MLOphthalmicSolution|EXPANSION 632|1001|N|Y|N||Preferred Generic|1855389-Levalbuterol2.5MG/MLInhalationSolution|EXPANSION 632|1001|Y|N|Y||Preferred Generic|891874-MorphineSulfate100MGExtendedReleaseOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|310362-Fluocinonide0.0005MG/MGTopicalGel|EXPANSION 632|1001|N|N|N||Preferred Generic|199192-famciclovir125MGOralTablet|EXPANSION 632|1001|N|Y|N||Preferred Brand|213307-Ciprofloxacin0.003MG/MGOphthalmicOintment[Ciloxan]|EXPANSION 632|1001|N|Y|N||Preferred Generic|1368954-mesalamine400MGDelayedReleaseOralCapsule|EXPANSION 632|1001|N|N|Y||Preferred Brand|1300468-0.5MLHaemophilusinfluenzaetypebstrain1482,capsularpolysaccharideinactivatedtetanustoxoidconjugatevaccine0.068MG/MLInj|EXPANSION 632|1001|N|N|N||Preferred Generic|197670-Estrogens,Esterified(USP)1.25MG/Methyltestosterone2.5MGOralTablet|EXPANSION 632|1001|N|Y|N||Preferred Generic|1368431-alogliptin25MG/pioglitazone30MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|686400-ErythromycinEthylsuccinate40MG/MLOralSuspension|EXPANSION 632|1001|N|N|N||Preferred Generic|313423-Tolnaftate10MG/MLTopicalSolution|EXPANSION 632|1001|Y|N|N||Preferred Generic|903857-PyridostigmineBromide60MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1870956-deflazacort18MGOralTablet[Emflaza]|EXPANSION 632|1001|Y|N|N||Preferred Generic|578325-candesartancilexetil16MG/Hydrochlorothiazide12.5MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|308988-Carbidopa25MG/Levodopa100MGExtendedReleaseOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|1098608-24HRlamotrigine300MGExtendedReleaseOralTablet|EXPANSION 632|1001|N|Y|N||Preferred Generic|1368410-alogliptin12.5MG/pioglitazone30MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|197659-Estradiol2MGOralTablet|EXPANSION 632|1001|N|Y|N||Preferred Generic|1368403-alogliptin12.5MG/pioglitazone15MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|1000897-PilocarpineHydrochloride40MG/MLOphthalmicSolution|EXPANSION 632|1001|N|Y|N||Preferred Generic|1368392-alogliptin12.5MG/Metforminhydrochloride500MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|310154-Erythromycin250MGDelayedReleaseOralCapsule|EXPANSION 632|1001|N|Y|N||Preferred Brand|2395785-0.5MLdulaglutide9MG/MLAuto-Injector[Trulicity]|EXPANSION 632|1001|N|N|N||Preferred Brand|2178792-0.3MLEpinephrine0.5MG/MLPrefilledSyringe[Symjepi]|EXPANSION 632|1001|N|Y|N||Preferred Generic|1368018-alogliptin6.25MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|283672-Citalopram10MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|198033-Nifedipine20MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|152695-meloxicam15MGOralTablet|EXPANSION 632|1001|N|Y|N||Preferred Generic|1246673-Ivermectin5MG/MLTopicalLotion|EXPANSION 632|1001|N|N|N||Preferred Generic|197657-Estradiol0.5MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|200284-Hydrochlorothiazide12.5MG/valsartan80MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|2120195-1MLerenumab-aooe140MG/MLAuto-Injector[Aimovig]|EXPANSION 632|1001|N|Y|N||Preferred Brand|996633-NamendaXR28DayTitrationPack|EXPANSION 632|1001|N|N|N||Preferred Generic|313217-Terazosin2MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|313142-Sulfasalazine500MGDelayedReleaseOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|850087-24HRlamotrigine100MGExtendedReleaseOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|861753-Glyburide5MG/Metforminhydrochloride500MGOralTablet|EXPANSION 632|1001|N|Y|N||Preferred Brand|833151-Savella4-WeekTitrationPack|EXPANSION 632|1001|N|N|N||Preferred Generic|197650-Erythromycin500MGOralTablet|EXPANSION 632|1001|N|Y|N||Preferred Brand|833149-Milnacipranhydrochloride25MGOralTablet[Savella]|EXPANSION 632|1001|N|N|N||Preferred Generic|151226-topiramate50MGOralTablet|EXPANSION 632|1001|N|Y|N||Preferred Brand|833146-Milnacipranhydrochloride50MGOralTablet[Savella]|EXPANSION 632|1001|N|N|N||Preferred Generic|313195-Tamoxifen20MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Brand|847199-3MLinsulinisophane,human100UNT/MLPenInjector[HumulinN]|EXPANSION 632|1001|Y|N|N||Preferred Generic|1111641-1MLglatirameracetate20MG/MLPrefilledSyringe|EXPANSION 632|1001|N|N|Y||Preferred Brand|1363484-hypromellose0.003MG/MGOphthalmicGel[SystaneOvernightTherapy]|EXPANSION 632|1001|N|N|N||Preferred Generic|313190-Tacrolimus0.5MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|197628-Doxazosin8MGOralTablet|EXPANSION 632|1001|N|Y|N||Preferred Brand|539789-rifaximin200MGOralTablet[XIFAXAN]|EXPANSION 632|1001|N|N|N||Preferred Generic|1000673-SulfacetamideSodium0.1MG/MGOphthalmicOintment|EXPANSION 632|1001|N|N|N||Preferred Generic|105585-Methotrexate2.5MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|2173508-Nonoxynol-91000MGVaginalSponge[TodaySponge]|EXPANSION 632|1001|N|N|N||Preferred Generic|863619-24HROxybutyninchloride10MGExtendedReleaseOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|596930-duloxetine30MGDelayedReleaseOralCapsule|EXPANSION 632|1001|N|Y|N||Preferred Brand|2398842-3MLsemaglutide1.34MG/MLPenInjector[Ozempic]|EXPANSION 632|1001|N|N|N||Preferred Generic|310534-Glyburide2.5MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|313134-Sulfamethoxazole40MG/ML/Trimethoprim8MG/MLOralSuspension|EXPANSION 632|1001|N|Y|N||Preferred Brand|2395779-0.5MLdulaglutide6MG/MLAuto-Injector[Trulicity]|EXPANSION 632|1001|N|N|N||Preferred Generic|198144-Prednisone1MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|313123-Sucralfate100MG/MLOralSuspension|EXPANSION 632|1001|N|N|N||Preferred Generic|199193-famciclovir250MGOralTablet|EXPANSION 632|1001|N|Y|N||Preferred Brand|833139-Milnacipranhydrochloride100MGOralTablet[Savella]|EXPANSION 632|1001|N|N|Y||Preferred Generic|596926-duloxetine20MGDelayedReleaseOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Brand|1595457-amylase24000UNT/lipase5000UNT/protease17000UNTDelayedReleaseOralCapsule[Zenpep]|EXPANSION 632|1001|N|N|N||Preferred Generic|197626-Doxazosin2MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|996571-Memantinehydrochloride5MGOralTablet|EXPANSION 632|1001|N|Y|N||Preferred Brand|1992816-ertugliflozin5MGOralTablet[Steglatro]|EXPANSION 632|1001|N|N|N||Preferred Generic|1359779-Fluticasonepropionate0.1MG/ACTUAT/salmeterol0.05MG/ACTUATDryPowderInhaler|EXPANSION 632|1001|N|N|N||Preferred Generic|1000647-PilocarpineHydrochloride10MG/MLOphthalmicSolution|EXPANSION 632|1001|N|N|N||Preferred Generic|313092-Sorbitol700MG/MLOralSolution|EXPANSION 632|1001|N|N|N||Preferred Generic|996561-Memantinehydrochloride10MGOralTablet|EXPANSION 632|1001|N|Y|N||Preferred Brand|1992700-ertugliflozin7.5MG/Metforminhydrochloride1000MGOralTablet[Segluromet]|EXPANSION 632|1001|N|N|Y||Preferred Brand|1190919-0.5MLdiphtheriatoxoidvaccine,inactivated4UNT/ML/tetanustoxoidvaccine,inactivated10UNT/MLPrefilledSyringe[Tenivac]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1657980-10MLtocilizumab20MG/MLInjection[Actemra]|EXPANSION 632|1001|N|N|N||Preferred Generic|312997-SodiumChloride9MG/MLInhalationSolution|EXPANSION 632|1001|N|N|N||Preferred Brand|753482-Apri28DayPack|EXPANSION 632|1001|N|Y|N||Preferred Brand|1992691-ertugliflozin2.5MG/Metforminhydrochloride1000MGOralTablet[Segluromet]|EXPANSION 632|1001|N|N|N||Preferred Generic|727316-NDA0194300.3MLEpinephrine0.5MG/MLAuto-Injector|EXPANSION 632|1001|N|N|N||Preferred Generic|310539-Glyburide6MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|1190225-120ACTUATAlbuterol0.1MG/ACTUAT/IpratropiumBromide0.02MG/ACTUATInhalationSpray[Combivent]|EXPANSION 632|1001|N|Y|N||Preferred Brand|1991311-0.25MG,0.5MGDose1.5MLsemaglutide1.34MG/MLPenInjector[Ozempic]|EXPANSION 632|1001|N|N|N||Preferred Generic|312961-Simvastatin20MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|1101778-Monobasicpotassiumphosphate0.0408MEQ/MLOralSolution[K-Phos]|EXPANSION 632|1001|N|Y|N||Preferred Brand|1551306-0.5MLdulaglutide3MG/MLAuto-Injector[Trulicity]|EXPANSION 632|1001|N|N|N||Preferred Generic|1000141-medroxyprogesteroneacetate5MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|197408-Betamethasone1MG/MLTopicalLotion|EXPANSION 632|1001|N|N|Y||Preferred Generic|200285-Hydrochlorothiazide12.5MG/valsartan160MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|312941-Sertraline50MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|213621-Bacitracin0.5UNT/MG/PolymyxinB10UNT/MGOphthalmicOintment[Polycin]|EXPANSION 632|1001|N|Y|N||Preferred Brand|1356673-BenzylAlcohol0.05ML/MLTopicalLotion[Ulesfia]|EXPANSION 632|1001|N|N|N||Preferred Generic|197310-Acyclovir200MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|197623-Disulfiram250MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|996757-CodeinePhosphate2MG/ML/PhenylephrineHydrochloride1MG/ML/PromethazineHydrochloride1.25MG/MLOralSolution|EXPANSION 632|1001|N|N|Y||Preferred Generic|995868-CodeinePhosphate2MG/ML/Guaifenesin20MG/MLOralSolution|EXPANSION 632|1001|N|N|N||Preferred Generic|312938-Sertraline100MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|993890-Acetaminophen300MG/CodeinePhosphate60MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|748868-{21(EthinylEstradiol0.02MG/Levonorgestrel0.1MGOralTablet)/7(InertIngredients1MGOralTablet)}Pack|EXPANSION 632|1001|N|N|Y||Preferred Generic|993781-Acetaminophen300MG/CodeinePhosphate30MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|312899-Salsalate500MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|1190572-AtropineSulfate0.025MG/DiphenoxylateHydrochloride2.5MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|209531-Acetaminophen80MGRectalSuppository[Feverall]|EXPANSION 632|1001|N|N|N||Preferred Generic|1000135-medroxyprogesteroneacetate2.5MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Brand|1547582-0.5MLStreptococcuspneumoniaetype1capsularpolysaccharideantigen0.05MG/ML/Streptococcuspneumoniaetype10Acapsularpolysac|EXPANSION 632|1001|Y|N|N||Preferred Generic|1299917-Tiagabinehydrochloride4MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|200311-Fenofibrate67MGOralCapsule|EXPANSION 632|1001|N|N|Y||Preferred Generic|993470-midodrinehydrochloride5MGOralTablet|EXPANSION 632|1001|N|Y|N||Preferred Brand|835721-Ethionamide250MGOralTablet[Trecator]|EXPANSION 632|1001|N|N|N||Preferred Generic|312847-ropinirole2MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|105551-Busulfan2MGOralTablet[Myleran]|EXPANSION 632|1001|N|N|N||Preferred Generic|310377-Fluorometholone1MG/MLOphthalmicSuspension|EXPANSION 632|1001|N|N|Y||Preferred Generic|993462-midodrinehydrochloride10MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|1855086-thyroid(USP)15MGOralTablet[NPThyroid]|EXPANSION 632|1001|N|N|N||Preferred Generic|312846-ropinirole0.5MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1657212-omalizumab150MGInjection[Xolair]|EXPANSION 632|1001|N|Y|N||Preferred Brand|856666-rifaximin550MGOralTablet[XIFAXAN]|EXPANSION 632|1001|N|N|Y||Preferred Brand|1364447-apixaban5MGOralTablet[Eliquis]|EXPANSION 632|1001|N|N|N||Preferred Generic|863636-24HROxybutyninchloride5MGExtendedReleaseOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|1547771-Tetracainehydrochloride5MG/MLOphthalmicSolution|EXPANSION 632|1001|N|N|N||Preferred Generic|856457-PropranololHydrochloride20MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|748961-{28(Norethindrone0.35MGOralTablet)}Pack|EXPANSION 632|1001|Y|N|N||Preferred Generic|1304979-icosapentethyl1000MGOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Brand|1921468-HumiraPen80MG/0.8MLand40MG/0.4ML-Psoriasis/UveitisStarterPackage(3count)|EXPANSION 632|1001|N|N|N||Preferred Generic|1000114-medroxyprogesteroneacetate10MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|905516-ChlordiazepoxideHydrochloride5MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|312750-quinapril5MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|905495-ChlordiazepoxideHydrochloride25MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Brand|213510-Auranofin3MGOralCapsule[Ridaura]|EXPANSION 632|1001|N|N|N||Preferred Generic|312749-quinapril20MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|197596-Dicloxacillin500MGOralCapsule|EXPANSION 632|1001|N|N|Y||Preferred Generic|904589-SotalolHydrochloride240MGOralTablet|EXPANSION 632|1001|N|Y|N||Preferred Generic|1085816-spinosad9MG/MLMedicatedShampoo|EXPANSION 632|1001|N|N|Y||Preferred Generic|904447-Alendronicacid0.933MG/MLOralSolution|EXPANSION 632|1001|N|N|N||Preferred Brand|1595292-amylase14000UNT/lipase3000UNT/protease10000UNTDelayedReleaseOralCapsule[Zenpep]|EXPANSION 632|1001|N|N|N||Preferred Brand|692694-thyroid(USP)65MGOralTablet[Westhroid]|EXPANSION 632|1001|N|N|Y||Preferred Generic|904419-Alendronicacid10MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|197595-Dicloxacillin250MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|312641-Progesterone200MGOralCapsule|EXPANSION 632|1001|N|N|Y||Preferred Generic|899557-dexmethylphenidatehydrochloride2.5MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|1000097-DoxepinHydrochloride75MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|312635-Prochlorperazine5MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|284184-Didanosine250MGDelayedReleaseOralCapsule|EXPANSION 632|1001|N|N|Y||Preferred Generic|1649990-DoxycyclineMonohydrate100MGOralCapsule|EXPANSION 632|1001|N|N|Y||Preferred Generic|899518-dexmethylphenidatehydrochloride5MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|722126-Amlodipine10MG/valsartan160MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|197583-Dexamethasone6MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1665900-1MLevolocumab140MG/MLAuto-Injector[Repatha]|EXPANSION 632|1001|N|N|N||Preferred Generic|749157-{7(EthinylEstradiol0.025MG/norgestimate0.18MGOralTablet)/7(EthinylEstradiol0.025MG/norgestimate0.215MGOralTablet)/7(Et|EXPANSION 632|1001|N|N|Y||Preferred Generic|897710-HydromorphoneHydrochloride8MGOralTablet|EXPANSION 632|1001|N|Y|N||Preferred Generic|1368006-alogliptin25MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|897702-HydromorphoneHydrochloride4MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|312615-Prednisone20MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|863664-Oxybutyninchloride5MGOralTablet|EXPANSION 632|1001|N|Y|Y||Preferred Generic|856535-24HRPropranololHydrochloride60MGExtendedReleaseOralCapsule|EXPANSION 632|1001|N|N|Y||Preferred Generic|897696-HydromorphoneHydrochloride2MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|310792-Hydrochlorothiazide12.5MG/irbesartan150MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|349353-Hydrochlorothiazide25MG/valsartan160MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|312594-Prazosin2MGOralCapsule|EXPANSION 632|1001|N|N|Y||Preferred Generic|897640-Verapamilhydrochloride180MGExtendedReleaseOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|2359285-24HRempagliflozin10MG/linagliptin5MG/metforminhydrochloride1000MGExtendedReleaseOralTablet[Trijardy]|EXPANSION 632|1001|N|N|N||Preferred Generic|1000076-DoxepinHydrochloride50MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|310379-Fluorouracil20MG/MLTopicalSolution|EXPANSION 632|1001|N|N|N||Preferred Brand|213291-ParoxetineHydrochloride2MG/MLOralSuspension[Paxil]|EXPANSION 632|1001|N|N|N||Preferred Generic|1992303-12HRTimolol5MG/MLOphthalmicSolution|EXPANSION 632|1001|N|N|Y||Preferred Generic|897618-24HRVerapamilhydrochloride180MGExtendedReleaseOralCapsule|EXPANSION 632|1001|N|N|Y||Preferred Brand|1547672-30ACTUATfluticasonefuroate0.2MG/ACTUATDryPowderInhaler[Arnuity]|EXPANSION 632|1001|N|N|N||Preferred Generic|197581-Dexamethasone2MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|312529-PotassiumChloride8MEQExtendedReleaseOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|894780-MorphineSulfate4MG/MLOralSolution|EXPANSION 632|1001|N|N|Y||Preferred Generic|200345-Simvastatin80MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|312515-PotassiumChloride1.33MEQ/MLOralSolution|EXPANSION 632|1001|N|N|Y||Preferred Generic|892625-MorphineSulfate20MG/MLOralSolution|EXPANSION 632|1001|Y|N|N||Preferred Generic|1359861-Budesonide0.16MG/ACTUAT/formoterolfumarate0.0045MG/ACTUATMeteredDoseInhaler|EXPANSION 632|1001|N|N|Y||Preferred Generic|892589-MorphineSulfate2MG/MLOralSolution|EXPANSION 632|1001|N|N|N||Preferred Generic|197580-Dexamethasone1.5MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|892582-MorphineSulfate15MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|1000070-DoxepinHydrochloride25MGOralCapsule|EXPANSION 632|1001|N|N|Y||Preferred Generic|884386-DextroamphetamineSulfate5MGOralTablet|EXPANSION 632|1001|N|Y|N||Preferred Generic|1368385-alogliptin12.5MG/Metforminhydrochloride1000MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|312441-pioglitazone45MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|884385-DextroamphetamineSulfate10MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|312440-pioglitazone30MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|197579-Dexamethasone1MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|863559-valganciclovir50MG/MLOralSolution|EXPANSION 632|1001|N|N|N||Preferred Generic|284185-Didanosine200MGDelayedReleaseOralCapsule|EXPANSION 632|1001|N|N|Y||Preferred Generic|862025-24HRGuanfacine4MGExtendedReleaseOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|862019-24HRGuanfacine3MGExtendedReleaseOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|995666-MeclizineHydrochloride25MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|312357-Phenobarbital15MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|197311-Acyclovir400MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|862006-24HRGuanfacine1MGExtendedReleaseOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|1000064-DoxepinHydrochloride150MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|312301-Pentoxifylline400MGExtendedReleaseOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|213284-hydroxyurea400MGOralCapsule[Droxia]|EXPANSION 632|1001|N|N|Y||Preferred Generic|861232-24HRAmphetamineaspartate7.5MG/AmphetamineSulfate7.5MG/Dextroamphetaminesaccharate7.5MG/DextroamphetamineSulfate7.5MGEx|EXPANSION 632|1001|N|N|N||Preferred Generic|866018-buspironehydrochloride15MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|861227-24HRAmphetamineaspartate6.25MG/AmphetamineSulfate6.25MG/Dextroamphetaminesaccharate6.25MG/DextroamphetamineSulfate6.25|EXPANSION 632|1001|N|N|N||Preferred Generic|197575-Desoximetasone0.0025MG/MGTopicalOintment|EXPANSION 632|1001|N|N|Y||Preferred Generic|861225-24HRAmphetamineaspartate5MG/AmphetamineSulfate5MG/Dextroamphetaminesaccharate5MG/DextroamphetamineSulfate5MGExtendedRe|EXPANSION 632|1001|N|N|N||Preferred Generic|749783-{6(Azithromycin250MGOralTablet)}Pack|EXPANSION 632|1001|Y|N|N||Preferred Generic|1373483-dimethylfumarate120MGDelayedReleaseOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|312138-oxcarbazepine600MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|1594673-amylase105000UNT/lipase25000UNT/protease79000UNTDelayedReleaseOralCapsule[Zenpep]|EXPANSION 632|1001|N|N|N||Preferred Generic|197448-Levocarnitine330MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|314076-Lisinopril10MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|198032-Nifedipine10MGOralCapsule|EXPANSION 632|1001|N|N|Y||Preferred Brand|1547950-CarboxymethylcelluloseSodium2.5MG/MLOphthalmicSolution[TheraTears]|EXPANSION 632|1001|N|N|N||Preferred Generic|312137-oxcarbazepine300MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|197558-Dapsone25MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|857005-Acetaminophen325MG/HydrocodoneBitartrate7.5MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|1000058-DoxepinHydrochloride100MGOralCapsule|EXPANSION 632|1001|N|N|Y||Preferred Generic|2047882-1MLtestosteronecypionate200MG/MLInjection|EXPANSION 632|1001|N|N|N||Preferred Generic|866083-buspironehydrochloride10MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|1098924-SodiumFluoride11MG/MLOralSolution[Flura-Drops]|EXPANSION 632|1001|N|N|Y||Preferred Generic|856999-Acetaminophen325MG/HydrocodoneBitartrate10MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|313306-Theophylline5.33MG/MLOralSolution|EXPANSION 632|1001|N|N|N||Preferred Generic|197557-Dapsone100MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|312059-Nystatin500000UNTOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|855633-DiclofenacSodium0.01MG/MGTopicalGel|EXPANSION 632|1001|N|N|N||Preferred Brand|1148646-28ACTUATFluticasonepropionate0.25MG/ACTUATDryPowderInhaler[Flovent]|EXPANSION 632|1001|N|N|N||Preferred Generic|1648755-NITROFURANTOIN,MACROCRYSTALS25MG/Nitrofurantoin,Monohydrate75MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|312055-Nystatin100000UNT/MLOralSuspension|EXPANSION 632|1001|N|N|N||Preferred Generic|199245-glimepiride1MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|854873-Zolpidemtartrate10MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|245134-72HRFentanyl0.025MG/HRTransdermalSystem|EXPANSION 632|1001|N|N|N||Preferred Generic|198040-Nitroglycerin0.6MGSublingualTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|203088-Ketoconazole20MG/MLTopicalCream|EXPANSION 632|1001|N|N|N||Preferred Generic|197553-Cyclosporine25MGOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Brand|1726639-ponatinib30MGOralTablet[Iclusig]|EXPANSION 632|1001|N|N|Y||Preferred Generic|854248-1MLEnoxaparinsodium100MG/MLPrefilledSyringe|EXPANSION 632|1001|N|N|N||Preferred Generic|1000054-DoxepinHydrochloride10MG/MLOralSolution|EXPANSION 632|1001|N|N|Y||Preferred Generic|854245-0.8MLEnoxaparinsodium150MG/MLPrefilledSyringe|EXPANSION 632|1001|N|N|N||Preferred Generic|312013-Nitroglycerin2.5MGExtendedReleaseOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Generic|900038-PhentermineHydrochloride30MGOralCapsule|EXPANSION 632|1001|N|N|Y||Preferred Generic|854241-0.8MLEnoxaparinsodium100MG/MLPrefilledSyringe|EXPANSION 632|1001|N|N|N||Preferred Brand|213283-hydroxyurea300MGOralCapsule[Droxia]|EXPANSION 632|1001|N|N|Y||Preferred Generic|854238-0.6MLEnoxaparinsodium100MG/MLPrefilledSyringe|EXPANSION 632|1001|N|N|N||Preferred Generic|311995-NITROFURANTOIN,MACROCRYSTALS50MGOralCapsule|EXPANSION 632|1001|N|N|Y||Preferred Generic|854235-0.4MLEnoxaparinsodium100MG/MLPrefilledSyringe|EXPANSION 632|1001|N|N|Y||Preferred Generic|854228-0.3MLEnoxaparinsodium100MG/MLPrefilledSyringe|EXPANSION 632|1001|N|N|Y||Preferred Generic|847252-3MLInsulinLispro25UNT/ML/insulinlisproprotamine,human75UNT/MLPenInjector|EXPANSION 632|1001|N|N|Y||Preferred Brand|1593140-0.5MLNeisseriameningitidisserogroupBrecombinantLP2086A05proteinvariantantigen0.12MG/ML/Neisseriameningitidisserogroup|EXPANSION 632|1001|N|N|N||Preferred Generic|311989-Nitrofurantoin5MG/MLOralSuspension|EXPANSION 632|1001|N|N|N||Preferred Generic|1191013-Proparacainehydrochloride5MG/MLOphthalmicSolution|EXPANSION 632|1001|N|N|N||Preferred Generic|979485-LosartanPotassium25MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|1000048-DoxepinHydrochloride10MGOralCapsule|EXPANSION 632|1001|N|N|Y||Preferred Generic|349199-valsartan80MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Brand|998666-carboxymethylcellulosesodium0.01MG/MGOphthalmicGel[TheraTears]|EXPANSION 632|1001|N|N|N||Preferred Generic|749860-{21(EthinylEstradiol0.035MG/norgestimate0.25MGOralTablet)/7(InertIngredients1MGOralTablet)}Pack|EXPANSION 632|1001|N|N|Y||Preferred Generic|835829-testosteronecypionate100MG/MLInjectableSolution|EXPANSION 632|1001|N|N|N||Preferred Generic|308976-Carbamazepine20MG/MLOralSuspension|EXPANSION 632|1001|N|N|Y||Preferred Generic|835603-tramadolhydrochloride50MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|197516-Clarithromycin250MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|834022-KetorolacTromethamine10MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|200096-irbesartan300MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|313291-Theophylline400MGExtendedReleaseOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|197379-Atenolol100MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|106336-Ketoconazole20MG/MLMedicatedShampoo|EXPANSION 632|1001|N|N|Y||Preferred Generic|313761-zaleplon10MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|313477-Trifluridine10MG/MLOphthalmicSolution|EXPANSION 632|1001|N|Y|N||Preferred Generic|1797863-flunisolide0.025MG/ACTUATMeteredDoseNasalSpray|EXPANSION 632|1001|N|N|N||Preferred Generic|866094-buspironehydrochloride5MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|1005856-SulfacetamideSodium100MG/ML/Sulfur50MG/MLTopicalLotion|EXPANSION 632|1001|Y|N|N||Preferred Generic|1487361-1MLglatirameracetate40MG/MLPrefilledSyringe|EXPANSION 632|1001|N|N|Y||Preferred Brand|1597099-0.5MLL1protein,Humanpapillomavirustype11Vaccine0.08MG/ML/L1protein,Humanpapillomavirustype16Vaccine0.12MG/ML/L1protei|EXPANSION 632|1001|N|N|N||Preferred Generic|310384-Fluoxetine10MGOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Generic|1435115-28ACTUATTeriparatide0.02MG/ACTUATPenInjector|EXPANSION 632|1001|N|N|Y||Preferred Generic|2123111-NDA020503200ACTUATAlbuterol0.09MG/ACTUATMeteredDoseInhaler|EXPANSION 632|1001|N|N|N||Preferred Generic|903456-liothyroninesodium0.005MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1729029-selexipag1.2MGOralTablet[Uptravi]|EXPANSION 632|1001|N|N|N||Preferred Generic|866111-buspironehydrochloride7.5MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|310385-Fluoxetine20MGOralCapsule|EXPANSION 632|1001|N|N|Y||Preferred Generic|313762-zaleplon5MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|284245-Famotidine40MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|197739-Glycopyrrolate2MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Brand|1597103-0.5MLL1protein,Humanpapillomavirustype11Vaccine0.08MG/ML/L1protein,Humanpapillomavirustype16Vaccine0.12MG/ML/L1protei|EXPANSION 632|1001|N|N|N||Preferred Generic|866144-Cyproheptadinehydrochloride4MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|1114041-DextromethorphanHydrobromide1MG/MLOralSolution[DayQuilCough]|EXPANSION 632|1001|N|N|N||Preferred Generic|199351-trandolapril2MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Brand|1601407-0.5MLmeningococcalgroupBvaccine0.1MG/ML/NeisseriameningitidisserogroupBrecombinantFHBPfusionproteinantigen0.1MG/ML/Ne|EXPANSION 632|1001|N|N|Y||Preferred Generic|200095-irbesartan150MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1729053-selexipag0.2MGOralTablet[Uptravi]|EXPANSION 632|1001|N|N|N||Preferred Generic|198046-Nortriptyline50MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|309291-ciclopirox80MG/MLTopicalSolution|EXPANSION 632|1001|N|N|Y||Preferred Generic|577961-Amphetamineaspartate5MG/AmphetamineSulfate5MG/Dextroamphetaminesaccharate5MG/DextroamphetamineSulfate5MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|310797-Hydrochlorothiazide12.5MG/quinapril20MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|866412-24HRmetoprololsuccinate100MGExtendedReleaseOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Brand|1656346-sacubitril24MG/valsartan26MGOralTablet[Entresto]|EXPANSION 632|1001|Y|N|N||Preferred Generic|1547565-Isotretinoin35MGOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Brand|1729033-selexipag1.4MGOralTablet[Uptravi]|EXPANSION 632|1001|N|N|N||Preferred Generic|996520-DextromethorphanHydrobromide2MG/ML/Guaifenesin20MG/MLOralSolution|EXPANSION 632|1001|N|N|Y||Preferred Brand|830263-1MLHepatitisBSurfaceAntigenVaccine0.04MG/MLInjection[Recombivax]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1729061-selexipag0.6MGOralTablet[Uptravi]|EXPANSION 632|1001|N|N|N||Preferred Generic|199352-trandolapril4MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|313564-valacyclovir1000MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|1550940-Colchicine0.6MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|762675-{21(Methylprednisolone4MGOralTablet)}Pack|EXPANSION 632|1001|N|N|N||Preferred Generic|307675-Acetaminophen32MG/MLOralSolution|EXPANSION 632|1001|N|N|N||Preferred Brand|1114135-amylase16000UNT/lipase3000UNT/protease10000UNTDelayedReleaseOralCapsule[Zenpep]|EXPANSION 632|1001|N|N|N||Preferred Generic|310015-dorzolamide20MG/MLOphthalmicSolution|EXPANSION 632|1001|N|N|N||Preferred Brand|212373-Estrogens,Esterified(USP)1.25MGOralTablet[Menest]|EXPANSION 632|1001|N|N|Y||Preferred Brand|1656351-sacubitril49MG/valsartan51MGOralTablet[Entresto]|EXPANSION 632|1001|Y|N|N||Preferred Generic|1597123-2500MGTestosterone0.01MG/MGTopicalGel|EXPANSION 632|1001|N|N|N||Preferred Generic|198047-Nortriptyline75MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|197316-Albuterol2MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|1797907-Fluticasonepropionate0.05MG/ACTUATMeteredDoseNasalSpray|EXPANSION 632|1001|Y|N|N||Preferred Brand|1729076-UptraviTitrationPack|EXPANSION 632|1001|N|N|Y||Preferred Generic|241946-84HREstradiol0.00156MG/HRTransdermalSystem|EXPANSION 632|1001|N|N|N||Preferred Generic|310490-Glipizide5MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|1048452-ColestipolHydrochloride5000MGGranulesforOralSuspension[Colestid]|EXPANSION 632|1001|N|N|N||Preferred Generic|1923428-Timolol2.5MG/MLOphthalmicSolution|EXPANSION 632|1001|N|N|N||Preferred Generic|1655968-8MLMethotrexate25MG/MLInjection|EXPANSION 632|1001|N|N|N||Preferred Generic|860107-KetorolacTromethamine5MG/MLOphthalmicSolution|EXPANSION 632|1001|N|Y|N||Preferred Generic|197506-Cimetidine300MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|240029-Cholecalciferol0.125MGOralCapsule|EXPANSION 632|1001|N|N|Y||Preferred Generic|310289-Fenofibrate200MGOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Generic|1599949-60ACTUATTestosterone30MG/ACTUATTopicalSolution|EXPANSION 632|1001|N|N|Y||Preferred Generic|242438-montelukast5MGChewableTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|763185-{21(Prednisone10MGOralTablet)}Pack|EXPANSION 632|1001|N|N|Y||Preferred Generic|310465-Gentamicin0.001MG/MGTopicalOintment|EXPANSION 632|1001|N|N|N||Preferred Generic|866436-24HRmetoprololsuccinate50MGExtendedReleaseOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|1607784-deferasirox180MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|349514-celecoxib400MGOralCapsule|EXPANSION 632|1001|N|N|Y||Preferred Brand|830253-0.5MLHepatitisBSurfaceAntigenVaccine0.01MG/MLPrefilledSyringe[Recombivax]|EXPANSION 632|1001|N|N|N||Preferred Generic|307718-Acetylcysteine100MG/MLInhalationSolution|EXPANSION 632|1001|N|N|N||Preferred Generic|313565-valacyclovir500MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|1191256-FluocinoloneAcetonide0.00025MG/MGTopicalOintment|EXPANSION 632|1001|N|N|N||Preferred Generic|312845-ropinirole0.25MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|311194-IsosorbideDinitrate40MGExtendedReleaseOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|1607796-deferasirox90MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1734642-elbasvir50MG/grazoprevir100MGOralTablet[Zepatier]|EXPANSION 632|1001|Y|N|N||Preferred Generic|898715-pregabalin20MG/MLOralSolution|EXPANSION 632|1001|Y|N|N||Preferred Brand|1605075-0.8MLFILGRASTIM-SNDZ0.6MG/MLPrefilledSyringe[Zarxio]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1741049-24HRtofacitinib11MGExtendedReleaseOralTablet[Xeljanz]|EXPANSION 632|1001|N|N|N||Preferred Generic|1191310-FluocinoloneAcetonide0.1MG/MLTopicalSolution|EXPANSION 632|1001|N|N|N||Preferred Generic|198427-lamotrigine100MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|242461-cilostazol100MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Brand|1658106-0.5MLhepatitisAvirusstrainCR326Fantigen,inactivated50UNT/MLInjection[Vaqta]|EXPANSION 632|1001|N|N|Y||Preferred Generic|242462-cilostazol50MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|1657160-0.5MLSumatriptan12MG/MLCartridge|EXPANSION 632|1001|N|N|N||Preferred Generic|197903-Lovastatin10MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|310687-Hydrocortisone10MG/ML/Neomycin3.5MG/ML/PolymyxinB10000UNT/MLOticSuspension|EXPANSION 632|1001|N|N|N||Preferred Generic|197318-Albuterol4MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|310430-gabapentin100MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|197407-Betamethasone1MG/MLTopicalCream|EXPANSION 632|1001|N|N|Y||Preferred Brand|1658150-1MLHepatitisBSurfaceAntigenVaccine0.01MG/MLInjection[Recombivax]|EXPANSION 632|1001|N|Y|N||Preferred Generic|197508-Cimetidine800MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|242891-84HREstradiol0.00208MG/HRTransdermalSystem|EXPANSION 632|1001|N|N|N||Preferred Brand|759473-20ACTUATZanamivir5MG/ACTUATDryPowderInhaler[Relenza]|EXPANSION 632|1001|N|N|N||Preferred Brand|152854-Itraconazole10MG/MLOralSolution[Sporanox]|EXPANSION 632|1001|N|N|N||Preferred Generic|1659263-1MLheparinsodium,porcine5000UNT/MLInjection|EXPANSION 632|1001|Y|N|N||Preferred Brand|1745114-1MLixekizumab80MG/MLPrefilledSyringe[Taltz]|EXPANSION 632|1001|N|N|N||Preferred Generic|866924-MetoprololTartrate25MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|828348-Cyclobenzaprinehydrochloride10MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|643714-lenalidomide15MGOralCapsule[Revlimid]|EXPANSION 632|1001|N|N|Y||Preferred Brand|1658155-0.5MLHepatitisBSurfaceAntigenVaccine0.01MG/MLInjection[Recombivax]|EXPANSION 632|1001|N|Y|N||Preferred Generic|197551-Cycloserine250MGOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Generic|1734399-1MLGranisetron1MG/MLInjection|EXPANSION 632|1001|Y|N|N||Preferred Brand|1747181-0.4MLMethotrexate31.3MG/MLAuto-Injector[Otrexup]|EXPANSION 632|1001|N|N|Y||Preferred Brand|830245-1MLHepatitisBSurfaceAntigenVaccine0.01MG/MLPrefilledSyringe[Recombivax]|EXPANSION 632|1001|N|N|N||Preferred Brand|896031-28ACTUATFluticasonepropionate0.1MG/ACTUATDryPowderInhaler[Flovent]|EXPANSION 632|1001|Y|N|N||Preferred Brand|828696-Zolpidemtartrate5MG/ACTUATOralSpray[Zolpimist]|EXPANSION 632|1001|N|N|N||Preferred Generic|310489-24HRGlipizide2.5MGExtendedReleaseOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|876193-POLYETHYLENEGLYCOL335017000MGPowderforOralSolution|EXPANSION 632|1001|N|N|Y||Preferred Generic|242892-84HREstradiol0.00417MG/HRTransdermalSystem|EXPANSION 632|1001|N|N|Y||Preferred Generic|248478-84HREstradiol0.00104MG/HRTransdermalSystem|EXPANSION 632|1001|N|N|N||Preferred Generic|106387-Permethrin50MG/MLTopicalCream|EXPANSION 632|1001|N|N|N||Preferred Generic|993503-12HRBupropionHydrochloride100MGExtendedReleaseOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|830882-24HRDiltiazemHydrochloride300MGExtendedReleaseOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1747187-0.4MLMethotrexate43.8MG/MLAuto-Injector[Otrexup]|EXPANSION 632|1001|Y|N|N||Preferred Generic|1737461-PamidronateDisodium90MGInjection|EXPANSION 632|1001|N|N|Y||Preferred Brand|1658472-0.5MLStreptococcuspneumoniaetype1capsularpolysaccharideantigen0.05MG/ML/Streptococcuspneumoniaetype10Acapsularpolysac|EXPANSION 632|1001|Y|N|N||Preferred Brand|847913-60ACTUATexenatide0.01MG/ACTUATPenInjector[Byetta]|EXPANSION 632|1001|N|N|Y||Preferred Generic|251872-pantoprazole20MGDelayedReleaseOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|198086-Phenobarbital16.2MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|884173-ClonidineHydrochloride0.1MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|831054-DiltiazemHydrochloride120MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|1191315-FluocinoloneAcetonide0.25MG/MLTopicalCream|EXPANSION 632|1001|N|N|N||Preferred Generic|432402-cinacalcet30MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1790546-infliximab-dyyb100MGInjection[Inflectra]|EXPANSION 632|1001|N|N|N||Preferred Generic|313582-venlafaxine25MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|310432-gabapentin400MGOralCapsule|EXPANSION 632|1001|N|N|Y||Preferred Brand|1667882-60ACTUATtiotropium0.00125MG/ACTUATInhalationSpray[Spiriva]|EXPANSION 632|1001|N|N|N||Preferred Generic|199703-cabergoline0.5MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|197362-ammoniumlactate120MG/MLTopicalLotion|EXPANSION 632|1001|N|N|N||Preferred Brand|2110513-60ACTUATFluticasonepropionate0.25MG/ACTUAT/salmeterol0.05MG/ACTUATDryPowderInhaler[Wixela]|EXPANSION 632|1001|N|N|Y||Preferred Generic|541878-Amphetamineaspartate1.25MG/AmphetamineSulfate1.25MG/Dextroamphetaminesaccharate1.25MG/DextroamphetamineSulfate1.25MGOr|EXPANSION 632|1001|N|N|N||Preferred Generic|308135-Amlodipine10MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|197686-Etodolac400MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|1799212-sofosbuvir400MG/velpatasvir100MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Brand|1723478-dabigatranetexilate110MGOralCapsule[Pradaxa]|EXPANSION 632|1001|N|N|N||Preferred Generic|310488-Glipizide10MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|259081-12HRAspirin25MG/Dipyridamole200MGExtendedReleaseOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|831102-DiltiazemHydrochloride90MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|349200-valsartan320MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|310467-Gentamicin3MG/MLOphthalmicSolution|EXPANSION 632|1001|Y|N|N||Preferred Generic|1737459-PamidronateDisodium30MGInjection|EXPANSION 632|1001|N|N|N||Preferred Generic|859751-Rosuvastatincalcium20MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|1359117-{24(EthinylEstradiol0.02MG/norethindroneacetate1MGOralTablet)/4(Ferrousfumarate75MGOralTablet)}Pack|EXPANSION 632|1001|N|N|N||Preferred Generic|884308-Nystatin100UNT/MGTopicalOintment|EXPANSION 632|1001|N|N|N||Preferred Generic|308136-Amlodipine2.5MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1801322-3.5MLevolocumab120MG/MLCartridge[Repatha]|EXPANSION 632|1001|N|N|N||Preferred Generic|311192-IsosorbideMononitrate10MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|211633-AluminumHydroxide200MG/MagnesiumHydroxide200MG/Simethicone25MGChewableTablet[Gelusil]|EXPANSION 632|1001|N|N|N||Preferred Generic|314006-24HRGlipizide5MGExtendedReleaseOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Brand|1736863-3MLInsulinGlargine100UNT/MLPenInjector[Basaglar]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1801519-Methylnaltrexonebromide150MGOralTablet[Relistor]|EXPANSION 632|1001|N|N|Y||Preferred Generic|199381-potassiumcitrate10MEQExtendedReleaseOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|890786-Butoconazolenitrate20MG/MLVaginalCream[Gynazole-1]|EXPANSION 632|1001|N|N|N||Preferred Generic|197320-Allopurinol300MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|722131-Amlodipine10MG/valsartan320MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|1860129-Abuse-Deterrent12HROxycodoneHydrochloride20MGExtendedReleaseOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|309955-Dipyridamole75MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|884707-Estradiol0.01MGVaginalInsert|EXPANSION 632|1001|N|N|Y||Preferred Generic|283407-Mirtazapine30MGDisintegratingOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|402505-12HRCarbamazepine200MGExtendedReleaseOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|309290-ciclopirox7.7MG/MLTopicalLotion|EXPANSION 632|1001|N|N|N||Preferred Generic|1665188-1MLLorazepam2MG/MLInjection|EXPANSION 632|1001|Y|N|N||Preferred Brand|1811182-icosapentethyl500MGOralCapsule[Vascepa]|EXPANSION 632|1001|N|N|N||Preferred Generic|992432-PromethazineHydrochloride1.25MG/MLOralSolution|EXPANSION 632|1001|N|N|N||Preferred Generic|310434-gabapentin800MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|1860157-Abuse-Deterrent12HROxycodoneHydrochloride10MGExtendedReleaseOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|1298091-FlurazepamHydrochloride30MGOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Brand|1307630-bosutinib100MGOralTablet[Bosulif]|EXPANSION 632|1001|N|N|Y||Preferred Generic|252559-Budesonide0.5MG/MLInhalationSuspension|EXPANSION 632|1001|N|N|N||Preferred Generic|1085633-TriamcinoloneAcetonide0.00025MG/MGTopicalOintment|EXPANSION 632|1001|Y|N|N||Preferred Brand|1813112-Rajani28DayPack|EXPANSION 632|1001|N|N|N||Preferred Generic|310442-Ganciclovir500MGInjection|EXPANSION 632|1001|N|N|Y||Preferred Brand|803371-1MLHepatitisAVaccine(Inactivated)StrainHM175720UNT/ML/HepatitisBSurfaceAntigenVaccine0.02MG/MLPrefilledSyringe[Twinrix|EXPANSION 632|1001|N|N|N||Preferred Generic|995632-MeclizineHydrochloride25MGChewableTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|349197-Clonazepam2MGDisintegratingOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|308177-Amoxicillin125MGChewableTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|261962-Ramipril10MGOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Generic|999996-Amlodipine5MG/Hydrochlorothiazide12.5MG/Olmesartanmedoxomil40MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|1085636-TriamcinoloneAcetonide0.001MG/MGTopicalOintment|EXPANSION 632|1001|Y|N|N||Preferred Generic|886634-ButorphanolTartrate1MG/ACTUATMeteredDoseNasalSpray|EXPANSION 632|1001|N|N|N||Preferred Generic|310594-Gramicidin0.025MG/ML/Neomycin1.75MG/ML/PolymyxinB10000UNT/MLOphthalmicSolution|EXPANSION 632|1001|N|N|N||Preferred Generic|239238-Griseofulvin25MG/MLOralSuspension|EXPANSION 632|1001|N|N|Y||Preferred Generic|309314-Citalopram40MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Brand|1992171-3MLInsulinLispro100UNT/MLPenInjector[Admelog]|EXPANSION 632|1001|N|N|Y||Preferred Generic|310149-Erythromycin0.005MG/MGOphthalmicOintment|EXPANSION 632|1001|N|N|N||Preferred Generic|198104-Pindolol10MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|1923822-deferasirox90MGOralGranules|EXPANSION 632|1001|Y|N|N||Preferred Brand|1650901-0.5MLInterferonbeta-1a0.06MG/MLAuto-Injector[Avonex]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1858833-12HRTreprostinil5MGExtendedReleaseOralTablet[Orenitram]|EXPANSION 632|1001|N|N|N||Preferred Generic|197361-Amlodipine5MGOralTablet|EXPANSION 632|1001|N|Y|N||Preferred Generic|311286-Levalbuterol0.21MG/MLInhalationSolution|EXPANSION 632|1001|N|N|Y||Preferred Brand|1992428-Eliquis30-DayStarterPack|EXPANSION 632|1001|N|N|N||Preferred Generic|886662-FlecainideAcetate50MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|310152-Erythromycin0.02MG/MGTopicalGel|EXPANSION 632|1001|Y|N|N||Preferred Generic|1923826-deferasirox360MGOralGranules|EXPANSION 632|1001|Y|N|N||Preferred Generic|1923828-deferasirox180MGOralGranules|EXPANSION 632|1001|N|N|N||Preferred Generic|1724437-thyroid(USP)90MGOralTablet[NPThyroid]|EXPANSION 632|1001|N|N|N||Preferred Generic|313586-venlafaxine75MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|308189-Amoxicillin80MG/MLOralSuspension|EXPANSION 632|1001|N|N|N||Preferred Brand|212039-Estrogens,Esterified(USP)0.3MGOralTablet[Menest]|EXPANSION 632|1001|N|N|N||Preferred Generic|310431-gabapentin300MGOralCapsule|EXPANSION 632|1001|N|Y|N||Preferred Generic|311345-linezolid20MG/MLOralSuspension|EXPANSION 632|1001|N|N|Y||Preferred Brand|1994352-0.5MLHepatitisBSurfaceAntigenVaccine0.04MG/MLInjection[Heplisav-B]|EXPANSION 632|1001|N|N|N||Preferred Brand|748859-Zovia1/35E28DayPack|EXPANSION 632|1001|N|N|N||Preferred Generic|1193360-100MLLevetiracetam15MG/MLInjection|EXPANSION 632|1001|N|N|N||Preferred Generic|308963-Captopril12.5MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Brand|999965-Glycopyrrolate0.2MG/MLOralSolution[Cuvposa]|EXPANSION 632|1001|N|N|N||Preferred Generic|199889-topiramate100MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Brand|798482-0.5MLHepatitisAVaccine(Inactivated)StrainHM1751440UNT/MLPrefilledSyringe[Havrix]|EXPANSION 632|1001|N|N|N||Preferred Generic|892246-LevothyroxineSodium0.1MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|310429-Furosemide20MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|1000500-Prempro0.625/528DayPack|EXPANSION 632|1001|N|Y|N||Preferred Generic|242754-Levalbuterol0.417MG/MLInhalationSolution|EXPANSION 632|1001|N|N|Y||Preferred Brand|1731317-3MLinsulin,regular,human500UNT/MLPenInjector[HumulinR]|EXPANSION 632|1001|Y|N|N||Preferred Generic|197696-72HRFentanyl0.075MG/HRTransdermalSystem|EXPANSION 632|1001|N|N|Y||Preferred Brand|1992169-InsulinLispro100UNT/MLInjectableSolution[Admelog]|EXPANSION 632|1001|N|N|N||Preferred Generic|832909-CalciumCarbonate1250MG/Cholecalciferol100UNTChewableTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|892251-LevothyroxineSodium0.2MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|866049-60ACTUATsalmeterol0.05MG/ACTUATDryPowderInhaler[Serevent]|EXPANSION 632|1001|N|N|Y||Preferred Generic|197591-Diazepam5MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|310818-Hydrochlorothiazide50MG/Triamterene75MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|349409-Treprostinil2.5MG/MLInjectableSolution|EXPANSION 632|1001|N|N|N||Preferred Generic|197699-Fluconazole150MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Brand|2000136-Vancomycin50MG/MLOralSolution[Firvanq]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1870960-deflazacort36MGOralTablet[Emflaza]|EXPANSION 632|1001|Y|N|N||Preferred Generic|197845-Isotretinoin40MGOralCapsule|EXPANSION 632|1001|N|N|Y||Preferred Generic|310288-Fenofibrate134MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|313786-AceticAcid20MG/ML/Hydrocortisone10MG/MLOticSolution|EXPANSION 632|1001|N|N|N||Preferred Generic|311665-Metipranolol3MG/MLOphthalmicSolution|EXPANSION 632|1001|N|N|N||Preferred Generic|1100457-PyridoxineHydrochloride25MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|198070-Penicillamine250MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|892255-LevothyroxineSodium0.3MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|1298088-FlurazepamHydrochloride15MGOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Brand|1870968-deflazacort22.75MG/MLOralSuspension[Emflaza]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1871459-lisdexamfetaminedimesylate40MGChewableTablet[Vyvanse]|EXPANSION 632|1001|N|N|Y||Preferred Brand|2000133-Vancomycin25MG/MLOralSolution[Firvanq]|EXPANSION 632|1001|N|N|N||Preferred Generic|199890-topiramate200MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|308191-Amoxicillin500MGOralCapsule|EXPANSION 632|1001|N|N|Y||Preferred Brand|2045382-30ACTUATfluticasonefuroate0.05MG/ACTUATDryPowderInhaler[Arnuity]|EXPANSION 632|1001|N|N|N||Preferred Generic|307730-Acyclovir40MG/MLOralSuspension|EXPANSION 632|1001|N|N|N||Preferred Generic|1193362-100MLLevetiracetam5MG/MLInjection|EXPANSION 632|1001|Y|N|N||Preferred Brand|1871463-lisdexamfetaminedimesylate20MGChewableTablet[Vyvanse]|EXPANSION 632|1001|N|N|N||Preferred Brand|830470-1MLrabiesvirusvaccinewistarstrainPM-1503-3M(Human),Inactivated2.5UNT/MLInjection[Imovax]|EXPANSION 632|1001|N|N|N||Preferred Brand|864010-ammoniumlactate120MG/MLTopicalLotion[Geri-Hydrolac]|EXPANSION 632|1001|N|N|N||Preferred Generic|308194-Amoxicillin875MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|198243-Temazepam7.5MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|834061-PenicillinVPotassium250MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|253039-Melatonin1MG/MLOralSolution|EXPANSION 632|1001|N|N|N||Preferred Generic|198108-Piroxicam20MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Brand|208547-thyroid(USP)180MGOralTablet[ArmourThyroid]|EXPANSION 632|1001|Y|N|N||Preferred Generic|1988974-24HRpregabalin165MGExtendedReleaseOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|199903-Hydrochlorothiazide12.5MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|895987-Fluticasonepropionate0.5MG/MLTopicalCream|EXPANSION 632|1001|Y|N|N||Preferred Generic|1988977-24HRpregabalin330MGExtendedReleaseOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Brand|2050059-0.5MLHepatitisBSurfaceAntigenVaccine0.04MG/MLPrefilledSyringe[Heplisav-B]|EXPANSION 632|1001|N|N|N||Preferred Generic|310353-Fluconazole40MG/MLOralSuspension|EXPANSION 632|1001|N|N|Y||Preferred Brand|1300370-0.5MLBordetellapertussisfilamentoushemagglutininvaccine,inactivated0.016MG/ML/Bordetellapertussispertactinvaccine,ina|EXPANSION 632|1001|N|N|N||Preferred Brand|351487-thyroid(USP)130MGOralTablet[Westhroid]|EXPANSION 632|1001|N|N|Y||Preferred Brand|798479-1MLHepatitisAVaccine(Inactivated)StrainHM1751440UNT/MLPrefilledSyringe[Havrix]|EXPANSION 632|1001|Y|N|N||Preferred Generic|1988980-24HRpregabalin82.5MGExtendedReleaseOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1871469-lisdexamfetaminedimesylate50MGChewableTablet[Vyvanse]|EXPANSION 632|1001|N|N|N||Preferred Generic|308212-Ampicillin500MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|1085644-TriamcinoloneAcetonide0.25MG/MLTopicalCream|EXPANSION 632|1001|N|N|N||Preferred Generic|310536-Glyburide3MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|2110510-60ACTUATFluticasonepropionate0.1MG/ACTUAT/salmeterol0.05MG/ACTUATDryPowderInhaler[Wixela]|EXPANSION 632|1001|N|N|N||Preferred Generic|834127-chlorhexidinegluconate1.2MG/MLMouthwash|EXPANSION 632|1001|N|N|Y||Preferred Brand|2053927-sodiumzirconiumcyclosilicate10000MGPowderforOralSuspension[Lokelma]|EXPANSION 632|1001|Y|N|N||Preferred Generic|199521-Vigabatrin500MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|307719-Acetylcysteine200MG/MLInhalationSolution|EXPANSION 632|1001|N|N|Y||Preferred Brand|311033-insulin,regular,human100UNT/MLInjectableSolution[NovolinR]|EXPANSION 632|1001|N|N|N||Preferred Generic|859424-Rosuvastatincalcium5MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|810075-24HRFesoterodineFumarate4MGExtendedReleaseOralTablet[Toviaz]|EXPANSION 632|1001|Y|N|N||Preferred Generic|876524-Amlodipine5MG/telmisartan40MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|197589-Diazepam10MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|847121-CalciumCitrate1500MG/Cholecalciferol250UNTOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|835564-ImipramineHydrochloride25MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|200329-Omeprazole40MGDelayedReleaseOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Brand|1873704-Mibelas24FeChewable28DayPack|EXPANSION 632|1001|N|N|N||Preferred Generic|896762-Labetalolhydrochloride200MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|200327-capecitabine150MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1873765-plecanatide3MGOralTablet[Trulance]|EXPANSION 632|1001|N|N|N||Preferred Generic|1234571-PhenylephrineHydrochloride100MG/MLOphthalmicSolution|EXPANSION 632|1001|N|N|N||Preferred Brand|863836-amylase30000UNT/lipase6000UNT/protease19000UNTDelayedReleaseOralCapsule[Creon]|EXPANSION 632|1001|N|N|Y||Preferred Generic|541363-Amphetamineaspartate7.5MG/AmphetamineSulfate7.5MG/Dextroamphetaminesaccharate7.5MG/DextroamphetamineSulfate7.5MGOralTa|EXPANSION 632|1001|N|N|Y||Preferred Brand|208821-Dexamethasone0.001MG/MG/Tobramycin0.003MG/MGOphthalmicOintment[Tobradex]|EXPANSION 632|1001|N|N|N||Preferred Generic|835568-ImipramineHydrochloride50MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|311207-Ivermectin3MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|205315-topiramate25MGOralCapsule|EXPANSION 632|1001|N|N|Y||Preferred Generic|314200-pantoprazole40MGDelayedReleaseOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1921010-0.1MLadalimumab100MG/MLPrefilledSyringe[Humira]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1921017-0.2MLadalimumab100MG/MLPrefilledSyringe[Humira]|EXPANSION 632|1001|N|N|N||Preferred Brand|1112715-Amethyst28DayPack|EXPANSION 632|1001|Y|N|N||Preferred Generic|904952-3MLibandronicacid1MG/MLPrefilledSyringe|EXPANSION 632|1001|Y|N|N||Preferred Brand|802652-1MLEtanercept50MG/MLPrefilledSyringe[Enbrel]|EXPANSION 632|1001|N|N|Y||Preferred Brand|2059017-rivaroxaban2.5MGOralTablet[Xarelto]|EXPANSION 632|1001|N|N|N||Preferred Generic|835593-ImipramineHydrochloride10MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|1094104-Phenazopyridinehydrochloride200MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|992153-methenaminemandelate1000MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Brand|798428-1MLHepatitisBSurfaceAntigenVaccine0.02MG/MLPrefilledSyringe[Engerix-B]|EXPANSION 632|1001|N|N|N||Preferred Generic|310410-FolicAcid1MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1921081-1.56MLabaloparatide2MG/MLPenInjector[Tymlos]|EXPANSION 632|1001|N|N|N||Preferred Brand|863829-amylase120000UNT/lipase24000UNT/protease76000UNTDelayedReleaseOralCapsule[Creon]|EXPANSION 632|1001|N|N|N||Preferred Generic|835886-cyclosporine,modified100MG/MLOralSolution|EXPANSION 632|1001|N|N|N||Preferred Generic|1085686-TriamcinoloneAcetonide5MG/MLTopicalCream|EXPANSION 632|1001|N|N|N||Preferred Generic|979492-LosartanPotassium50MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|897584-24HRVerapamilhydrochloride100MGExtendedReleaseOralCapsule|EXPANSION 632|1001|N|N|Y||Preferred Brand|211140-PentosanPolysulfate100MGOralCapsule[Elmiron]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1921240-0.8MLadalimumab100MG/MLAuto-Injector[Humira]|EXPANSION 632|1001|N|N|Y||Preferred Generic|485484-tizanidine6MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|995599-EthambutolHydrochloride100MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|240912-Granisetron1MG/MLInjectableSolution|EXPANSION 632|1001|N|N|Y||Preferred Brand|211609-hypromellose5MG/MLOphthalmicSolution[IsoptoAlkaline]|EXPANSION 632|1001|N|N|N||Preferred Generic|995607-EthambutolHydrochloride400MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|2000013-1.1MLhydroxyprogesteronecaproate(USP)250MG/MLAuto-Injector[Makena]|EXPANSION 632|1001|N|N|Y||Preferred Brand|847213-3MLInsulinLispro50UNT/ML/insulinlisproprotamine,human50UNT/MLPenInjector[HumalogMix]|EXPANSION 632|1001|N|N|N||Preferred Generic|1242786-Alyacen1/3528-DayKit|EXPANSION 632|1001|Y|N|N||Preferred Brand|1923338-1.14MLsarilumab132MG/MLPrefilledSyringe[Kevzara]|EXPANSION 632|1001|N|N|N||Preferred Generic|197885-Hydrochlorothiazide12.5MG/Lisinopril10MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|308459-Azithromycin20MG/MLOralSuspension|EXPANSION 632|1001|N|N|N||Preferred Generic|897624-24HRVerapamilhydrochloride240MGExtendedReleaseOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|835913-MefloquineHydrochloride250MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Brand|211947-Atovaquone150MG/MLOralSuspension[Mepron]|EXPANSION 632|1001|N|N|Y||Preferred Brand|797641-0.5MLNeisseriameningitidisserogroupAcapsularpolysaccharidediphtheriatoxoidproteinconjugatevaccine0.104MG/ML/Neisseriam|EXPANSION 632|1001|Y|N|N||Preferred Generic|876514-Amlodipine10MG/telmisartan40MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|835925-cyclosporine,modified50MGOralCapsule|EXPANSION 632|1001|N|N|Y||Preferred Generic|198035-24HRNifedipine60MGExtendedReleaseOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|200060-mycophenolatemofetil500MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|349194-Clonazepam0.125MGDisintegratingOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1925257-0.7MLabatacept125MG/MLPrefilledSyringe[Orencia]|EXPANSION 632|1001|N|N|N||Preferred Brand|352210-Mesna400MGOralTablet[Mesnex]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1927290-infliximab-abda100MGInjection[Renflexis]|EXPANSION 632|1001|N|N|N||Preferred Brand|856467-Tri-Lo-Sprintec28DayPack|EXPANSION 632|1001|N|N|N||Preferred Generic|897649-Verapamilhydrochloride240MGExtendedReleaseOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|866419-24HRmetoprololsuccinate200MGExtendedReleaseOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|313412-tizanidine2MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|200064-letrozole2.5MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Brand|2166204-10ACTUATtiotropium0.0025MG/ACTUATInhalationSpray[Spiriva]|EXPANSION 632|1001|N|N|N||Preferred Generic|836358-IpratropiumBromide0.2MG/MLInhalationSolution|EXPANSION 632|1001|N|N|Y||Preferred Generic|1149632-84HREstradiol0.00313MG/HRTransdermalSystem|EXPANSION 632|1001|N|N|Y||Preferred Generic|312075-Ofloxacin3MG/MLOphthalmicSolution|EXPANSION 632|1001|N|N|N||Preferred Generic|1801298-MicroencapsulatedPotassiumChloride10MEQExtendedReleaseOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|751875-Necon0.5/3528DayPack|EXPANSION 632|1001|N|N|N||Preferred Brand|808118-prednisolone5MGOralTablet[MILLIPRED]|EXPANSION 632|1001|Y|N|N||Preferred Generic|310437-Galantamine8MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1946522-4-Month1.5MLLeuprolideAcetate20MG/MLPrefilledSyringe[Lupron]|EXPANSION 632|1001|N|N|N||Preferred Generic|198146-Prednisone2.5MGOralTablet|EXPANSION 632|1001|N|Y|N||Preferred Generic|686429-mesalamine1200MGDelayedReleaseOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Brand|213442-insulinisophane,human70UNT/ML/insulin,regular,human30UNT/MLInjectableSuspension[Novolin]|EXPANSION 632|1001|Y|N|N||Preferred Generic|310436-Galantamine4MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|897683-Verapamilhydrochloride80MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Brand|2166928-10ACTUATolodaterol0.0025MG/ACTUAT/tiotropium0.0025MG/ACTUATInhalationSpray[Stiolto]|EXPANSION 632|1001|N|N|N||Preferred Generic|311681-Metronidazole500MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|311204-Itraconazole100MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Brand|855871-Phenytoinsodium30MGExtendedReleaseOralCapsule[Dilantin]|EXPANSION 632|1001|N|N|N||Preferred Generic|1242787-Alyacen7/7/7Kit|EXPANSION 632|1001|N|N|N||Preferred Generic|308508-Bacitracin0.5UNT/MGOphthalmicOintment|EXPANSION 632|1001|N|N|N||Preferred Generic|848176-AugmentedBetamethasone0.5MG/MLTopicalCream|EXPANSION 632|1001|Y|N|N||Preferred Generic|864978-MethadoneHydrochloride40MGTabletforOralSuspension|EXPANSION 632|1001|N|N|N||Preferred Generic|1190570-AtropineSulfate0.01MG/MGOphthalmicOintment|EXPANSION 632|1001|N|N|N||Preferred Generic|897722-Verapamilhydrochloride40MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1989109-1MLbenralizumab30MG/MLPrefilledSyringe[Fasenra]|EXPANSION 632|1001|N|N|N||Preferred Generic|198148-Prednisone50MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|349094-Budesonide0.125MG/MLInhalationSuspension|EXPANSION 632|1001|Y|N|N||Preferred Generic|313165-0.5MLSumatriptan12MG/MLInjection|EXPANSION 632|1001|N|N|N||Preferred Generic|313988-Furosemide40MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|1091497-MethylphenidateHydrochloride5MGOralTablet|EXPANSION 632|1001|N|Y|N||Preferred Generic|745791-200ACTUATLevalbuterol0.045MG/ACTUATMeteredDoseInhaler|EXPANSION 632|1001|Y|N|N||Preferred Brand|1999389-symdeko100MG/150MGand150MGPack|EXPANSION 632|1001|N|N|N||Preferred Generic|848943-CholestyramineResin4000MGPowderforOralSuspension|EXPANSION 632|1001|N|N|N||Preferred Generic|861495-ClobetasolPropionate0.5MG/MLTopicalCream|EXPANSION 632|1001|N|N|Y||Preferred Brand|795737-ChantixStartingMonthPAK|EXPANSION 632|1001|N|N|N||Preferred Generic|849506-DesmopressinAcetate0.01MG/ACTUATNasalSpray|EXPANSION 632|1001|Y|N|N||Preferred Generic|313210-temozolomide250MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|1085745-TriamcinoloneAcetonide1MG/MLTopicalLotion|EXPANSION 632|1001|N|N|N||Preferred Generic|308512-Bacitracin0.5UNT/MG/PolymyxinB10UNT/MGTopicalOintment|EXPANSION 632|1001|N|N|N||Preferred Generic|197391-Baclofen10MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|898346-Amlodipine10MG/Benazeprilhydrochloride40MGOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Generic|313211-temozolomide5MGOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Generic|153822-candesartancilexetil4MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|310965-Ibuprofen200MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|209360-Acetaminophen325MGRectalSuppository[Acephen]|EXPANSION 632|1001|N|N|Y||Preferred Brand|2360588-0.5MLNeisseriameningitidisserogroupAcapsularpolysaccharidetetanustoxoidproteinconjugatevaccine0.02MG/ML/Neisseriameni|EXPANSION 632|1001|N|N|Y||Preferred Brand|311026-insulinisophane,human100UNT/MLInjectableSuspension[HumulinN]|EXPANSION 632|1001|N|N|N||Preferred Generic|200132-Acarbose25MGOralTablet|EXPANSION 632|1001|N|Y|N||Preferred Generic|730988-Carbidopa50MG/entacapone200MG/Levodopa200MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|864769-MethadoneHydrochloride2MG/MLOralSolution|EXPANSION 632|1001|N|N|N||Preferred Generic|238920-Betamethasone0.5MG/MLTopicalCream|EXPANSION 632|1001|N|N|N||Preferred Generic|197392-Baclofen20MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|485485-tizanidine4MGOralCapsule|EXPANSION 632|1001|N|Y|N||Preferred Generic|857564-24HRtrospiumchloride60MGExtendedReleaseOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|313989-Fluoxetine40MGOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Brand|809159-0.5MLEtanercept50MG/MLPrefilledSyringe[Enbrel]|EXPANSION 632|1001|N|N|N||Preferred Brand|201338-Nadolol80MGOralTablet[Corgard]|EXPANSION 632|1001|N|N|N||Preferred Generic|309115-Cephalexin250MGOralTablet|EXPANSION 632|1001|N|Y|N||Preferred Generic|810083-Carbidopa31.25MG/entacapone200MG/Levodopa125MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|1440936-Hydrocortisone25MG/MLTopicalCream[ProctozoneHC]|EXPANSION 632|1001|Y|N|N||Preferred Generic|313209-temozolomide20MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|898350-Amlodipine2.5MG/Benazeprilhydrochloride10MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|849515-DesmopressinAcetate0.1MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|311196-24HRIsosorbideMononitrate120MGExtendedReleaseOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|200133-12HRCarbamazepine200MGExtendedReleaseOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|1738483-ParoxetineHydrochloride10MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|854921-BisoprololFumarate5MG/Hydrochlorothiazide6.25MGOralTablet[Ziac]|EXPANSION 632|1001|N|N|N||Preferred Generic|1243585-Flurbiprofensodium0.3MG/MLOphthalmicSolution|EXPANSION 632|1001|N|N|N||Preferred Generic|1731350-deferoxaminemesylate500MGInjection|EXPANSION 632|1001|Y|N|N||Preferred Brand|2045638-1MLerenumab-aooe70MG/MLAuto-Injector[Aimovig]|EXPANSION 632|1001|N|N|Y||Preferred Generic|197541-Colchicine0.6MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|308493-Bacitracin0.4UNT/MG/Neomycin0.0035MG/MG/PolymyxinB10UNT/MGOphthalmicOintment|EXPANSION 632|1001|N|N|N||Preferred Generic|898353-Amlodipine5MG/Benazeprilhydrochloride10MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|197732-Furosemide80MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|2045959-Doptelet40MGDailyDoseCartonPack|EXPANSION 632|1001|N|N|Y||Preferred Generic|313222-terbinafine250MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|349253-bosentan62.5MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|852913-QuinidineSulfate300MGOralTablet|EXPANSION 632|1001|N|Y|N||Preferred Generic|606730-Esomeprazole40MGDelayedReleaseOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|898356-Amlodipine5MG/Benazeprilhydrochloride20MGOralCapsule|EXPANSION 632|1001|N|N|Y||Preferred Brand|795735-ChantixContinuingMonthsOfTherapy1MGPack|EXPANSION 632|1001|Y|N|N||Preferred Brand|2047596-1MLepoetinalfa-epbx10000UNT/MLInjection[Retacrit]|EXPANSION 632|1001|N|N|N||Preferred Brand|1113046-amylase15000UNT/lipase3000UNT/protease9500UNTDelayedReleaseOralCapsule[Creon]|EXPANSION 632|1001|N|N|Y||Preferred Generic|315223-Sumatriptan25MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Brand|311027-insulinisophane,human100UNT/MLInjectableSuspension[NovolinN]|EXPANSION 632|1001|N|N|N||Preferred Generic|898342-Amlodipine10MG/Benazeprilhydrochloride20MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|198153-Colchicine0.5MG/Probenecid500MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|308689-BenzoylPeroxide0.025MG/MGTopicalGel|EXPANSION 632|1001|N|N|N||Preferred Generic|283485-Mirtazapine45MGDisintegratingOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|2045961-Doptelet60MGDailyDoseCartonPack|EXPANSION 632|1001|Y|N|N||Preferred Generic|864718-MethadoneHydrochloride5MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|311963-Niacin750MGExtendedReleaseOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|1806187-30/70Release24HRMethylphenidateHydrochloride20MGExtendedReleaseOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|702519-Phenobarbital4MG/MLOralSolution|EXPANSION 632|1001|Y|N|N||Preferred Generic|864761-MethadoneHydrochloride1MG/MLOralSolution|EXPANSION 632|1001|N|N|N||Preferred Brand|404475-Azathioprine75MGOralTablet[Azasan]|EXPANSION 632|1001|Y|N|N||Preferred Brand|2047608-1MLepoetinalfa-epbx3000UNT/MLInjection[Retacrit]|EXPANSION 632|1001|N|N|N||Preferred Generic|859193-selegilinehydrochloride5MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|854918-BisoprololFumarate2.5MG/Hydrochlorothiazide6.25MGOralTablet[Ziac]|EXPANSION 632|1001|N|N|N||Preferred Generic|197517-Clarithromycin500MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|349410-Treprostinil5MG/MLInjectableSolution|EXPANSION 632|1001|N|N|N||Preferred Generic|308694-BenzoylPeroxide0.05MG/MGTopicalGel|EXPANSION 632|1001|N|N|N||Preferred Generic|309686-Dexamethasone0.1MG/MLOralSolution|EXPANSION 632|1001|N|N|N||Preferred Generic|898359-Amlodipine5MG/Benazeprilhydrochloride40MGOralCapsule|EXPANSION 632|1001|N|Y|N||Preferred Generic|825130-24HRmesalamine375MGExtendedReleaseOralCapsule|EXPANSION 632|1001|N|N|Y||Preferred Brand|351427-24HRNicotine0.583MG/HRTransdermalSystem[NicodermC-Q]|EXPANSION 632|1001|N|N|N||Preferred Generic|854801-DiclofenacSodium1MG/MLOphthalmicSolution|EXPANSION 632|1001|Y|N|N||Preferred Brand|1650282-RebifRebidoseTitrationPack|EXPANSION 632|1001|N|N|N||Preferred Generic|198165-Propantheline15MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|349434-voriconazole200MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|750243-Ogestrel28DayPack|EXPANSION 632|1001|N|N|N||Preferred Generic|308962-Captopril100MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|311376-Lorazepam2MG/MLOralSolution|EXPANSION 632|1001|Y|N|N||Preferred Generic|349435-voriconazole50MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|830861-24HRDiltiazemHydrochloride120MGExtendedReleaseOralCapsule|EXPANSION 632|1001|N|N|Y||Preferred Brand|351429-24HRNicotine0.875MG/HRTransdermalSystem[NicodermC-Q]|EXPANSION 632|1001|N|Y|N||Preferred Generic|855178-tolterodinetartrate1MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|2047623-1MLepoetinalfa-epbx40000UNT/MLInjection[Retacrit]|EXPANSION 632|1001|N|N|N||Preferred Generic|1099296-DesipramineHydrochloride150MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|208549-thyroid(USP)240MGOralTablet[ArmourThyroid]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1945048-30ACTUATfluticasonefuroate0.1MG/ACTUAT/umeclidinium0.0625MG/ACTUAT/vilanterol0.025MG/ACTUATDryPowderInhaler[Trelegy]|EXPANSION 632|1001|Y|N|N||Preferred Generic|351114-5MLzoledronicacid0.8MG/MLInjection|EXPANSION 632|1001|Y|N|Y||Preferred Generic|892646-MorphineSulfate200MGExtendedReleaseOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|896019-60ACTUATFluticasonepropionate0.05MG/ACTUATDryPowderInhaler[Flovent]|EXPANSION 632|1001|N|N|N||Preferred Generic|1738495-ParoxetineHydrochloride20MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|1012021-Prednisolonesodiumphosphate2.5MG/ML/SulfacetamideSodium100MG/MLOphthalmicSolution|EXPANSION 632|1001|N|N|N||Preferred Generic|1245230-chlorhexidinegluconate20MG/MLMedicatedLiquidSoap|EXPANSION 632|1001|N|N|N||Preferred Generic|308696-BenzoylPeroxide50MG/MLMedicatedLiquidSoap|EXPANSION 632|1001|N|N|N||Preferred Generic|200257-repaglinide0.5MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|898372-Benazeprilhydrochloride20MG/Hydrochlorothiazide25MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|197382-Atenolol100MG/Chlorthalidone25MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|2048025-0.6MLpegfilgrastim-jmdb10MG/MLPrefilledSyringe[Fulphila]|EXPANSION 632|1001|N|N|Y||Preferred Brand|351433-24HRNicotine0.292MG/HRTransdermalSystem[NicodermC-Q]|EXPANSION 632|1001|N|N|N||Preferred Generic|308868-Calcitriol0.0005MGOralCapsule|EXPANSION 632|1001|N|N|Y||Preferred Brand|731281-InsulinLispro50UNT/ML/insulinlisproprotamine,human50UNT/MLInjectableSuspension[HumalogMix]|EXPANSION 632|1001|N|N|Y||Preferred Generic|830837-24HRDiltiazemHydrochloride240MGExtendedReleaseOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Brand|2053512-ivacaftor125MG/lumacaftor100MGOralGranules[ORKAMBI]|EXPANSION 632|1001|N|N|Y||Preferred Generic|314135-naratriptan2.5MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|898378-Benazeprilhydrochloride5MG/Hydrochlorothiazide6.25MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Brand|261315-Oseltamivir75MGOralCapsule[Tamiflu]|EXPANSION 632|1001|Y|N|N||Preferred Generic|864675-Atovaquone250MG/proguanilhydrochloride100MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|312835-rivastigmine3MGOralCapsule|EXPANSION 632|1001|N|N|Y||Preferred Brand|311036-insulin,regular,human100UNT/MLInjectableSolution[HumulinR]|EXPANSION 632|1001|N|N|N||Preferred Generic|855168-levocetirizinedihydrochloride0.5MG/MLOralSolution|EXPANSION 632|1001|N|N|N||Preferred Generic|200346-cefdinir300MGOralCapsule|EXPANSION 632|1001|N|N|Y||Preferred Generic|313570-Vancomycin125MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Brand|845305-Nonoxynol-90.04MG/MGVaginalGel[Conceptrol]|EXPANSION 632|1001|N|N|Y||Preferred Generic|1091145-8HRMethylphenidateHydrochloride10MGExtendedReleaseOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|2054995-lusutrombopag3MGOralTablet[Mulpleta]|EXPANSION 632|1001|N|N|N||Preferred Generic|855172-levocetirizinedihydrochloride5MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|403878-imatinib100MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|799830-dasatinib100MGOralTablet[Sprycel]|EXPANSION 632|1001|N|N|Y||Preferred Brand|404448-84HRoxybutynin0.162MG/HRTransdermalSystem[Oxytrol]|EXPANSION 632|1001|N|N|N||Preferred Generic|310891-Hydrocortisone25MG/MLTopicalCream|EXPANSION 632|1001|N|N|Y||Preferred Generic|313571-Vancomycin250MGOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Brand|205532-DornaseAlfa1MG/MLInhalationSolution[Pulmozyme]|EXPANSION 632|1001|N|N|N||Preferred Generic|898687-Benazeprilhydrochloride10MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|857002-Acetaminophen325MG/HydrocodoneBitartrate5MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|1000001-Amlodipine5MG/Hydrochlorothiazide25MG/Olmesartanmedoxomil40MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|314055-IsosorbideDinitrate5MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|855288-WarfarinSodium1MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|898690-Benazeprilhydrochloride20MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|1245468-DocusateSodium250MGOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Brand|2056700-1.5MLfremanezumab-vfrm150MG/MLPrefilledSyringe[Ajovy]|EXPANSION 632|1001|N|N|Y||Preferred Generic|314209-rizatriptan10MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Brand|351859-insulin,regular,human500UNT/MLInjectableSolution[HumulinR]|EXPANSION 632|1001|N|Y|N||Preferred Generic|855194-tolterodinetartrate2MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|311955-Niacin250MGExtendedReleaseOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|403879-imatinib400MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|198181-Pyrazinamide500MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|308714-Betamethasone0.5MG/ML/Clotrimazole10MG/MLTopicalCream|EXPANSION 632|1001|N|N|Y||Preferred Brand|630981-PolyvinylAlcohol27MG/ML/Povidone20MG/MLOphthalmicSolution[Freshkote]|EXPANSION 632|1001|N|N|Y||Preferred Generic|861223-24HRAmphetamineaspartate3.75MG/AmphetamineSulfate3.75MG/Dextroamphetaminesaccharate3.75MG/DextroamphetamineSulfate3.75|EXPANSION 632|1001|N|N|N||Preferred Generic|1738503-ParoxetineHydrochloride30MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|864706-MethadoneHydrochloride10MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|197444-Carbidopa25MG/Levodopa100MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|898723-Benazeprilhydrochloride5MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|245136-72HRFentanyl0.1MG/HRTransdermalSystem|EXPANSION 632|1001|Y|N|N||Preferred Generic|477130-Hydrochlorothiazide25MG/telmisartan80MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|836368-200ACTUATIpratropiumBromide0.017MG/ACTUATMeteredDoseInhaler[Atrovent]|EXPANSION 632|1001|N|N|N||Preferred Generic|308725-bexarotene75MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|702249-ferroussulfate44MG/MLOralSolution|EXPANSION 632|1001|N|N|Y||Preferred Brand|637188-varenicline0.5MGOralTablet[Chantix]|EXPANSION 632|1001|N|N|N||Preferred Generic|855296-WarfarinSodium10MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|312086-Ondansetron8MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|198201-Rifampin150MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|238600-seleniumsulfide25MG/MLMedicatedShampoo|EXPANSION 632|1001|Y|N|N||Preferred Generic|477367-solifenacinsuccinate5MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|311486-meloxicam7.5MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|861237-24HRAmphetamineaspartate1.25MG/AmphetamineSulfate1.25MG/Dextroamphetaminesaccharate1.25MG/DextroamphetamineSulfate1.25|EXPANSION 632|1001|Y|N|N||Preferred Brand|2058887-1MLgalcanezumab-gnlm120MG/MLPrefilledSyringe[Emgality]|EXPANSION 632|1001|N|N|Y||Preferred Brand|637190-varenicline1MGOralTablet[Chantix]|EXPANSION 632|1001|Y|N|N||Preferred Generic|477347-lanthanumcarbonate500MGChewableTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|283077-prednisolone3MG/MLOralSolution|EXPANSION 632|1001|N|N|Y||Preferred Generic|197529-Clonazepam2MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|795749-RebifTitrationPack|EXPANSION 632|1001|N|N|N||Preferred Generic|197577-Dexamethasone0.5MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Brand|752388-InsulinLispro25UNT/ML/insulinlisproprotamine,human75UNT/MLInjectableSuspension[HumalogMix]|EXPANSION 632|1001|N|N|N||Preferred Brand|1005928-ulipristalacetate30MGOralTablet[Ella]|EXPANSION 632|1001|N|N|N||Preferred Generic|903697-liothyroninesodium0.025MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|485421-24HRdarifenacin15MGExtendedReleaseOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|753543-Reclipsen28DayPack|EXPANSION 632|1001|N|N|N||Preferred Generic|204135-Desonide0.0005MG/MGTopicalOintment|EXPANSION 632|1001|Y|N|N||Preferred Brand|2058906-cannabidiol100MG/MLOralSolution[Epidiolex]|EXPANSION 632|1001|N|N|N||Preferred Generic|1367410-Ergocalciferol1.25MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|308867-Calcitriol0.00025MGOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Generic|485423-24HRdarifenacin7.5MGExtendedReleaseOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|208551-thyroid(USP)300MGOralTablet[ArmourThyroid]|EXPANSION 632|1001|N|N|Y||Preferred Brand|707566-PolyethyleneGlycol4004MG/ML/Propyleneglycol3MG/MLOphthalmicSolution[Systane]|EXPANSION 632|1001|N|N|N||Preferred Generic|855312-WarfarinSodium2.5MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|1731345-deferoxaminemesylate2000MGInjection|EXPANSION 632|1001|N|N|Y||Preferred Generic|485465-Eszopiclone3MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|485434-entecavir0.5MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|313919-salmoncalcitonin200UNT/ACTUATNasalSpray|EXPANSION 632|1001|N|N|N||Preferred Generic|309114-Cephalexin500MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|308182-Amoxicillin250MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|903703-liothyroninesodium0.05MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|795085-certolizumabpegol200MGInjection[Cimzia]|EXPANSION 632|1001|N|N|N||Preferred Generic|1738511-ParoxetineHydrochloride40MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|855318-WarfarinSodium3MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|245135-72HRFentanyl0.05MG/HRTransdermalSystem|EXPANSION 632|1001|Y|N|N||Preferred Brand|903855-2MLPyridostigmineBromide5MG/MLInjection[Regonol]|EXPANSION 632|1001|N|N|Y||Preferred Brand|762602-SalmonellatyphiTy21aliveantigen2000000000UNTDelayedReleaseOralCapsule[Vivotif]|EXPANSION 632|1001|N|N|N||Preferred Generic|1245919-Marlissa28DayPack|EXPANSION 632|1001|Y|N|N||Preferred Brand|205912-EpoetinAlfa10000UNT/MLInjectableSolution[Epogen]|EXPANSION 632|1001|Y|N|N||Preferred Brand|205913-EpoetinAlfa10000UNT/MLInjectableSolution[Procrit]|EXPANSION 632|1001|N|N|Y||Preferred Generic|1091392-MethylphenidateHydrochloride20MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|830463-1MLrabiesvirusvaccineflury-lepstrain2.5UNT/MLInjection[RabAvert]|EXPANSION 632|1001|N|N|Y||Preferred Generic|197527-Clonazepam0.5MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|855324-WarfarinSodium4MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|485489-Temazepam22.5MGOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Brand|205917-1MLEpoetinAlfa2000UNT/MLInjection[Epogen]|EXPANSION 632|1001|N|N|N||Preferred Generic|1359858-Fluticasonepropionate0.5MG/ACTUAT/salmeterol0.05MG/ACTUATDryPowderInhaler|EXPANSION 632|1001|Y|N|N||Preferred Generic|863038-bepotastinebesilate15MG/MLOphthalmicSolution|EXPANSION 632|1001|N|N|Y||Preferred Generic|314285-zonisamide100MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|903887-FluvoxamineMaleate25MGOralTablet|EXPANSION 632|1001|N|Y|N||Preferred Generic|996615-24HRMemantinehydrochloride7MGExtendedReleaseOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|314077-Lisinopril20MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|1014314-TriamcinoloneAcetonide1MG/MLTopicalCream|EXPANSION 632|1001|N|N|N||Preferred Generic|198211-Simvastatin40MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|855332-WarfarinSodium5MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|730046-0.5MLdarbepoetinalfa0.2MG/MLPrefilledSyringe[Aranesp]|EXPANSION 632|1001|N|N|N||Preferred Generic|204423-Hydrocortisone10MG/ML/Neomycin3.5MG/ML/PolymyxinB10000UNT/MLOticSolution|EXPANSION 632|1001|Y|N|N||Preferred Generic|477372-solifenacinsuccinate10MGOralTablet|EXPANSION 632|1001|N|Y|N||Preferred Generic|996603-24HRMemantinehydrochloride21MGExtendedReleaseOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|859052-Pramipexoledihydrochloride1MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|2059189-amikacinliposomal70.3MG/MLInhalationSuspension[Arikayce]|EXPANSION 632|1001|N|N|N||Preferred Generic|903891-FluvoxamineMaleate50MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|577208-Omega-3AcidEthylEsters(USP)1000MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|309680-Dexamethasone1MG/ML/Neomycin3.5MG/ML/PolymyxinB10000UNT/MLOphthalmicSuspension|EXPANSION 632|1001|N|N|Y||Preferred Generic|897630-24HRVerapamilhydrochloride360MGExtendedReleaseOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|897590-24HRVerapamilhydrochloride200MGExtendedReleaseOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|855338-WarfarinSodium6MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Brand|1292459-0.5MLVaricella-ZosterVirusVaccineLive(Oka-Merck)strain2700UNT/MLInjection[Varivax]|EXPANSION 632|1001|N|N|N||Preferred Brand|827713-MineralOil0.03MG/MG/Petrolatum0.94MG/MGOphthalmicOintment[SystaneNighttime]|EXPANSION 632|1001|N|N|N||Preferred Generic|979480-LosartanPotassium100MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|577348-ramelteon8MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|1095725-ClemastineFumarate1.34MGOralTablet[Dayhist-1]|EXPANSION 632|1001|N|N|N||Preferred Generic|308891-CalciumCarbonate250MG/MLOralSuspension|EXPANSION 632|1001|Y|N|N||Preferred Brand|1649996-0.5MLInterferonbeta-1a0.044MG/MLAuto-Injector[Rebif]|EXPANSION 632|1001|N|N|N||Preferred Generic|310352-Fluconazole10MG/MLOralSuspension|EXPANSION 632|1001|N|Y|Y||Preferred Brand|1716215-patiromer8400MGPowderforOralSuspension[Veltassa]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1746898-10MLreslizumab10MG/MLInjection[Cinqair]|EXPANSION 632|1001|N|N|N||Preferred Generic|309952-Dipyridamole25MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|318202-Erythromycin20MG/MLTopicalSolution|EXPANSION 632|1001|Y|N|N||Preferred Generic|577776-candesartancilexetil16MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|904170-PrimaquinePhosphate26.3MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|309110-Cephalexin25MG/MLOralSuspension|EXPANSION 632|1001|N|Y|Y||Preferred Brand|1716219-patiromer16800MGPowderforOralSuspension[Veltassa]|EXPANSION 632|1001|Y|N|N||Preferred Brand|205924-1MLEpoetinAlfa4000UNT/MLInjection[Procrit]|EXPANSION 632|1001|Y|N|N||Preferred Generic|578018-bromfenac0.9MG/MLOphthalmicSolution|EXPANSION 632|1001|N|N|N||Preferred Generic|197745-Guanfacine1MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|1422081-Enskyce28DayPack|EXPANSION 632|1001|N|N|N||Preferred Generic|198222-Spironolactone100MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|1250490-hydrocortisoneacetate5MG/MLTopicalCream|EXPANSION 632|1001|N|N|N||Preferred Generic|855474-alclometasonedipropionate0.5MG/MLTopicalCream|EXPANSION 632|1001|N|N|N||Preferred Brand|1426881-Levonorgestrel1.5MGOralTablet[MyWay]|EXPANSION 632|1001|N|N|N||Preferred Generic|205284-leflunomide10MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|1797851-CromolynSodium5.2MG/ACTUATMeteredDoseNasalSpray|EXPANSION 632|1001|N|N|N||Preferred Generic|904396-Alendronicacid35MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|485442-Eszopiclone2MGOralTablet|EXPANSION 632|1001|Y|N|Y||Preferred Brand|665036-sitagliptin100MGOralTablet[Januvia]|EXPANSION 632|1001|Y|N|Y||Preferred Generic|891881-MorphineSulfate15MGExtendedReleaseOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|198223-Spironolactone50MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|311372-Loratadine10MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|904431-Alendronicacid70MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|2102705-0.6MLpegfilgrastim-cbqv10MG/MLPrefilledSyringe[Udenyca]|EXPANSION 632|1001|Y|N|N||Preferred Generic|579148-Galantamine12MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|855480-alclometasonedipropionate0.0005MG/MGTopicalOintment|EXPANSION 632|1001|N|N|N||Preferred Generic|859048-Pramipexoledihydrochloride1.5MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|308416-Aspirin81MGDelayedReleaseOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|313160-Sumatriptan100MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|314131-Niacin250MGExtendedReleaseOralCapsule|EXPANSION 632|1001|N|N|Y||Preferred Generic|1091225-8HRMethylphenidateHydrochloride20MGExtendedReleaseOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|205285-leflunomide20MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|308345-apraclonidine5MG/MLOphthalmicSolution|EXPANSION 632|1001|N|Y|Y||Preferred Brand|2200658-semaglutide7MGOralTablet[Rybelsus]|EXPANSION 632|1001|N|N|N||Preferred Brand|404492-5MLLaronidase0.58MG/MLInjection[Aldurazyme]|EXPANSION 632|1001|N|Y|Y||Preferred Brand|2200654-semaglutide3MGOralTablet[Rybelsus]|EXPANSION 632|1001|N|N|Y||Preferred Brand|2106334-0.5MLdiphtheriatoxoidvaccine,inactivated4UNT/ML/tetanustoxoidvaccine,inactivated4UNT/MLInjection[Tdvax]|EXPANSION 632|1001|N|N|Y||Preferred Generic|349195-Clonazepam0.25MGDisintegratingOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|2106362-rifamycinSV194MGDelayedReleaseOralTablet[Aemcolo]|EXPANSION 632|1001|N|N|N||Preferred Generic|311893-nabumetone750MGOralTablet|EXPANSION 632|1001|N|Y|Y||Preferred Generic|1111339-olopatadine1MG/MLOphthalmicSolution|EXPANSION 632|1001|Y|N|N||Preferred Generic|597770-deferasirox250MGTabletforOralSuspension|EXPANSION 632|1001|N|N|N||Preferred Generic|1098134-24HRNiacin1000MGExtendedReleaseOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|311678-Metronidazole7.5MG/MLTopicalCream|EXPANSION 632|1001|N|N|N||Preferred Brand|797023-DexPakTaperPak13DayPack|EXPANSION 632|1001|N|N|Y||Preferred Brand|1547664-14ACTUATfluticasonefuroate0.1MG/ACTUATDryPowderInhaler[Arnuity]|EXPANSION 632|1001|N|N|N||Preferred Brand|895996-120ACTUATFluticasonepropionate0.044MG/ACTUATMeteredDoseInhaler[Flovent]|EXPANSION 632|1001|N|N|N||Preferred Generic|242590-ferrousgluconate240MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|597772-deferasirox500MGTabletforOralSuspension|EXPANSION 632|1001|N|N|N||Preferred Generic|1010878-LidocaineHydrochloride40MG/MLMucousMembraneTopicalSolution|EXPANSION 632|1001|Y|N|N||Preferred Brand|2107351-prucalopride1MGOralTablet[Motegrity]|EXPANSION 632|1001|N|N|N||Preferred Generic|904467-PravastatinSodium20MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|349196-Clonazepam1MGDisintegratingOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|2265689-Voxelotor500MGOralTablet[Oxbryta]|EXPANSION 632|1001|N|N|N||Preferred Generic|1291082-hydrocortisoneacetate25MGRectalSuppository|EXPANSION 632|1001|Y|N|N||Preferred Brand|2107355-prucalopride2MGOralTablet[Motegrity]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1661567-TOBIPodhalerDailyKit,8|EXPANSION 632|1001|N|N|Y||Preferred Generic|977880-AmilorideHydrochloride5MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|485486-tizanidine2MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|197770-Hydrochlorothiazide50MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|314182-PotassiumChloride2.67MEQ/MLOralSolution|EXPANSION 632|1001|N|N|Y||Preferred Generic|991486-CodeinePhosphate2MG/ML/PromethazineHydrochloride1.25MG/MLOralSolution|EXPANSION 632|1001|N|N|N||Preferred Generic|896766-Labetalolhydrochloride300MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|855671-Phenytoinsodium100MGExtendedReleaseOralCapsule|EXPANSION 632|1001|N|Y|Y||Preferred Generic|1797865-mometasonefuroate0.05MG/ACTUATMeteredDoseNasalSpray|EXPANSION 632|1001|Y|N|N||Preferred Generic|603203-erlotinib100MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|995218-HydroxyzineHydrochloride10MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|855812-prasugrel10MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|603208-erlotinib25MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|762663-Jolessa91DayPack|EXPANSION 632|1001|N|N|N||Preferred Generic|238154-Acetaminophen325MG/butalbital50MG/Caffeine40MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|308964-Captopril50MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|198232-Sulfasalazine500MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|1233850-Vestura28DayPack|EXPANSION 632|1001|N|N|N||Preferred Generic|904475-PravastatinSodium40MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|855818-prasugrel5MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|349198-Clonazepam0.5MGDisintegratingOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|314203-quinapril40MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|197606-Digoxin0.25MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|636045-Hydrochlorothiazide25MG/valsartan320MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|861375-sevelamercarbonate800MGPowderforOralSuspension|EXPANSION 632|1001|Y|N|N||Preferred Generic|603206-erlotinib150MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1876609-naldemedine0.2MGOralTablet[Symproic]|EXPANSION 632|1001|Y|N|N||Preferred Generic|616578-lubiprostone0.024MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|197782-Hydrocortisone10MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|200328-capecitabine500MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|855861-Phenytoinsodium200MGExtendedReleaseOralCapsule|EXPANSION 632|1001|N|N|Y||Preferred Generic|993755-Acetaminophen24MG/ML/CodeinePhosphate2.4MG/MLOralSolution|EXPANSION 632|1001|N|N|Y||Preferred Generic|993770-Acetaminophen300MG/CodeinePhosphate15MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|1299911-Tiagabinehydrochloride2MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|198013-Naproxen250MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|992475-PromethazineHydrochloride50MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|309113-Cephalexin50MG/MLOralSuspension|EXPANSION 632|1001|N|N|N||Preferred Generic|197500-Chlorthalidone50MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|2123314-Mayzent0.25MGStarterPack|EXPANSION 632|1001|N|Y|Y||Preferred Generic|197979-Metolazone2.5MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|644088-aprepitant40MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Brand|208513-Estrogens,Conjugated(USP)0.3MGOralTablet[Premarin]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1045404-dasatinib140MGOralTablet[Sprycel]|EXPANSION 632|1001|N|N|N||Preferred Generic|855873-Phenytoinsodium300MGExtendedReleaseOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|1099288-DesipramineHydrochloride10MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|639537-candesartancilexetil32MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|1298066-Cyclopentolatehydrochloride10MG/MLOphthalmicSolution|EXPANSION 632|1001|N|N|N||Preferred Generic|314231-Simvastatin10MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|205326-Lisinopril30MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|656659-bosentan125MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|1724481-thyroid(USP)60MGOralTablet[NPThyroid]|EXPANSION 632|1001|Y|N|N||Preferred Brand|213475-1MLEpoetinAlfa40000UNT/MLInjection[Procrit]|EXPANSION 632|1001|N|Y|N||Preferred Brand|1190334-24HRFexofenadinehydrochloride180MG/PseudoephedrineHydrochloride240MGExtendedReleaseOralTablet[Wal-FexD]|EXPANSION 632|1001|N|N|N||Preferred Brand|1373327-amylase180000UNT/lipase36000UNT/protease114000UNTDelayedReleaseOralCapsule[Creon]|EXPANSION 632|1001|N|N|N||Preferred Generic|905158-Sirolimus0.5MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|205305-telmisartan80MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|905199-HydralazineHydrochloride10MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|485440-Eszopiclone1MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|2166401-ivacaftor25MGOralGranules[Kalydeco]|EXPANSION 632|1001|N|N|Y||Preferred Generic|477562-Fenofibrate48MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|692783-Loratadine1MG/MLOralSolution|EXPANSION 632|1001|N|N|N||Preferred Brand|762007-Nortrel7/7/728DayPack|EXPANSION 632|1001|Y|N|N||Preferred Brand|810002-lacosamide50MGOralTablet[Vimpat]|EXPANSION 632|1001|Y|N|N||Preferred Generic|700883-temozolomide140MGOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Brand|978950-Natazia28DayPack|EXPANSION 632|1001|Y|N|N||Preferred Brand|2170613-1MLgalcanezumab-gnlm100MG/MLPrefilledSyringe[Emgality]|EXPANSION 632|1001|N|N|N||Preferred Generic|905222-HydralazineHydrochloride100MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|859044-Pramipexoledihydrochloride0.5MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|314234-Sucralfate1000MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|197624-Disulfiram500MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|855911-2MLPhenytoinsodium50MG/MLCartridge|EXPANSION 632|1001|N|N|Y||Preferred Brand|804186-0.5MLMeaslesVirusVaccineLive,Enders'attenuatedEdmonstonstrain2000UNT/ML/MumpsVirusVaccineLive,JerylLynnStrain25000UNT/|EXPANSION 632|1001|N|N|Y||Preferred Generic|349287-Fenofibrate160MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|896758-Labetalolhydrochloride100MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|830801-24HRDiltiazemHydrochloride300MGExtendedReleaseOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|200031-carvedilol6.25MGOralTablet|EXPANSION 632|1001|N|Y|Y||Preferred Generic|2001568-BXRating24HRMethylphenidateHydrochloride54MGExtendedReleaseOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|686379-celecoxib50MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|309679-Dexamethasone0.001MG/MG/Neomycin0.0035MG/MG/PolymyxinB10UNT/MGOphthalmicOintment|EXPANSION 632|1001|N|N|N||Preferred Generic|1099292-DesipramineHydrochloride100MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|855926-DiclofenacSodium75MGDelayedReleaseOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|672149-lapatinib250MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|904932-ibandronicacid150MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|2173822-1MLmepolizumab100MG/MLPrefilledSyringe[Nucala]|EXPANSION 632|1001|Y|N|N||Preferred Brand|212218-EpoetinAlfa20000UNT/MLInjectableSolution[Epogen]|EXPANSION 632|1001|Y|N|N||Preferred Generic|722116-ambrisentan10MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|1000491-Prempro0.3/1.528DayPack|EXPANSION 632|1001|N|N|N||Preferred Generic|198240-Tamoxifen10MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|750839-erythromycinstearate250MGOralTablet[ErythrocinStearate]|EXPANSION 632|1001|N|N|Y||Preferred Generic|197512-Ciprofloxacin750MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|762001-Kariva28DayPack|EXPANSION 632|1001|N|N|N||Preferred Generic|197445-Carbidopa25MG/Levodopa250MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|722122-ambrisentan5MGOralTablet|EXPANSION 632|1001|N|Y|N||Preferred Brand|1992703-ertugliflozin7.5MG/Metforminhydrochloride500MGOralTablet[Segluromet]|EXPANSION 632|1001|N|N|N||Preferred Generic|308979-Carbamazepine200MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1649495-ivabradine7.5MGOralTablet[Corlanor]|EXPANSION 632|1001|N|Y|Y||Preferred Generic|200193-zolmitriptan2.5MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|197700-Fluconazole200MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|979471-Hydrochlorothiazide25MG/LosartanPotassium100MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|1358780-Junel1/2021DayPack|EXPANSION 632|1001|Y|N|N||Preferred Generic|724859-armodafinil150MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|2182340-1MLEtanercept50MG/MLCartridge[Enbrel]|EXPANSION 632|1001|N|Y|Y||Preferred Generic|244374-BenzoylPeroxide0.05MG/MG/Erythromycin0.03MG/MGTopicalGel|EXPANSION 632|1001|N|N|N||Preferred Generic|1298070-Cyclopentolatehydrochloride20MG/MLOphthalmicSolution|EXPANSION 632|1001|N|N|N||Preferred Brand|751884-Lutera28DayPack|EXPANSION 632|1001|Y|N|N||Preferred Generic|724861-armodafinil250MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|314241-Theophylline450MGExtendedReleaseOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1649491-ivabradine5MGOralTablet[Corlanor]|EXPANSION 632|1001|N|N|N||Preferred Generic|966220-LevothyroxineSodium0.025MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|724863-armodafinil50MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|1806181-30/70Release24HRMethylphenidateHydrochloride10MGExtendedReleaseOralCapsule|EXPANSION 632|1001|N|N|Y||Preferred Generic|199206-Riluzole50MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|856377-TrazodoneHydrochloride50MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|2203897-ledipasvir45MG/sofosbuvir200MGOralTablet[Harvoni]|EXPANSION 632|1001|N|N|N||Preferred Brand|1359032-Microgestin1.5/3021DayPack|EXPANSION 632|1001|N|N|N||Preferred Generic|197627-Doxazosin4MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|241834-cyclosporine,modified100MGOralCapsule|EXPANSION 632|1001|N|Y|Y||Preferred Generic|309332-Clindamycin0.01MG/MGTopicalGel|EXPANSION 632|1001|N|N|N||Preferred Generic|1797913-TriamcinoloneAcetonide0.055MG/ACTUATMeteredDoseNasalSpray|EXPANSION 632|1001|N|N|N||Preferred Brand|2563002-0.5MLinfluenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.09MG/ML/influenzaAvirusA/Wisconsin/588/2019(H1N1)antigen0.09MG/|EXPANSION 632|1001|N|N|N||Preferred Generic|311354-Lisinopril5MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|197443-Carbidopa10MG/Levodopa100MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1871467-lisdexamfetaminedimesylate60MGChewableTablet[Vyvanse]|EXPANSION 632|1001|N|Y|N||Preferred Brand|402092-Cyclosporine0.5MG/MLOphthalmicSuspension[Restasis]|EXPANSION 632|1001|N|N|N||Preferred Generic|310346-Finasteride5MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|1014676-cetirizinehydrochloride5MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|966221-LevothyroxineSodium0.05MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|314277-venlafaxine50MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|861430-PropafenoneHydrochloride300MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|2205634-1MLbenralizumab30MG/MLAuto-Injector[Fasenra]|EXPANSION 632|1001|N|N|N||Preferred Generic|197787-Hydrocortisone5MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|2101899-Sodiumpolystyrenesulfonate15000MGPowderforOralSuspension|EXPANSION 632|1001|N|N|N||Preferred Generic|856422-Hydrochlorothiazide25MG/PropranololHydrochloride40MGOralTablet|EXPANSION 632|1001|Y|N|Y||Preferred Generic|313451-Tretinoin0.00025MG/MGTopicalGel|EXPANSION 632|1001|Y|N|N||Preferred Brand|2256943-lasmiditan100MGOralTablet[Reyvow]|EXPANSION 632|1001|N|N|N||Preferred Generic|905225-HydralazineHydrochloride25MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|310364-Fluocinonide0.5MG/MLTopicalSolution|EXPANSION 632|1001|N|N|Y||Preferred Brand|1364441-apixaban2.5MGOralTablet[Eliquis]|EXPANSION 632|1001|Y|N|N||Preferred Brand|753437-9HRMethylphenidate1.11MG/HRTransdermalSystem[Daytrana]|EXPANSION 632|1001|N|N|N||Preferred Generic|856429-Hydrochlorothiazide25MG/PropranololHydrochloride80MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|2257013-trikafta100MG/50MG/75MGand150MGPack|EXPANSION 632|1001|N|N|N||Preferred Generic|313797-Amoxicillin25MG/MLOralSuspension|EXPANSION 632|1001|Y|N|N||Preferred Generic|860715-24HRgalantaminehydrobromide8MGExtendedReleaseOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Generic|754508-{1(aprepitant125MGOralCapsule)/2(aprepitant80MGOralCapsule)}Pack|EXPANSION 632|1001|N|N|N||Preferred Generic|861427-PropafenoneHydrochloride225MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|197405-Betamethasone0.0005MG/MGTopicalOintment|EXPANSION 632|1001|Y|N|N||Preferred Generic|794639-lubiprostone0.008MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|1298072-Cyclopentolatehydrochloride5MG/MLOphthalmicSolution|EXPANSION 632|1001|Y|N|N||Preferred Brand|748738-Topotecan0.25MGOralCapsule[Hycamtin]|EXPANSION 632|1001|N|N|Y||Preferred Generic|349593-atomoxetine25MGOralCapsule|EXPANSION 632|1001|N|Y|N||Preferred Generic|317094-entacapone200MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Brand|2047639-sodiumzirconiumcyclosilicate5000MGPowderforOralSuspension[Lokelma]|EXPANSION 632|1001|Y|N|Y||Preferred Generic|313450-Tretinoin0.0001MG/MGTopicalGel|EXPANSION 632|1001|N|N|N||Preferred Generic|966224-LevothyroxineSodium0.125MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|2262719-MicronizedIsotretinoin24MGOralCapsule[Absorica]|EXPANSION 632|1001|N|N|N||Preferred Generic|311892-nabumetone500MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|248420-mesalamine1000MGRectalSuppository|EXPANSION 632|1001|N|N|N||Preferred Brand|207273-Nitroglycerin0.02MG/MGTopicalOintment[Nitro-Bid]|EXPANSION 632|1001|N|N|N||Preferred Generic|198316-Hydrochlorothiazide25MG/Triamterene37.5MGOralCapsule|EXPANSION 632|1001|N|N|Y||Preferred Generic|198342-Urea400MG/MLTopicalCream|EXPANSION 632|1001|N|N|N||Preferred Generic|310812-Hydrochlorothiazide25MG/Triamterene37.5MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|966225-LevothyroxineSodium0.15MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|1190568-AtropineSulfate0.005MG/ML/DiphenoxylateHydrochloride0.5MG/MLOralSolution|EXPANSION 632|1001|Y|N|N||Preferred Generic|803353-PhentermineHydrochloride37.5MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|197511-Ciprofloxacin250MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|902626-dexlansoprazole60MGDelayedReleaseOralCapsule[Dexilant]|EXPANSION 632|1001|Y|N|N||Preferred Brand|2262731-MicronizedIsotretinoin8MGOralCapsule[Absorica]|EXPANSION 632|1001|N|N|N||Preferred Generic|309367-Clotrimazole10MG/MLTopicalCream|EXPANSION 632|1001|N|N|N||Preferred Generic|315107-24HRGlipizide10MGExtendedReleaseOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|966248-LevothyroxineSodium0.112MGOralTablet|EXPANSION 632|1001|N|Y|Y||Preferred Generic|314266-Tacrolimus0.001MG/MGTopicalOintment|EXPANSION 632|1001|N|N|N||Preferred Brand|754766-Metronidazole0.0075MG/MGVaginalGel[MetroGel]|EXPANSION 632|1001|Y|N|N||Preferred Generic|810096-{7(EthinylEstradiol0.01MGOralTablet)/84(EthinylEstradiol0.02MG/Levonorgestrel0.1MGOralTablet)}Pack|EXPANSION 632|1001|N|N|N||Preferred Brand|153473-Altretamine50MGOralCapsule[Hexalen]|EXPANSION 632|1001|Y|N|N||Preferred Generic|860707-24HRgalantaminehydrobromide24MGExtendedReleaseOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|895487-Fluticasonepropionate0.00005MG/MGTopicalOintment|EXPANSION 632|1001|N|N|Y||Preferred Generic|349595-atomoxetine60MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|1724439-thyroid(USP)30MGOralTablet[NPThyroid]|EXPANSION 632|1001|Y|N|N||Preferred Generic|824295-rufinamide200MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|1099300-DesipramineHydrochloride25MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|198107-Piroxicam10MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|979468-Hydrochlorothiazide12.5MG/LosartanPotassium50MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|226343-Dexamethasonephosphate1MG/MLOphthalmicSolution|EXPANSION 632|1001|N|N|N||Preferred Brand|210000-AluminumHydroxide80MG/ML/MagnesiumHydroxide80MG/ML/Simethicone8MG/MLOralSuspension[Almacone]|EXPANSION 632|1001|N|Y|N||Preferred Generic|311787-moxifloxacin400MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|856519-PropranololHydrochloride40MGOralTablet|EXPANSION 632|1001|N|Y|Y||Preferred Generic|483438-pregabalin100MGOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Brand|2268231-ubrogepant50MGOralTablet[Ubrelvy]|EXPANSION 632|1001|N|N|N||Preferred Brand|105553-Chlorambucil2MGOralTablet[Leukeran]|EXPANSION 632|1001|Y|N|N||Preferred Generic|824301-rufinamide400MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|968766-PhentermineHydrochloride15MGOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Generic|833234-mesalamine800MGDelayedReleaseOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|1000158-0.65MLmedroxyprogesteroneacetate160MG/MLPrefilledSyringe[depo-subQprovera]|EXPANSION 632|1001|N|N|N||Preferred Generic|966253-LevothyroxineSodium0.088MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|309112-Cephalexin250MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|856556-PropranololHydrochloride60MGOralTablet|EXPANSION 632|1001|N|Y|Y||Preferred Generic|483442-pregabalin25MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|834046-PenicillinVPotassium25MG/MLOralSolution|EXPANSION 632|1001|N|N|N||Preferred Generic|1313112-Phenytoin25MG/MLOralSuspension|EXPANSION 632|1001|Y|N|N||Preferred Brand|1648789-30ACTUATfluticasonefuroate0.2MG/ACTUAT/vilanterol0.025MG/ACTUATDryPowderInhaler[Breo]|EXPANSION 632|1001|N|N|N||Preferred Generic|315183-PotassiumChloride8MEQExtendedReleaseOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Brand|207588-Procarbazine50MGOralCapsule[Matulane]|EXPANSION 632|1001|Y|N|N||Preferred Brand|2273115-24HRtofacitinib22MGExtendedReleaseOralTablet[Xeljanz]|EXPANSION 632|1001|Y|N|N||Preferred Brand|226917-orlistat120MGOralCapsule[Xenical]|EXPANSION 632|1001|N|N|Y||Preferred Generic|477560-Fenofibrate145MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|106346-Mupirocin0.02MG/MGTopicalOintment|EXPANSION 632|1001|N|N|Y||Preferred Generic|1812013-Osmotic24HRNifedipine60MGExtendedReleaseOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|848131-Amlodipine10MG/Hydrochlorothiazide12.5MG/valsartan160MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|966270-LevothyroxineSodium0.137MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|237420-CalciumCarbonate1500MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|856706-AmitriptylineHydrochloride10MG/Perphenazine2MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|995281-HydroxyzineHydrochloride50MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|2282320-Rimegepant75MGDisintegratingOralTablet[Nurtec]|EXPANSION 632|1001|N|N|Y||Preferred Generic|351246-montelukast4MGOralGranules|EXPANSION 632|1001|Y|N|N||Preferred Generic|848135-Amlodipine10MG/Hydrochlorothiazide25MG/valsartan320MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|309594-vitaminB121MG/MLInjectableSolution|EXPANSION 632|1001|N|N|N||Preferred Generic|1085640-TriamcinoloneAcetonide0.005MG/MGTopicalOintment|EXPANSION 632|1001|Y|N|Y||Preferred Generic|891893-MorphineSulfate60MGExtendedReleaseOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|966914-POLYETHYLENEGLYCOL3350240000MG/PotassiumChloride2980MG/SodiumBicarbonate6720MG/SodiumChloride5840MG/sodiumsulfate22720|EXPANSION 632|1001|N|N|N||Preferred Brand|896006-120ACTUATFluticasonepropionate0.22MG/ACTUATMeteredDoseInhaler[Flovent]|EXPANSION 632|1001|N|N|N||Preferred Generic|979444-MetaproterenolSulfate2MG/MLOralSolution|EXPANSION 632|1001|N|N|N||Preferred Generic|311166-isoniazid100MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|197805-Ibuprofen400MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|315187-Prednisone1MG/MLOralSolution|EXPANSION 632|1001|Y|N|Y||Preferred Generic|577033-sildenafil20MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|1000499-Prempro0.625/2.528DayPack|EXPANSION 632|1001|N|N|N||Preferred Generic|198380-tioconazole0.065MG/MGVaginalOintment|EXPANSION 632|1001|N|N|N||Preferred Brand|212232-Estrogens,Esterified(USP)0.625MGOralTablet[Menest]|EXPANSION 632|1001|Y|N|N||Preferred Generic|197844-Isotretinoin20MGOralCapsule|EXPANSION 632|1001|Y|N|Y||Preferred Generic|310140-eprosartan600MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|1099304-DesipramineHydrochloride50MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|206961-Nadolol20MGOralTablet[Corgard]|EXPANSION 632|1001|N|N|N||Preferred Brand|905379-HydralazineHydrochloride37.5MG/IsosorbideDinitrate20MGOralTablet[Bidil]|EXPANSION 632|1001|N|N|Y||Preferred Generic|311265-lamotrigine5MGChewableTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|349592-atomoxetine18MGOralCapsule|EXPANSION 632|1001|N|Y|Y||Preferred Generic|483446-pregabalin200MGOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Brand|2283236-bempedoicacid180MG/ezetimibe10MGOralTablet[Nexlizet]|EXPANSION 632|1001|N|N|Y||Preferred Brand|1115892-MineralOil0.15MG/MG/Petrolatum0.85MG/MGOphthalmicOintment[Puralube]|EXPANSION 632|1001|N|N|N||Preferred Generic|237723-Ergocalciferol0.2MG/MLOralSolution|EXPANSION 632|1001|N|N|N||Preferred Brand|1046771-12HRHyoscyamineSulfate0.375MGExtendedReleaseOralTablet[Levbid]|EXPANSION 632|1001|N|N|N||Preferred Generic|966920-POLYETHYLENEGLYCOL3350236000MG/PotassiumChloride2970MG/SodiumBicarbonate6740MG/SodiumChloride5860MG/sodiumsulfate22740|EXPANSION 632|1001|N|N|N||Preferred Brand|751890-Portia28DayPack|EXPANSION 632|1001|N|N|N||Preferred Generic|317128-Misoprostol0.2MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|801966-4MLDiazepam5MG/MLRectalGel|EXPANSION 632|1001|N|N|N||Preferred Generic|993541-24HRBupropionHydrochloride150MGExtendedReleaseOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|2359353-24HRempagliflozin25MG/linagliptin5MG/metforminhydrochloride1000MGExtendedReleaseOralTablet[Trijardy]|EXPANSION 632|1001|N|N|N||Preferred Brand|207478-Primidone50MGOralTablet[Mysoline]|EXPANSION 632|1001|Y|N|N||Preferred Generic|1607792-deferasirox360MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|198335-Sulfamethoxazole800MG/Trimethoprim160MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|848151-Amlodipine10MG/Hydrochlorothiazide25MG/valsartan160MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|856724-PropranololHydrochloride4MG/MLOralSolution|EXPANSION 632|1001|N|Y|Y||Preferred Generic|798133-Erythromycin20MG/MLMedicatedPad[Ery]|EXPANSION 632|1001|N|N|N||Preferred Generic|313580-venlafaxine100MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|317136-Nortriptyline25MGOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Generic|860103-KetorolacTromethamine4MG/MLOphthalmicSolution|EXPANSION 632|1001|Y|N|N||Preferred Generic|850091-24HRlamotrigine50MGExtendedReleaseOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|311353-Lisinopril2.5MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|861416-Azithromycin1000MGPowderforOralSuspension|EXPANSION 632|1001|Y|N|N||Preferred Generic|197730-Furosemide10MG/MLOralSolution|EXPANSION 632|1001|Y|N|N||Preferred Generic|999967-Amlodipine5MG/Hydrochlorothiazide12.5MG/Olmesartanmedoxomil20MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|833528-Amiodaronehydrochloride200MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|801961-2MLDiazepam5MG/MLRectalGel|EXPANSION 632|1001|Y|N|N||Preferred Generic|992395-gatifloxacin5MG/MLOphthalmicSolution|EXPANSION 632|1001|N|N|Y||Preferred Generic|359818-Nicotine4MGOralLozenge|EXPANSION 632|1001|N|N|N||Preferred Generic|197454-Cephalexin500MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|979464-Hydrochlorothiazide12.5MG/LosartanPotassium100MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|1745091-Lidocaine0.05MG/MGMedicatedPatch|EXPANSION 632|1001|N|Y|Y||Preferred Generic|856460-24HRPropranololHydrochloride120MGExtendedReleaseOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Brand|731250-0.3MLdarbepoetinalfa0.2MG/MLPrefilledSyringe[Aranesp]|EXPANSION 632|1001|N|N|N||Preferred Generic|979092-HydroxychloroquineSulfate200MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|903843-PyridostigmineBromide12MG/MLOralSolution|EXPANSION 632|1001|N|N|N||Preferred Generic|992447-PromethazineHydrochloride25MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|1313885-Phenytoin50MGChewableTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|237776-vitaminB121MGExtendedReleaseOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|856762-AmitriptylineHydrochloride100MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|2387331-120ACTUATbudesonide0.16MG/ACTUAT/formoterolfumarate0.0048MG/ACTUAT/glycopyrrolate0.009MG/ACTUATMeteredDoseInhaler[Bre|EXPANSION 632|1001|N|N|N||Preferred Generic|1797867-Azelastinehydrochloride0.137MG/ACTUATMeteredDoseNasalSpray|EXPANSION 632|1001|Y|N|N||Preferred Generic|857224-Sevelamerhydrochloride800MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|317573-pioglitazone15MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|993943-Acetaminophen325MG/butalbital50MG/Caffeine40MG/CodeinePhosphate30MGOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Generic|892349-24HRMorphineSulfate60MGExtendedReleaseOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|1923422-SotalolHydrochloride120MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|855626-Twice-Dailydiclofenacepolamine0.013MG/MGMedicatedPatch|EXPANSION 632|1001|N|N|Y||Preferred Generic|1049214-Acetaminophen325MG/OxycodoneHydrochloride10MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|886671-FlecainideAcetate150MGOralTablet|EXPANSION 632|1001|N|Y|Y||Preferred Generic|854868-Rabeprazolesodium20MGDelayedReleaseOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|310325-ferroussulfate325MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|876529-Amlodipine5MG/telmisartan80MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|854894-Zolpidemtartrate6.25MGExtendedReleaseOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|542059-Didanosine10MG/MLOralSolution[Videx]|EXPANSION 632|1001|Y|N|N||Preferred Generic|876519-Amlodipine10MG/telmisartan80MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|979409-MetaproterenolSulfate10MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|833217-DiltiazemHydrochloride30MGOralTablet|EXPANSION 632|1001|N|Y|Y||Preferred Generic|860654-epinastinehydrochloride0.5MG/MLOphthalmicSolution|EXPANSION 632|1001|Y|N|N||Preferred Brand|2395775-30ACTUATfluticasonefuroate0.2MG/ACTUAT/umeclidinium0.0625MG/ACTUAT/vilanterol0.025MG/ACTUATDryPowderInhaler[Trelegy]|EXPANSION 632|1001|N|N|N||Preferred Generic|856773-AmitriptylineHydrochloride150MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|207373-Mitotane500MGOralTablet[Lysodren]|EXPANSION 632|1001|N|N|Y||Preferred Generic|198318-Triazolam0.25MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|731245-0.42MLdarbepoetinalfa0.06MG/MLPrefilledSyringe[Aranesp]|EXPANSION 632|1001|N|N|N||Preferred Generic|238006-Estrogens,Esterified(USP)0.625MG/Methyltestosterone1.25MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|1099316-DesipramineHydrochloride75MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|197815-Indapamide1.25MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|1596780-60ACTUATTestosterone12.5MG/ACTUATTopicalGel|EXPANSION 632|1001|N|N|Y||Preferred Generic|403922-168HREstradiol0.00156MG/HRTransdermalSystem|EXPANSION 632|1001|Y|N|N||Preferred Brand|2463733-epoetinalfa-epbx10000UNT/MLInjectableSolution[Retacrit]|EXPANSION 632|1001|N|N|Y||Preferred Generic|403923-168HREstradiol0.0025MG/HRTransdermalSystem|EXPANSION 632|1001|N|N|N||Preferred Generic|686405-ErythromycinEthylsuccinate400MGOralTablet|EXPANSION 632|1001|Y|N|Y||Preferred Generic|245723-Tretinoin0.0005MG/MGTopicalGel|EXPANSION 632|1001|N|Y|Y||Preferred Generic|998675-168HRClonidine0.00833MG/HRTransdermalSystem|EXPANSION 632|1001|N|N|N||Preferred Generic|885857-Balsalazidedisodium750MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|197856-Ketoprofen75MGOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Brand|2463737-epoetinalfa-epbx20000UNT/MLInjectableSolution[Retacrit]|EXPANSION 632|1001|N|N|N||Preferred Generic|311288-Levetiracetam250MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|857216-Sevelamerhydrochloride400MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|855642-DiclofenacSodium0.03MG/MGTopicalGel|EXPANSION 632|1001|N|N|N||Preferred Generic|311727-Misoprostol0.1MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1002300-nilotinib150MGOralCapsule[Tasigna]|EXPANSION 632|1001|N|Y|N||Preferred Generic|310600-Griseofulvin500MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|311290-Levetiracetam750MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|328161-Methylprednisolone16MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|2045958-avatrombopag20MGOralTablet[Doptelet]|EXPANSION 632|1001|Y|N|N||Preferred Generic|848140-Amlodipine5MG/Hydrochlorothiazide12.5MG/valsartan160MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|197499-Chlorthalidone25MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1011715-aliskiren150MG/Hydrochlorothiazide25MGOralTablet[TekturnaHCT]|EXPANSION 632|1001|Y|N|N||Preferred Generic|845515-everolimus5MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|351109-Budesonide0.25MG/MLInhalationSuspension|EXPANSION 632|1001|N|N|N||Preferred Brand|751870-Nortrel1/3528DayPack|EXPANSION 632|1001|N|N|N||Preferred Generic|198369-torsemide10MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|2563020-influenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Washington/19/2020(H1N1)antigen0.03MG/ML/in|EXPANSION 632|1001|Y|N|N||Preferred Brand|1011752-aliskiren300MG/Hydrochlorothiazide12.5MGOralTablet[TekturnaHCT]|EXPANSION 632|1001|N|N|N||Preferred Brand|854910-BisoprololFumarate10MG/Hydrochlorothiazide6.25MGOralTablet[Ziac]|EXPANSION 632|1001|N|N|N||Preferred Generic|211365-chlorhexidinegluconate40MG/MLMedicatedLiquidSoap|EXPANSION 632|1001|Y|N|N||Preferred Generic|802749-candesartancilexetil32MG/Hydrochlorothiazide25MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|858824-EnalaprilMaleate5MG/Hydrochlorothiazide12.5MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|2475856-vericiguat2.5MGOralTablet[Verquvo]|EXPANSION 632|1001|N|N|N||Preferred Generic|966222-LevothyroxineSodium0.075MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1605172-0.4MLdarbepoetinalfa0.025MG/MLPrefilledSyringe[Aranesp]|EXPANSION 632|1001|Y|N|N||Preferred Brand|2475860-vericiguat5MGOralTablet[Verquvo]|EXPANSION 632|1001|N|N|N||Preferred Generic|311296-Levofloxacin750MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|725023-24HRrivastigmine0.396MG/HRTransdermalSystem|EXPANSION 632|1001|N|N|Y||Preferred Generic|403884-Levetiracetam100MG/MLOralSolution|EXPANSION 632|1001|N|N|N||Preferred Generic|313585-24HRvenlafaxine75MGExtendedReleaseOralCapsule|EXPANSION 632|1001|N|N|Y||Preferred Brand|1797888-Nicotine0.5MG/ACTUATMeteredDoseNasalSpray[Nicotrol]|EXPANSION 632|1001|N|N|Y||Preferred Generic|1918209-60ACTUATfluticasonepropionate0.055MG/ACTUAT/salmeterol0.014MG/ACTUATDryPowderInhaler|EXPANSION 632|1001|N|N|N||Preferred Generic|860975-24HRMetforminhydrochloride500MGExtendedReleaseOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|860901-galantaminehydrobromide4MG/MLOralSolution|EXPANSION 632|1001|Y|N|N||Preferred Brand|2531134-HumiraPen80MG/0.8ML-StarterPackageforPediatricUlcerativeColitis(4count)|EXPANSION 632|1001|Y|N|N||Preferred Brand|1040058-DextromethorphanHydrobromide20MG/QuinidineSulfate10MGOralCapsule[Nuedexta]|EXPANSION 632|1001|N|N|N||Preferred Generic|206842-IsosorbideDinitrate20MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|861370-sevelamercarbonate2400MGPowderforOralSuspension|EXPANSION 632|1001|Y|N|N||Preferred Brand|884619-eltrombopag75MGOralTablet[Promacta]|EXPANSION 632|1001|Y|N|N||Preferred Generic|700885-temozolomide180MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|349208-Sirolimus1MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|197818-Indomethacin50MGOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Brand|731241-1MLdarbepoetinalfa0.5MG/MLPrefilledSyringe[Aranesp]|EXPANSION 632|1001|N|N|N||Preferred Generic|979475-MetaproterenolSulfate20MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|1359135-Tri-LegestFe28DayPack|EXPANSION 632|1001|N|N|Y||Preferred Generic|1091150-MethylphenidateHydrochloride10MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|197726-Flutamide125MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|856840-AmitriptylineHydrochloride50MG/Perphenazine4MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|1099026-Loryna28DayPack|EXPANSION 632|1001|Y|N|N||Preferred Brand|2536752-24HRviloxazine150MGExtendedReleaseOralCapsule[Qelbree]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1043574-24HRMetforminhydrochloride1000MG/saxagliptin5MGExtendedReleaseOralTablet[Kombiglyze]|EXPANSION 632|1001|Y|N|N||Preferred Generic|616749-12HRranolazine500MGExtendedReleaseOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|904481-PravastatinSodium80MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|349332-Escitalopram10MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|404062-Isotretinoin20MGOralCapsule[Claravis]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1653225-1MLEtanercept50MG/MLAuto-Injector[Enbrel]|EXPANSION 632|1001|N|N|Y||Preferred Generic|309309-Ciprofloxacin500MGOralTablet|EXPANSION 632|1001|Y|N|Y||Preferred Generic|197636-dronabinol5MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|205304-telmisartan40MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Brand|1986830-0.5MLVaricellazostervirusglycoproteinE,recombinant0.1MG/MLInjection[Shingrix]|EXPANSION 632|1001|Y|N|N||Preferred Generic|602635-lanthanumcarbonate1000MGChewableTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|349373-Olmesartanmedoxomil5MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|750264-Necon7/7/728DayPack|EXPANSION 632|1001|N|N|Y||Preferred Generic|310190-estradiolvalerate20MG/MLInjectableSolution|EXPANSION 632|1001|Y|N|N||Preferred Brand|1043582-24HRMetforminhydrochloride500MG/saxagliptin5MGExtendedReleaseOralTablet[Kombiglyze]|EXPANSION 632|1001|Y|N|N||Preferred Brand|2536758-24HRviloxazine200MGExtendedReleaseOralCapsule[Qelbree]|EXPANSION 632|1001|N|N|N||Preferred Generic|904458-PravastatinSodium10MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|103456-Fluocinonide0.5MG/MLTopicalCream|EXPANSION 632|1001|Y|N|N||Preferred Generic|597768-deferasirox125MGTabletforOralSuspension|EXPANSION 632|1001|N|N|N||Preferred Generic|831261-CromolynSodium20MG/MLOralSolution|EXPANSION 632|1001|N|N|N||Preferred Brand|207136-Methylprednisolone2MGOralTablet[Medrol]|EXPANSION 632|1001|N|N|Y||Preferred Generic|313415-Tobramycin3MG/MLOphthalmicSolution|EXPANSION 632|1001|Y|N|N||Preferred Generic|578330-candesartancilexetil32MG/Hydrochlorothiazide12.5MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|896245-120ACTUATFluticasonepropionate0.115MG/ACTUAT/salmeterol0.021MG/ACTUATMeteredDoseInhaler[Advair]|EXPANSION 632|1001|N|N|N||Preferred Generic|1006688-SulfacetamideSodium100MG/MLTopicalLotion|EXPANSION 632|1001|Y|N|N||Preferred Brand|1046402-1.7MLdenosumab70MG/MLInjection[Xgeva]|EXPANSION 632|1001|N|N|N||Preferred Generic|351249-Escitalopram5MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|731235-0.4MLdarbepoetinalfa0.5MG/MLPrefilledSyringe[Aranesp]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1801278-HumiraPsoriasisStarterPack40MG/0.8MLPen(4count)|EXPANSION 632|1001|Y|N|N||Preferred Generic|545835-LeuprolideAcetate5MG/MLInjectableSolution|EXPANSION 632|1001|Y|N|N||Preferred Generic|543218-1MLGranisetron0.1MG/MLInjection|EXPANSION 632|1001|N|N|N||Preferred Generic|349401-Olmesartanmedoxomil20MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|903884-FluvoxamineMaleate100MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1091650-azilsartanmedoxomil40MGOralTablet[Edarbi]|EXPANSION 632|1001|Y|N|N||Preferred Generic|485436-entecavir1MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|750244-Low-Ogestrel28DayPack|EXPANSION 632|1001|N|N|N||Preferred Generic|310537-Glyburide5MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|310798-Hydrochlorothiazide25MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1091654-azilsartanmedoxomil80MGOralTablet[Edarbi]|EXPANSION 632|1001|Y|N|N||Preferred Brand|2559707-1.14MLdupilumab175MG/MLAuto-Injector[Dupixent]|EXPANSION 632|1001|N|N|N||Preferred Generic|197383-Atenolol50MG/Chlorthalidone25MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|993691-BupropionHydrochloride75MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1091843-Roflumilast0.5MGOralTablet[Daliresp]|EXPANSION 632|1001|Y|N|N||Preferred Generic|864681-Atovaquone62.5MG/proguanilhydrochloride25MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|1099681-ValproicAcid250MGOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Generic|465355-voriconazole40MG/MLOralSuspension|EXPANSION 632|1001|Y|N|N||Preferred Generic|403930-Isotretinoin30MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|349420-desloratadine5MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1100706-Linagliptin5MGOralTablet[Tradjenta]|EXPANSION 632|1001|N|N|N||Preferred Generic|831109-CromolynSodium40MG/MLOphthalmicSolution|EXPANSION 632|1001|N|N|Y||Preferred Brand|895756-PolyethyleneGlycol4000.004MG/MG/Propyleneglycol0.003MG/MGOphthalmicGel[Systane]|EXPANSION 632|1001|Y|N|N||Preferred Generic|1860148-Abuse-Deterrent12HROxycodoneHydrochloride80MGExtendedReleaseOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|1193358-100MLLevetiracetam10MG/MLInjection|EXPANSION 632|1001|Y|N|N||Preferred Generic|403811-aprepitant125MGOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Generic|402506-12HRCarbamazepine400MGExtendedReleaseOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|991233-bexarotene0.01MG/MGTopicalGel[Targretin]|EXPANSION 632|1001|N|N|N||Preferred Generic|1053697-Nystatin100UNT/MG/TriamcinoloneAcetonide0.001MG/MGTopicalOintment|EXPANSION 632|1001|N|N|N||Preferred Generic|857169-FosinoprilSodium10MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|311960-Niacin500MGExtendedReleaseOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|198372-torsemide5MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|351136-Albuterol0.417MG/MLInhalationSolution|EXPANSION 632|1001|N|N|Y||Preferred Generic|1000126-1MLmedroxyprogesteroneacetate150MG/MLInjection|EXPANSION 632|1001|Y|N|N||Preferred Brand|1114074-Vandetanib100MGOralTablet[Caprelsa]|EXPANSION 632|1001|Y|N|N||Preferred Generic|349408-Treprostinil10MG/MLInjectableSolution|EXPANSION 632|1001|Y|N|N||Preferred Brand|261362-alosetron1MGOralTablet[Lotronex]|EXPANSION 632|1001|N|N|N||Preferred Brand|206978-Ketoconazole20MG/MLMedicatedShampoo[Nizoral]|EXPANSION 632|1001|N|N|N||Preferred Generic|103457-Fluocinonide0.0005MG/MGTopicalOintment|EXPANSION 632|1001|N|N|N||Preferred Generic|831103-DiltiazemHydrochloride60MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|1918203-60ACTUATfluticasonepropionate0.232MG/ACTUAT/salmeterol0.014MG/ACTUATDryPowderInhaler|EXPANSION 632|1001|N|N|N||Preferred Generic|197853-Ketoconazole200MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|348719-Tobramycin60MG/MLInhalationSolution|EXPANSION 632|1001|Y|N|N||Preferred Brand|352045-1MLdarbepoetinalfa0.04MG/MLInjection[Aranesp]|EXPANSION 632|1001|Y|N|N||Preferred Generic|317160-temozolomide100MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|991061-DicyclomineHydrochloride10MGOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Generic|313472-Trientinehydrochloride250MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Brand|1359030-Junel1.5/3021DayPack|EXPANSION 632|1001|N|N|Y||Preferred Generic|1806191-30/70Release24HRMethylphenidateHydrochloride40MGExtendedReleaseOralCapsule|EXPANSION 632|1001|N|N|Y||Preferred Generic|313413-tizanidine4MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|200131-12HRCarbamazepine300MGExtendedReleaseOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Brand|1115259-1.5MLLeuprolideAcetate30MG/MLPrefilledSyringe[Lupron]|EXPANSION 632|1001|Y|N|N||Preferred Generic|310599-Granisetron1MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|749151-Tri-Norinyl28DayPack|EXPANSION 632|1001|N|N|N||Preferred Generic|897666-Verapamilhydrochloride120MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|991086-DicyclomineHydrochloride20MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|283317-Hydrochlorothiazide12.5MG/telmisartan80MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|857187-FosinoprilSodium40MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|993687-BupropionHydrochloride100MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Brand|1037181-dabigatranetexilate75MGOralCapsule[Pradaxa]|EXPANSION 632|1001|Y|N|N||Preferred Generic|283316-Hydrochlorothiazide12.5MG/telmisartan40MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|260218-modafinil100MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|209002-prednisolone1.2MG/MLOphthalmicSuspension[PredMild]|EXPANSION 632|1001|N|N|N||Preferred Generic|310324-ferroussulfate325MGDelayedReleaseOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|310433-gabapentin600MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|897596-24HRVerapamilhydrochloride300MGExtendedReleaseOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|858817-EnalaprilMaleate10MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|1115698-Oseltamivir6MG/MLOralSuspension|EXPANSION 632|1001|N|N|N||Preferred Generic|993536-12HRBupropionHydrochloride200MGExtendedReleaseOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|2198370-pretomanid200MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|200033-carvedilol25MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|198034-24HRNifedipine30MGExtendedReleaseOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|2123194-PulmonaryHypertensiontadalafil20MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|349407-Treprostinil1MG/MLInjectableSolution|EXPANSION 632|1001|N|N|N||Preferred Generic|309371-Clotrimazole10MGOralLozenge|EXPANSION 632|1001|Y|N|N||Preferred Generic|205324-modafinil200MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|205316-topiramate15MGOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Brand|1115464-1MLLeuprolideAcetate7.5MG/MLPrefilledSyringe[Lupron]|EXPANSION 632|1001|Y|N|N||Preferred Generic|728231-12HRranolazine1000MGExtendedReleaseOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|239191-Amoxicillin50MG/MLOralSuspension|EXPANSION 632|1001|N|N|N||Preferred Generic|857297-ClomipramineHydrochloride25MGOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Brand|1115468-1.5MLLeuprolideAcetate15MG/MLPrefilledSyringe[Lupron]|EXPANSION 632|1001|N|N|N||Preferred Generic|1150836-LevobunololHydrochloride5MG/MLOphthalmicSolution|EXPANSION 632|1001|Y|N|N||Preferred Brand|404059-Isotretinoin10MGOralCapsule[Claravis]|EXPANSION 632|1001|N|N|N||Preferred Generic|200256-repaglinide1MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|748865-Trivora28DayPack|EXPANSION 632|1001|Y|N|N||Preferred Generic|200220-tolcapone100MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|1244214-Budesonide3MGDelayedReleaseOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Brand|1115473-1.5MLLeuprolideAcetate7.5MG/MLPrefilledSyringe[Lupron]|EXPANSION 632|1001|N|N|N||Preferred Generic|309337-Clindamycin20MG/MLVaginalCream|EXPANSION 632|1001|Y|N|N||Preferred Generic|199378-12HRCarbamazepine100MGExtendedReleaseOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|1860137-Abuse-Deterrent12HROxycodoneHydrochloride40MGExtendedReleaseOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|896209-60ACTUATFluticasonepropionate0.25MG/ACTUAT/salmeterol0.05MG/ACTUATDryPowderInhaler|EXPANSION 632|1001|N|N|Y||Preferred Generic|198252-tetracyclinehydrochloride500MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|898367-Benazeprilhydrochloride20MG/Hydrochlorothiazide12.5MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|207864-crotamiton100MG/MLTopicalCream[Eurax]|EXPANSION 632|1001|Y|N|N||Preferred Generic|198200-Rifabutin150MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|353538-24HRIsosorbideMononitrate60MGExtendedReleaseOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|404065-Isotretinoin40MGOralCapsule[Claravis]|EXPANSION 632|1001|Y|N|N||Preferred Generic|198071-Penicillamine250MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|311726-Mirtazapine45MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|881341-adefovirdipivoxil10MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|992184-methenaminemandelate500MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|1099569-24HRDivalproexSodium500MGExtendedReleaseOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1145932-1MLabatacept125MG/MLPrefilledSyringe[Orencia]|EXPANSION 632|1001|N|N|N||Preferred Generic|103951-Tolnaftate10MG/MLTopicalCream|EXPANSION 632|1001|Y|N|N||Preferred Generic|197843-Isotretinoin10MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|1806189-30/70Release24HRMethylphenidateHydrochloride30MGExtendedReleaseOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Generic|1796690-1MLhydroxyprogesteronecaproate(USP)250MG/MLInjection|EXPANSION 632|1001|Y|N|N||Preferred Generic|403818-moxifloxacin5MG/MLOphthalmicSolution|EXPANSION 632|1001|N|N|N||Preferred Generic|282755-telmisartan20MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|199888-topiramate25MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|857305-ClomipramineHydrochloride75MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|359296-calciumacetate667MGOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Generic|1918042-abirateroneacetate500MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|1665050-Cefazolin1000MGInjection|EXPANSION 632|1001|Y|N|N||Preferred Generic|1874559-24HRdesvenlafaxinesuccinate50MGExtendedReleaseOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|1099596-DivalproexSodium125MGDelayedReleaseOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Generic|1874553-24HRdesvenlafaxinesuccinate100MGExtendedReleaseOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1148506-crizotinib250MGOralCapsule[Xalkori]|EXPANSION 632|1001|N|N|N||Preferred Generic|884185-ClonidineHydrochloride0.2MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|198378-Tacrolimus5MGOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Generic|892342-24HRMorphineSulfate30MGExtendedReleaseOralCapsule|EXPANSION 632|1001|N|N|Y||Preferred Brand|1658157-1MLHepatitisBSurfaceAntigenVaccine0.02MG/MLInjection[Engerix-B]|EXPANSION 632|1001|N|N|N||Preferred Brand|150840-Estrogens,Conjugated(USP)0.625MGOralTablet[Premarin]|EXPANSION 632|1001|N|N|N||Preferred Generic|308078-AluminumHydroxide64MG/MLOralSuspension|EXPANSION 632|1001|Y|N|N||Preferred Generic|1860154-Abuse-Deterrent12HROxycodoneHydrochloride15MGExtendedReleaseOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|1860151-Abuse-Deterrent12HROxycodoneHydrochloride30MGExtendedReleaseOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|993557-24HRBupropionHydrochloride300MGExtendedReleaseOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|199884-Levofloxacin250MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|200371-Citalopram20MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|349591-atomoxetine10MGOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Brand|1149667-Camrese91DayPack|EXPANSION 632|1001|N|N|N||Preferred Generic|856797-AmitriptylineHydrochloride25MG/Perphenazine2MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|309307-Ciprofloxacin3MG/MLOphthalmicSolution|EXPANSION 632|1001|N|N|N||Preferred Generic|884189-ClonidineHydrochloride0.3MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|1860127-Abuse-Deterrent12HROxycodoneHydrochloride60MGExtendedReleaseOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|198377-Tacrolimus1MGOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Brand|404450-Thalidomide200MGOralCapsule[Thalomid]|EXPANSION 632|1001|Y|N|N||Preferred Generic|1793916-0.5MLSumatriptan8MG/MLAuto-Injector|EXPANSION 632|1001|N|N|N||Preferred Generic|360110-Sirolimus2MGOralTablet|EXPANSION 632|1001|N|Y|N||Preferred Generic|204119-Malathion5MG/MLTopicalLotion|EXPANSION 632|1001|N|N|N||Preferred Generic|857321-BethanecholChloride10MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|707333-SodiumChloride0.111MEQ/MLNasalSolution[AyrSalineNasal]|EXPANSION 632|1001|Y|N|N||Preferred Generic|897021-12HRdalfampridine10MGExtendedReleaseOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|762334-Velivet28DayPack|EXPANSION 632|1001|N|N|N||Preferred Generic|197319-Allopurinol100MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|1728055-5MLpalonosetron0.05MG/MLInjection|EXPANSION 632|1001|Y|N|N||Preferred Brand|1191128-EdrophoniumChloride10MG/MLInjectableSolution[Enlon]|EXPANSION 632|1001|N|N|N||Preferred Brand|206314-Hydrocortisone0.01MG/MGTopicalOintment[Cortizone]|EXPANSION 632|1001|Y|N|N||Preferred Generic|1657173-0.5MLSumatriptan8MG/MLCartridge|EXPANSION 632|1001|N|N|Y||Preferred Generic|1543069-Lidocaine0.05MG/MGTopicalOintment|EXPANSION 632|1001|N|N|N||Preferred Brand|992481-PromethazineHydrochloride50MGRectalSuppository[Promethegan]|EXPANSION 632|1001|N|N|Y||Preferred Generic|728113-Oseltamivir45MGOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Generic|1607990-{24(EthinylEstradiol0.025MG/Norethindrone0.8MGChewableTablet)/4(Ferrousfumarate75MGChewableTablet)}Pack|EXPANSION 632|1001|N|N|N||Preferred Generic|856853-AmitriptylineHydrochloride75MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|308973-Carbamazepine100MGChewableTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|311759-montelukast4MGChewableTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|1049221-Acetaminophen325MG/OxycodoneHydrochloride5MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|866511-MetoprololTartrate100MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|313584-venlafaxine37.5MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|199353-trandolapril1MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|381056-IsosorbideDinitrate10MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|602862-magnesiumaminoacidchelate133MGOralTablet[MGPlusProtein]|EXPANSION 632|1001|N|N|N||Preferred Generic|857328-BethanecholChloride25MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|1597129-5000MGTestosterone0.01MG/MGTopicalGel|EXPANSION 632|1001|N|N|N||Preferred Generic|992441-PromethazineHydrochloride12.5MGRectalSuppository|EXPANSION 632|1001|N|N|N||Preferred Generic|198102-vitaminK15MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|860805-Azelastinehydrochloride0.5MG/MLOphthalmicSolution|EXPANSION 632|1001|Y|N|N||Preferred Generic|1591943-ledipasvir90MG/sofosbuvir400MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|858813-EnalaprilMaleate5MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|705008-Cefixime40MG/MLOralSuspension[Suprax]|EXPANSION 632|1001|Y|N|N||Preferred Generic|1547561-Isotretinoin25MGOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Brand|1235157-azilsartanmedoxomil40MG/Chlorthalidone25MGOralTablet[Edarbyclor]|EXPANSION 632|1001|Y|N|N||Preferred Generic|577057-72HRFentanyl0.012MG/HRTransdermalSystem|EXPANSION 632|1001|N|N|Y||Preferred Generic|198242-Temazepam30MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|204844-Azithromycin600MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Brand|1658102-1MLhepatitisAvirusstrainCR326Fantigen,inactivated50UNT/MLInjection[Vaqta]|EXPANSION 632|1001|N|N|N||Preferred Generic|199246-glimepiride2MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|1426600-{24(EthinylEstradiol0.02MG/norethindroneacetate1MGChewableTablet)/4(Ferrousfumarate75MGOralTablet)}Pack|EXPANSION 632|1001|Y|N|N||Preferred Generic|1373503-{7(EthinylEstradiol0.01MGOralTablet)/42(EthinylEstradiol0.02MG/Levonorgestrel0.15MGOralTablet)/21(EthinylEstradiol0.0|EXPANSION 632|1001|N|N|N||Preferred Generic|1099625-DivalproexSodium125MGDelayedReleaseOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1242233-lenalidomide2.5MGOralCapsule[Revlimid]|EXPANSION 632|1001|Y|N|N||Preferred Generic|1366550-24HRBudesonide9MGExtendedReleaseOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|391937-Lactulose667MG/MLOralSolution|EXPANSION 632|1001|Y|N|N||Preferred Generic|900164-24HRlamotrigine25MGExtendedReleaseOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|1360304-Budesonide0.08MG/ACTUAT/formoterolfumarate0.0045MG/ACTUATMeteredDoseInhaler|EXPANSION 632|1001|N|N|N||Preferred Generic|313581-24HRvenlafaxine150MGExtendedReleaseOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|857336-BethanecholChloride5MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|861164-12HRPropafenoneHydrochloride325MGExtendedReleaseOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|197433-calciumacetate667MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|616018-abatacept250MGInjection[Orencia]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1242613-Isotretinoin20MGOralCapsule[Myorisan]|EXPANSION 632|1001|N|N|N||Preferred Generic|199425-Melatonin1MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|577957-Amphetamineaspartate3.75MG/AmphetamineSulfate3.75MG/Dextroamphetaminesaccharate3.75MG/DextroamphetamineSulfate3.75MGOr|EXPANSION 632|1001|N|N|N||Preferred Generic|199224-anastrozole1MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|687043-Amphetamineaspartate3.125MG/AmphetamineSulfate3.125MG/Dextroamphetaminesaccharate3.125MG/DextroamphetamineSulfate3.125|EXPANSION 632|1001|N|N|N||Preferred Generic|992454-PromethazineHydrochloride25MGRectalSuppository|EXPANSION 632|1001|N|N|N||Preferred Generic|1099870-DivalproexSodium500MGDelayedReleaseOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|1046985-HyoscyamineSulfate0.125MGDisintegratingOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|2550713-0.5MLsecukinumab150MG/MLPrefilledSyringe[Cosentyx]|EXPANSION 632|1001|Y|N|N||Preferred Generic|1299909-Tiagabinehydrochloride16MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|206216-2MLIron-DextranComplex50MG/MLInjection[InFed]|EXPANSION 632|1001|N|N|N||Preferred Generic|393245-Digoxin0.05MG/MLOralSolution|EXPANSION 632|1001|N|N|N||Preferred Generic|857340-BethanecholChloride50MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|727816-0.5MLInterferonbeta-1a0.06MG/MLPrefilledSyringe[Avonex]|EXPANSION 632|1001|N|N|N||Preferred Generic|197862-Leucovorin25MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|1119400-everolimus7.5MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|616114-lenalidomide10MGOralCapsule[Revlimid]|EXPANSION 632|1001|Y|N|N||Preferred Generic|903847-PyridostigmineBromide180MGExtendedReleaseOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|309098-Cefuroxime500MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|1100075-abirateroneacetate250MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|1649401-DoxycyclineMonohydrate50MGOralCapsule|EXPANSION 632|1001|N|N|Y||Preferred Generic|198241-Temazepam15MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Brand|896001-120ACTUATFluticasonepropionate0.11MG/ACTUATMeteredDoseInhaler[Flovent]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1594358-HumiraPediatricCrohn'sDiseaseStarterPackage(3count)|EXPANSION 632|1001|Y|N|N||Preferred Generic|1095229-FlavoxateHydrochloride100MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|999613-SulfacetamideSodium100MG/ML/Sulfur50MG/MLMedicatedLiquidSoap|EXPANSION 632|1001|N|N|N||Preferred Generic|861743-Glyburide1.25MG/Metforminhydrochloride250MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|240209-Betamethasone0.5MG/MLTopicalLotion|EXPANSION 632|1001|N|Y|N||Preferred Generic|197984-Minocycline100MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|861156-12HRPropafenoneHydrochloride225MGExtendedReleaseOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|199168-Phenobarbital64.8MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|1946772-Methotrexate25MG/MLInjectableSolution|EXPANSION 632|1001|Y|N|N||Preferred Generic|1011739-aliskiren300MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|402696-24HRFelodipine5MGExtendedReleaseOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|198083-Phenobarbital100MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|1011736-aliskiren150MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|688242-Estrogens,Conjugated(USP)0.625MG/MLVaginalCream[Premarin]|EXPANSION 632|1001|N|N|N||Preferred Generic|861487-ClobetasolPropionate0.5MG/MLTopicalSolution|EXPANSION 632|1001|Y|N|N||Preferred Brand|616283-sunitinib12.5MGOralCapsule[Sutent]|EXPANSION 632|1001|Y|N|N||Preferred Brand|979115-0.6MLMethylnaltrexonebromide20MG/MLInjection[Relistor]|EXPANSION 632|1001|Y|N|N||Preferred Brand|616116-lenalidomide5MGOralCapsule[Revlimid]|EXPANSION 632|1001|Y|N|N||Preferred Brand|861045-1.5MLpramlintideacetate1MG/MLPenInjector[Symlin]|EXPANSION 632|1001|N|N|N||Preferred Generic|992438-PromethazineHydrochloride12.5MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|857677-TerbutalineSulfate2.5MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|153183-adapalene0.001MG/MGTopicalGel[Differin]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1011712-aliskiren150MG/Hydrochlorothiazide12.5MGOralTablet[TekturnaHCT]|EXPANSION 632|1001|N|N|N||Preferred Generic|402698-24HRFelodipine2.5MGExtendedReleaseOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1243052-ivacaftor150MGOralTablet[Kalydeco]|EXPANSION 632|1001|N|N|N||Preferred Generic|1362706-MexiletineHydrochloride150MGOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Brand|616287-sunitinib25MGOralCapsule[Sutent]|EXPANSION 632|1001|N|N|N||Preferred Brand|102250-Hydrocortisone1.67MG/MLEnema[Cortenema]|EXPANSION 632|1001|N|N|N||Preferred Generic|199163-Melatonin3MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|897126-3MLliraglutide6MG/MLPenInjector[Victoza]|EXPANSION 632|1001|N|N|N||Preferred Generic|199885-Levofloxacin500MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|642452-lanthanumcarbonate750MGChewableTablet|EXPANSION 632|1001|Y|N|Y||Preferred Brand|804547-difluprednate0.5MG/MLOphthalmicSuspension[Durezol]|EXPANSION 632|1001|Y|N|N||Preferred Brand|896273-120ACTUATFluticasonepropionate0.23MG/ACTUAT/salmeterol0.021MG/ACTUATMeteredDoseInhaler[Advair]|EXPANSION 632|1001|Y|N|N||Preferred Brand|861043-2.7MLpramlintideacetate1MG/MLPenInjector[Symlin]|EXPANSION 632|1001|N|N|N||Preferred Generic|861200-Brimonidinetartrate2MG/MLOphthalmicSolution|EXPANSION 632|1001|N|N|Y||Preferred Generic|359817-Nicotine2MGOralLozenge|EXPANSION 632|1001|N|N|N||Preferred Brand|2563039-0.5MLinfluenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.03MG/|EXPANSION 632|1001|N|N|Y||Preferred Generic|991528-DextromethorphanHydrobromide3MG/ML/PromethazineHydrochloride1.25MG/MLOralSolution|EXPANSION 632|1001|N|N|N||Preferred Brand|644304-Tamoxifen2MG/MLOralSolution[Soltamox]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1243843-24HRMetforminhydrochloride1000MG/sitagliptin50MGExtendedReleaseOralTablet[Janumet]|EXPANSION 632|1001|N|N|Y||Preferred Generic|197735-Gentamicin1MG/MLTopicalCream|EXPANSION 632|1001|Y|N|N||Preferred Brand|1593858-lisdexamfetaminedimesylate10MGOralCapsule[Vyvanse]|EXPANSION 632|1001|Y|N|N||Preferred Brand|643173-dasatinib20MGOralTablet[Sprycel]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1243848-24HRMetforminhydrochloride500MG/sitagliptin50MGExtendedReleaseOralTablet[Janumet]|EXPANSION 632|1001|N|N|N||Preferred Generic|309370-Clotrimazole10MG/MLTopicalSolution|EXPANSION 632|1001|Y|N|N||Preferred Brand|1243833-24HRMetforminhydrochloride1000MG/sitagliptin100MGExtendedReleaseOralTablet[Janumet]|EXPANSION 632|1001|N|N|N||Preferred Generic|857683-TerbutalineSulfate5MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|866514-MetoprololTartrate50MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|206208-aluminumchloride200MG/MLTopicalSolution[Drysol]|EXPANSION 632|1001|N|N|N||Preferred Generic|199390-Etodolac500MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|199149-Acarbose50MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|705824-100MLzoledronicacid0.05MG/MLInjection|EXPANSION 632|1001|Y|N|N||Preferred Brand|858366-KetorolacTromethamine4.5MG/MLOphthalmicSolution[Acuvail]|EXPANSION 632|1001|Y|N|N||Preferred Brand|858044-saxagliptin2.5MGOralTablet[Onglyza]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1244062-0.6MLMethylnaltrexonebromide20MG/MLPrefilledSyringe[Relistor]|EXPANSION 632|1001|N|N|N||Preferred Generic|403854-Hydrochlorothiazide12.5MG/Olmesartanmedoxomil40MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|1099648-5MLValproicAcid100MG/MLInjection|EXPANSION 632|1001|Y|N|N||Preferred Brand|854852-lisdexamfetaminedimesylate50MGOralCapsule[Vyvanse]|EXPANSION 632|1001|N|N|N||Preferred Generic|198428-lamotrigine150MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|197987-Minoxidil2.5MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|854848-lisdexamfetaminedimesylate60MGOralCapsule[Vyvanse]|EXPANSION 632|1001|N|N|N||Preferred Generic|856834-AmitriptylineHydrochloride25MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1745108-1MLixekizumab80MG/MLAuto-Injector[Taltz]|EXPANSION 632|1001|N|N|N||Preferred Brand|1359025-JunelFe28DayPack|EXPANSION 632|1001|Y|N|N||Preferred Brand|854844-lisdexamfetaminedimesylate70MGOralCapsule[Vyvanse]|EXPANSION 632|1001|Y|N|N||Preferred Brand|643177-dasatinib70MGOralTablet[Sprycel]|EXPANSION 632|1001|Y|N|N||Preferred Brand|854836-lisdexamfetaminedimesylate30MGOralCapsule[Vyvanse]|EXPANSION 632|1001|N|N|Y||Preferred Generic|1812015-Osmotic24HRNifedipine90MGExtendedReleaseOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|905395-HydralazineHydrochloride50MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|860981-24HRMetforminhydrochloride750MGExtendedReleaseOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1244632-AmethiaLo91DayPack|EXPANSION 632|1001|N|N|N||Preferred Generic|199047-Famotidine10MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|725021-24HRrivastigmine0.192MG/HRTransdermalSystem|EXPANSION 632|1001|N|N|N||Preferred Generic|1860100-ferroussulfate324MGDelayedReleaseOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|1293639-Caffeine100MG/ErgotamineTartrate2MGRectalSuppository[Migergot]|EXPANSION 632|1001|Y|N|N||Preferred Brand|848164-0.5MLgolimumab100MG/MLPrefilledSyringe[Simponi]|EXPANSION 632|1001|Y|N|N||Preferred Brand|847917-60ACTUATexenatide0.005MG/ACTUATPenInjector[Byetta]|EXPANSION 632|1001|N|N|N||Preferred Generic|403855-Hydrochlorothiazide25MG/Olmesartanmedoxomil40MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|845512-everolimus10MGOralTablet[Afinitor]|EXPANSION 632|1001|Y|N|N||Preferred Brand|836649-Zolpidemtartrate5MGSublingualTablet[Edluar]|EXPANSION 632|1001|Y|N|N||Preferred Generic|999991-Amlodipine10MG/Hydrochlorothiazide25MG/Olmesartanmedoxomil40MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|836645-Zolpidemtartrate10MGSublingualTablet[Edluar]|EXPANSION 632|1001|Y|N|N||Preferred Brand|828364-hydrocortisoneacetate10MG/ML/Pramoxinehydrochloride10MG/MLRectalFoam[Proctofoam-HC]|EXPANSION 632|1001|N|N|N||Preferred Generic|997501-Fexofenadinehydrochloride60MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|198857-Simethicone66.7MG/MLOralSuspension|EXPANSION 632|1001|Y|N|N||Preferred Brand|1012899-fingolimod0.5MGOralCapsule[Gilenya]|EXPANSION 632|1001|N|N|N||Preferred Generic|348472-Theophylline600MGExtendedReleaseOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1291092-hydrocortisoneacetate30MGRectalSuppository[Proctocort]|EXPANSION 632|1001|N|N|N||Preferred Brand|2561270-0.5MLinfluenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.03MG/|EXPANSION 632|1001|N|N|Y||Preferred Generic|1009145-Amphetamineaspartate1.875MG/AmphetamineSulfate1.875MG/Dextroamphetaminesaccharate1.875MG/DextroamphetamineSulfate1.87|EXPANSION 632|1001|N|N|Y||Preferred Generic|313161-Sumatriptan50MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|198760-Niacin50MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|1536586-168HREthinylEstradiol0.00146MG/HR/norelgestromin0.00625MG/HRTransdermalSystem[Xulane]|EXPANSION 632|1001|Y|N|N||Preferred Brand|825170-HumiraPen40MG/0.8ML-Crohn'sDiseaseStarterPack|EXPANSION 632|1001|N|N|N||Preferred Generic|801054-POLYETHYLENEGLYCOL3350420000MG/PotassiumChloride1480MG/SodiumBicarbonate5720MG/SodiumChloride11200MGPowderforOralSolut|EXPANSION 632|1001|Y|N|N||Preferred Brand|810079-24HRFesoterodineFumarate8MGExtendedReleaseOralTablet[Toviaz]|EXPANSION 632|1001|N|N|N||Preferred Generic|403967-zonisamide50MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Brand|617333-Amoxicillin25MG/ML/Clavulanate6.25MG/MLOralSuspension[Augmentin]|EXPANSION 632|1001|N|N|Y||Preferred Generic|241527-168HREstradiol0.00312MG/HRTransdermalSystem|EXPANSION 632|1001|N|N|N||Preferred Generic|1047895-HyoscyamineSulfate0.125MG/MLOralSolution|EXPANSION 632|1001|Y|N|Y||Preferred Brand|1292435-0.65MLVaricella-ZosterVirusVaccineLive(Oka-Merck)strain29800UNT/MLInjection[Zostavax]|EXPANSION 632|1001|N|N|Y||Preferred Brand|1046920-Nicotine4MGInhalationSolution[Nicotrol]|EXPANSION 632|1001|Y|N|N||Preferred Brand|809998-lacosamide200MGOralTablet[Vimpat]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1011755-aliskiren300MG/Hydrochlorothiazide25MGOralTablet[TekturnaHCT]|EXPANSION 632|1001|N|N|Y||Preferred Brand|1656356-sacubitril97MG/valsartan103MGOralTablet[Entresto]|EXPANSION 632|1001|N|N|Y||Preferred Generic|205323-celecoxib200MGOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Brand|809994-lacosamide150MGOralTablet[Vimpat]|EXPANSION 632|1001|N|N|N||Preferred Brand|205669-Dexamethasone1MG/MLOphthalmicSuspension[Maxidex]|EXPANSION 632|1001|Y|N|N||Preferred Brand|809990-lacosamide100MGOralTablet[Vimpat]|EXPANSION 632|1001|N|N|N||Preferred Generic|860215-MegestrolAcetate20MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|198429-lamotrigine200MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|197886-Hydrochlorothiazide12.5MG/Lisinopril20MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|242446-Ofloxacin3MG/MLOticSolution|EXPANSION 632|1001|N|N|Y||Preferred Generic|313566-valganciclovir450MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|859186-selegilinehydrochloride5MGOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Brand|1302845-24HRPhentermine3.75MG/topiramate23MGExtendedReleaseOralCapsule[Qsymia]|EXPANSION 632|1001|N|N|N||Preferred Generic|858625-Pramipexoledihydrochloride0.75MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|861132-24HRAlfuzosinhydrochloride10MGExtendedReleaseOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|763565-0.4MLadalimumab50MG/MLPrefilledSyringe[Humira]|EXPANSION 632|1001|Y|N|N||Preferred Brand|700418-Thalidomide150MGOralCapsule[Thalomid]|EXPANSION 632|1001|N|N|Y||Preferred Generic|197900-Lorazepam0.5MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|758032-0.5MLInterferonbeta-1a0.044MG/MLPrefilledSyringe[Rebif]|EXPANSION 632|1001|N|N|N||Preferred Generic|311666-Metoclopramide10MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|668606-Vorinostat100MGOralCapsule[Zolinza]|EXPANSION 632|1001|Y|N|N||Preferred Brand|758027-0.5MLInterferonbeta-1a0.088MG/MLPrefilledSyringe[Rebif]|EXPANSION 632|1001|N|N|N||Preferred Generic|429503-Hydrochlorothiazide12.5MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1302856-24HRPhentermine15MG/topiramate92MGExtendedReleaseOralCapsule[Qsymia]|EXPANSION 632|1001|Y|N|N||Preferred Brand|706872-Azithromycin10MG/MLOphthalmicSolution[AzaSite]|EXPANSION 632|1001|N|N|N||Preferred Generic|858747-Ursodiol300MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Brand|616450-MycophenolicAcid180MGDelayedReleaseOralTablet[Myfortic]|EXPANSION 632|1001|N|N|Y||Preferred Generic|197738-Glycopyrrolate1MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|834235-febuxostat40MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|748740-Topotecan1MGOralCapsule[Hycamtin]|EXPANSION 632|1001|N|N|Y||Preferred Generic|1812011-Osmotic24HRNifedipine30MGExtendedReleaseOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|1359134-TiliaFe28DayPack|EXPANSION 632|1001|N|N|N||Preferred Generic|1099678-DivalproexSodium250MGDelayedReleaseOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|746609-nilotinib200MGOralCapsule[Tasigna]|EXPANSION 632|1001|Y|N|N||Preferred Generic|834241-febuxostat80MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|1607617-24HRdesvenlafaxinesuccinate25MGExtendedReleaseOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|432400-cinacalcet90MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|858828-EnalaprilMaleate10MG/Hydrochlorothiazide25MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|238151-mesalamine66.7MG/MLEnema|EXPANSION 632|1001|N|N|N||Preferred Generic|198546-CalciumGluconate500MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|310261-exemestane25MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|731231-0.3MLdarbepoetinalfa0.5MG/MLPrefilledSyringe[Aranesp]|EXPANSION 632|1001|N|N|N||Preferred Generic|432401-cinacalcet60MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|858804-EnalaprilMaleate2.5MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|731229-0.6MLdarbepoetinalfa0.5MG/MLPrefilledSyringe[Aranesp]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1149617-COLLAGENASE0.25UNT/MGTopicalOintment[Santyl]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1310138-everolimus2MGTabletforOralSuspension[Afinitor]|EXPANSION 632|1001|N|N|N||Preferred Generic|197409-Betamethasone0.001MG/MGTopicalOintment|EXPANSION 632|1001|N|N|Y||Preferred Generic|312840-rizatriptan5MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|198317-Triazolam0.125MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|727714-0.67MLanakinra149MG/MLPrefilledSyringe[Kineret]|EXPANSION 632|1001|N|N|Y||Preferred Brand|1658060-1MLHepatitisAVaccine(Inactivated)StrainHM1751440UNT/MLInjection[Havrix]|EXPANSION 632|1001|N|N|N||Preferred Brand|616449-MycophenolicAcid360MGDelayedReleaseOralTablet[Myfortic]|EXPANSION 632|1001|N|N|N||Preferred Generic|198440-Acetaminophen500MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|723846-orlistat60MGOralCapsule[Alli]|EXPANSION 632|1001|N|N|N||Preferred Generic|997491-Fexofenadinehydrochloride6MG/MLOralSuspension|EXPANSION 632|1001|N|N|N||Preferred Generic|1870230-NDA0208000.3MLEpinephrine1MG/MLAuto-Injector|EXPANSION 632|1001|Y|N|N||Preferred Brand|1310147-everolimus5MGTabletforOralSuspension[Afinitor]|EXPANSION 632|1001|N|Y|Y||Preferred Generic|311671-Metolazone5MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|978006-LoperamideHydrochloride2MGOralCapsule|EXPANSION 632|1001|N|N|Y||Preferred Generic|198189-Ramipril5MGOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Generic|854880-Zolpidemtartrate12.5MGExtendedReleaseOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|866427-24HRmetoprololsuccinate25MGExtendedReleaseOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|643722-lenalidomide25MGOralCapsule[Revlimid]|EXPANSION 632|1001|Y|N|Y||Preferred Brand|861771-Metforminhydrochloride1000MG/sitagliptin50MGOralTablet[Janumet]|EXPANSION 632|1001|N|N|N||Preferred Generic|1047905-HyoscyamineSulfate0.125MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|858616-Nicardipinehydrochloride30MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Brand|205562-Estramustine140MGOralCapsule[Emcyt]|EXPANSION 632|1001|N|N|N||Preferred Generic|244967-PolymyxinB10000UNT/ML/Trimethoprim1MG/MLOphthalmicSolution|EXPANSION 632|1001|Y|N|N||Preferred Brand|643488-Isotretinoin30MGOralCapsule[Claravis]|EXPANSION 632|1001|N|N|Y||Preferred Generic|242333-168HREstradiol0.00104MG/HRTransdermalSystem|EXPANSION 632|1001|N|N|N||Preferred Generic|886666-FlecainideAcetate100MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|858613-Nicardipinehydrochloride20MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|856783-AmitriptylineHydrochloride10MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|643175-dasatinib50MGOralTablet[Sprycel]|EXPANSION 632|1001|N|N|Y||Preferred Generic|728109-Oseltamivir30MGOralCapsule|EXPANSION 632|1001|N|Y|Y||Preferred Generic|998679-168HRClonidine0.0125MG/HRTransdermalSystem|EXPANSION 632|1001|Y|N|N||Preferred Brand|1310535-teriflunomide7MGOralTablet[Aubagio]|EXPANSION 632|1001|N|N|Y||Preferred Generic|1049225-Acetaminophen325MG/OxycodoneHydrochloride7.5MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|858810-EnalaprilMaleate20MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|616292-sunitinib50MGOralCapsule[Sutent]|EXPANSION 632|1001|N|N|Y||Preferred Brand|864650-Ganciclovir0.0015MG/MGOphthalmicGel[Zirgan]|EXPANSION 632|1001|N|N|N||Preferred Brand|1359027-MicrogestinFe1.5/3028DayPack|EXPANSION 632|1001|Y|N|N||Preferred Brand|1551888-0.2MLadalimumab50MG/MLPrefilledSyringe[Humira]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1000089-alcaftadine2.5MG/MLOphthalmicSolution[Lastacaft]|EXPANSION 632|1001|N|N|N||Preferred Brand|1359020-Microgestin1/2021DayPack|EXPANSION 632|1001|N|N|N||Preferred Generic|857461-ClemastineFumarate2.68MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|208949-Estrogens,Conjugated(USP)0.9MGOralTablet[Premarin]|EXPANSION 632|1001|N|N|N||Preferred Generic|992775-{1(MiconazoleNitrate1200MGVaginalInsert)/1(9000MG)(MiconazoleNitrate20MG/MLVaginalCream)}Pack|EXPANSION 632|1001|N|N|N||Preferred Generic|198509-Bisacodyl10MGRectalSuppository|EXPANSION 632|1001|Y|N|N||Preferred Brand|1313061-24HRPhentermine11.25MG/topiramate69MGExtendedReleaseOralCapsule[Qsymia]|EXPANSION 632|1001|N|N|N||Preferred Generic|198382-famciclovir500MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|615979-sorafenib200MGOralTablet[Nexavar]|EXPANSION 632|1001|Y|N|Y||Preferred Generic|106302-Tretinoin0.25MG/MLTopicalCream|EXPANSION 632|1001|N|N|N||Preferred Generic|1363309-ChlorpheniramineMaleate4MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1242968-exenatide2MGInjection[Bydureon]|EXPANSION 632|1001|Y|N|N||Preferred Brand|607579-entecavir0.05MG/MLOralSolution[Baraclude]|EXPANSION 632|1001|Y|N|N||Preferred Brand|731227-0.4MLdarbepoetinalfa0.1MG/MLPrefilledSyringe[Aranesp]|EXPANSION 632|1001|Y|N|N||Preferred Brand|603978-nepafenac1MG/MLOphthalmicSuspension[Nevanac]|EXPANSION 632|1001|N|N|N||Preferred Brand|616444-mycophenolatemofetil200MG/MLOralSuspension[Cellcept]|EXPANSION 632|1001|Y|N|Y||Preferred Generic|106303-Tretinoin0.5MG/MLTopicalCream|EXPANSION 632|1001|Y|N|N||Preferred Brand|582595-Iloprost0.01MG/MLInhalationSolution[Ventavis]|EXPANSION 632|1001|Y|N|N||Preferred Brand|580286-mesalamine500MGExtendedReleaseOralCapsule[Pentasa]|EXPANSION 632|1001|Y|N|N||Preferred Generic|860695-24HRgalantaminehydrobromide16MGExtendedReleaseOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Brand|540181-alosetron0.5MGOralTablet[Lotronex]|EXPANSION 632|1001|N|N|Y||Preferred Generic|1918194-60ACTUATfluticasonepropionate0.113MG/ACTUAT/salmeterol0.014MG/ACTUATDryPowderInhaler|EXPANSION 632|1001|N|N|N||Preferred Generic|310459-Gemfibrozil600MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|404449-Thalidomide100MGOralCapsule[Thalomid]|EXPANSION 632|1001|N|N|N||Preferred Generic|857301-ClomipramineHydrochloride50MGOralCapsule|EXPANSION 632|1001|Y|N|Y||Preferred Generic|197634-dronabinol10MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|245314-Albuterol5MG/MLInhalationSolution|EXPANSION 632|1001|N|N|N||Preferred Brand|1095362-Balziva28DayPack|EXPANSION 632|1001|Y|N|N||Preferred Brand|352262-1MLdarbepoetinalfa0.3MG/MLInjection[Aranesp]|EXPANSION 632|1001|N|N|Y||Preferred Generic|311975-Nicotine4MGChewingGum|EXPANSION 632|1001|N|N|N||Preferred Brand|751871-Nortrel1/3521DayPack|EXPANSION 632|1001|Y|N|N||Preferred Brand|352047-1MLdarbepoetinalfa0.1MG/MLInjection[Aranesp]|EXPANSION 632|1001|Y|N|N||Preferred Brand|352046-1MLdarbepoetinalfa0.06MG/MLInjection[Aranesp]|EXPANSION 632|1001|N|N|N||Preferred Generic|486131-BenzoylPeroxide0.1MG/MGTopicalGel|EXPANSION 632|1001|N|N|N||Preferred Generic|857183-FosinoprilSodium20MGOralTablet|EXPANSION 632|1001|Y|N|Y||Preferred Generic|197635-dronabinol2.5MGOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Generic|857700-DiclofenacSodium15MG/MLTopicalSolution|EXPANSION 632|1001|Y|N|N||Preferred Brand|352044-1MLdarbepoetinalfa0.025MG/MLInjection[Aranesp]|EXPANSION 632|1001|N|N|N||Preferred Brand|544597-PotassiumIodide1000MG/MLOralSolution[SSKIbrandofPotassiumIodide]|EXPANSION 632|1001|N|N|Y||Preferred Generic|801957-0.5MLDiazepam5MG/MLRectalGel|EXPANSION 632|1001|Y|N|N||Preferred Brand|261105-Etanercept25MG/MLInjectableSolution[Enbrel]|EXPANSION 632|1001|N|N|Y||Preferred Generic|198188-Ramipril2.5MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|198371-torsemide20MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|2557216-trikafta50MG/37.5MG/25MGand75MGPack|EXPANSION 632|1001|N|N|N||Preferred Brand|855205-docosanol100MG/MLTopicalCream[Abreva]|EXPANSION 632|1001|N|N|N||Preferred Generic|104884-Metoclopramide1MG/MLOralSolution|EXPANSION 632|1001|N|N|N||Preferred Generic|856845-AmitriptylineHydrochloride50MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1365866-nepafenac3MG/MLOphthalmicSuspension[Ilevro]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1364477-teduglutide5MGInjection[Gattex]|EXPANSION 632|1001|N|N|N||Preferred Generic|103401-Hydrocortisone0.025MG/MGTopicalOintment|EXPANSION 632|1001|Y|N|N||Preferred Brand|1364515-Bedaquiline100MGOralTablet[Sirturo]|EXPANSION 632|1001|N|N|N||Preferred Generic|198370-torsemide100MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|2536554-24HRviloxazine100MGExtendedReleaseOralCapsule[Qelbree]|EXPANSION 632|1001|N|N|N||Preferred Generic|1099563-24HRDivalproexSodium250MGExtendedReleaseOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|486148-24HRNitroglycerin0.2MG/HRTransdermalSystem|EXPANSION 632|1001|N|N|N||Preferred Brand|1039273-Hydrocortisone10MG/MLTopicalSolution[ScalpicinItchRelief]|EXPANSION 632|1001|N|N|N||Preferred Generic|1116758-chloroquinephosphate500MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|643102-Ibuprofen200MGOralTablet[Wal-Profen]|EXPANSION 632|1001|N|N|N||Preferred Generic|403966-zonisamide25MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|856825-AmitriptylineHydrochloride25MG/Perphenazine4MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|310809-Hydrochlorothiazide25MG/quinapril20MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|317769-Theophylline300MGExtendedReleaseOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|2475852-vericiguat10MGOralTablet[Verquvo]|EXPANSION 632|1001|Y|N|N||Preferred Brand|2475406-voclosporin7.9MGOralCapsule[Lupkynis]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1373333-Isotretinoin10MGOralCapsule[Zenatane]|EXPANSION 632|1001|Y|N|N||Preferred Brand|2473042-ponatinib10MGOralTablet[Iclusig]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1300803-24HRmirabegron50MGExtendedReleaseOralTablet[Myrbetriq]|EXPANSION 632|1001|N|N|N||Preferred Generic|198365-Prochlorperazine10MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|213282-hydroxyurea200MGOralCapsule[Droxia]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1373337-Isotretinoin40MGOralCapsule[Zenatane]|EXPANSION 632|1001|N|N|N||Preferred Generic|248109-Ribavirin200MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|617296-Amoxicillin500MG/Clavulanate125MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|2392142-0.5MLetanercept50MG/MLInjection[Enbrel]|EXPANSION 632|1001|N|N|N||Preferred Generic|310386-Fluoxetine4MG/MLOralSolution|EXPANSION 632|1001|N|N|N||Preferred Generic|486152-24HRNitroglycerin0.4MG/HRTransdermalSystem|EXPANSION 632|1001|N|N|N||Preferred Generic|756209-Zidovudine10MG/MLOralSolution|EXPANSION 632|1001|N|N|N||Preferred Generic|198352-Zidovudine100MGOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Brand|2373941-bedaquiline20MGOralTablet[Sirturo]|EXPANSION 632|1001|Y|N|N||Preferred Brand|2371768-Oriahnn28DayKit|EXPANSION 632|1001|N|N|N||Preferred Generic|856733-PropranololHydrochloride8MG/MLOralSolution|EXPANSION 632|1001|Y|N|N||Preferred Brand|2359358-24HRempagliflozin5MG/linagliptin2.5MG/metforminhydrochloride1000MGExtendedReleaseOralTablet[Trijardy]|EXPANSION 632|1001|Y|N|N||Preferred Brand|2359290-24HRempagliflozin12.5MG/linagliptin2.5MG/metforminhydrochloride1000MGExtendedReleaseOralTablet[Trijardy]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1592752-nintedanib150MGOralCapsule[Ofev]|EXPANSION 632|1001|N|N|Y||Preferred Generic|238004-168HREstradiol0.00417MG/HRTransdermalSystem|EXPANSION 632|1001|N|N|Y||Preferred Generic|351297-insulinaspartprotamine,human70UNT/ML/insulinaspart,human30UNT/MLInjectableSuspension|EXPANSION 632|1001|Y|N|N||Preferred Brand|2287905-1.5MLfremanezumab-vfrm150MG/MLAuto-Injector[Ajovy]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1375922-bromfenac0.7MG/MLOphthalmicSolution[Prolensa]|EXPANSION 632|1001|N|N|Y||Preferred Generic|1926331-0.5UNTDoses3MLInsulinLispro100UNT/MLPenInjector|EXPANSION 632|1001|N|N|N||Preferred Generic|260376-Terazosin10MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|198334-Sulfamethoxazole400MG/Trimethoprim80MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|848145-Amlodipine5MG/Hydrochlorothiazide25MG/valsartan160MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|2282414-bempedoicacid180MGOralTablet[Nexletol]|EXPANSION 632|1001|N|N|N||Preferred Generic|311725-Mirtazapine15MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|861064-Sertraline20MG/MLOralSolution|EXPANSION 632|1001|N|N|N||Preferred Generic|856578-PropranololHydrochloride80MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|106351-SilverSulfadiazine10MG/MLTopicalCream|EXPANSION 632|1001|N|N|N||Preferred Generic|197919-Melphalan2MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|284988-Didanosine400MGDelayedReleaseOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|198332-Trimethoprim100MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|544455-Lactulose667MG/MLOralSolution[Generlac]|EXPANSION 632|1001|N|N|N||Preferred Generic|1115005-DocusateSodium100MGOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Brand|2268227-ubrogepant100MGOralTablet[Ubrelvy]|EXPANSION 632|1001|N|N|N||Preferred Generic|1049167-PseudoephedrineHydrochloride60MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|404550-Estrogens,Conjugated(USP)0.45MGOralTablet[Premarin]|EXPANSION 632|1001|N|N|Y||Preferred Generic|104894-Ondansetron4MGDisintegratingOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|317173-Captopril25MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|197971-Methylprednisolone32MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|1000153-1MLmedroxyprogesteroneacetate150MG/MLPrefilledSyringe|EXPANSION 632|1001|Y|N|N||Preferred Generic|153823-candesartancilexetil8MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|2262727-MicronizedIsotretinoin32MGOralCapsule[Absorica]|EXPANSION 632|1001|Y|N|Y||Preferred Brand|665040-sitagliptin25MGOralTablet[Januvia]|EXPANSION 632|1001|N|N|N||Preferred Brand|202301-Estrogens,Conjugated(USP)1.25MGOralTablet[Premarin]|EXPANSION 632|1001|N|N|Y||Preferred Generic|807832-24HRLevetiracetam500MGExtendedReleaseOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|2262713-MicronizedIsotretinoin16MGOralCapsule[Absorica]|EXPANSION 632|1001|N|N|N||Preferred Generic|198293-Tolazamide500MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1431647-4MLgolimumab12.5MG/MLInjection[Simponi]|EXPANSION 632|1001|Y|N|N||Preferred Brand|2256947-lasmiditan50MGOralTablet[Reyvow]|EXPANSION 632|1001|N|N|N||Preferred Generic|562251-Amoxicillin250MG/Clavulanate125MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|1648759-NITROFURANTOIN,MACROCRYSTALS100MGOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Brand|857799-Treprostinil0.6MG/MLInhalationSolution[Tyvaso]|EXPANSION 632|1001|N|N|N||Preferred Generic|859040-Pramipexoledihydrochloride0.25MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|858040-saxagliptin5MGOralTablet[Onglyza]|EXPANSION 632|1001|N|N|N||Preferred Generic|995232-HydroxyzinePamoate100MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|198292-Tolazamide250MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|2203893-sofosbuvir200MGOralTablet[Sovaldi]|EXPANSION 632|1001|N|N|N||Preferred Generic|1099687-ValproicAcid50MG/MLOralSolution|EXPANSION 632|1001|Y|N|N||Preferred Brand|2201540-romiplostim0.125MGInjection[Nplate]|EXPANSION 632|1001|N|N|N||Preferred Generic|198555-Capsaicin0.25MG/MLTopicalCream|EXPANSION 632|1001|N|N|N||Preferred Generic|856373-TrazodoneHydrochloride100MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|2196592-120ACTUATformoterolfumarate0.005MG/ACTUAT/mometasonefuroate0.05MG/ACTUATMeteredDoseInhaler[Dulera]|EXPANSION 632|1001|N|N|N||Preferred Generic|856364-TrazodoneHydrochloride150MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|198630-ferrousgluconate324MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|753442-9HRMethylphenidate2.22MG/HRTransdermalSystem[Daytrana]|EXPANSION 632|1001|N|N|N||Preferred Brand|404509-CalciumCarbonate1000MG/Simethicone60MGChewableTablet[MaaloxMaxQuickDissolve]|EXPANSION 632|1001|N|N|N||Preferred Generic|995241-HydroxyzineHydrochloride2MG/MLOralSolution|EXPANSION 632|1001|Y|N|N||Preferred Generic|998189-everolimus2.5MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|2170993-1MLmepolizumab100MG/MLAuto-Injector[Nucala]|EXPANSION 632|1001|N|N|Y||Preferred Brand|1596445-7ACTUATumeclidinium0.0625MG/ACTUATDryPowderInhaler[Incruse]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1439896-riociguat1MGOralTablet[Adempas]|EXPANSION 632|1001|N|N|N||Preferred Generic|197682-Ethosuximide250MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|198239-Sulindac200MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1439899-riociguat1.5MGOralTablet[Adempas]|EXPANSION 632|1001|Y|N|Y||Preferred Generic|835809-testosteroneenanthate200MG/MLInjectableSolution|EXPANSION 632|1001|N|N|N||Preferred Generic|855906-DiclofenacSodium50MGDelayedReleaseOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|213360-Thalidomide50MGOralCapsule[Thalomid]|EXPANSION 632|1001|Y|N|N||Preferred Brand|753443-9HRMethylphenidate3.33MG/HRTransdermalSystem[Daytrana]|EXPANSION 632|1001|N|N|N||Preferred Generic|198238-Sulindac150MGOralTablet|EXPANSION 632|1001|Y|N|Y||Preferred Brand|665044-sitagliptin50MGOralTablet[Januvia]|EXPANSION 632|1001|Y|N|N||Preferred Brand|212219-EpoetinAlfa20000UNT/MLInjectableSolution[Procrit]|EXPANSION 632|1001|N|N|N||Preferred Generic|1801294-MicroencapsulatedPotassiumChloride20MEQExtendedReleaseOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|197313-Acyclovir800MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1439901-riociguat2MGOralTablet[Adempas]|EXPANSION 632|1001|N|N|N||Preferred Generic|562510-SodiumFluoride2MG/MLMouthwash|EXPANSION 632|1001|Y|N|N||Preferred Brand|2121100-siponimod2MGOralTablet[Mayzent]|EXPANSION 632|1001|N|Y|N||Preferred Generic|1368417-alogliptin12.5MG/pioglitazone45MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|859033-Pramipexoledihydrochloride0.125MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Generic|1490065-RaloxifeneHydrochloride60MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|992759-Homatropinehydrobromide50MG/MLOphthalmicSolution[Homatropaire]|EXPANSION 632|1001|N|N|N||Preferred Generic|1020477-DiphenhydramineHydrochloride50MGOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Brand|1429282-NeostigmineMethylsulfate0.5MG/MLInjectableSolution[Bloxiverz]|EXPANSION 632|1001|N|N|N||Preferred Generic|251156-ferroussulfate75MG/MLOralSolution|EXPANSION 632|1001|Y|N|N||Preferred Brand|2119391-Spravato56MGDoseKit|EXPANSION 632|1001|N|Y|N||Preferred Generic|197417-Bumetanide0.5MGOralTablet|EXPANSION 632|1001|Y|N|Y||Preferred Brand|861821-Metforminhydrochloride500MG/sitagliptin50MGOralTablet[Janumet]|EXPANSION 632|1001|Y|N|N||Preferred Brand|2119389-Spravato84MGDoseKit|EXPANSION 632|1001|N|N|N||Preferred Brand|993804-Gianvi28-DayPack|EXPANSION 632|1001|N|N|N||Preferred Generic|309045-Cefaclor250MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|198224-Hydrochlorothiazide25MG/Spironolactone25MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|751901-{84(EthinylEstradiol0.03MG/Levonorgestrel0.15MGOralTablet)/7(InertIngredients1MGOralTablet)}Pack|EXPANSION 632|1001|Y|N|N||Preferred Generic|900156-24HRlamotrigine200MGExtendedReleaseOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|855664-DiclofenacSodium25MGDelayedReleaseOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1441407-0.4MLMethotrexate25MG/MLAuto-Injector[Otrexup]|EXPANSION 632|1001|N|N|Y||Preferred Generic|608143-atomoxetine80MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|995253-HydroxyzinePamoate25MGOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Brand|208083-sargramostim0.25MG/MLInjectableSolution[Leukine]|EXPANSION 632|1001|N|N|N||Preferred Generic|1923424-SotalolHydrochloride160MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|1049630-DiphenhydramineHydrochloride25MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|207059-interferonbeta-1b0.3MGInjection[Betaseron]|EXPANSION 632|1001|N|N|N||Preferred Brand|201747-Primidone250MGOralTablet[Mysoline]|EXPANSION 632|1001|Y|N|N||Preferred Brand|206791-mesalamine250MGExtendedReleaseOralCapsule[Pentasa]|EXPANSION 632|1001|Y|N|Y||Preferred Generic|198300-Tretinoin1MG/MLTopicalCream|EXPANSION 632|1001|N|N|N||Preferred Generic|562524-12HRAcetazolamide500MGExtendedReleaseOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|562508-Amoxicillin875MG/Clavulanate125MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|855344-WarfarinSodium7.5MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|197528-Clonazepam1MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|198707-Hydrocortisone5MG/MLTopicalCream|EXPANSION 632|1001|Y|N|N||Preferred Brand|1729013-selexipag1MGOralTablet[Uptravi]|EXPANSION 632|1001|N|N|N||Preferred Generic|310169-Estradiol0.1MG/MLVaginalCream|EXPANSION 632|1001|N|N|N||Preferred Generic|197940-Methazolamide50MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|311289-Levetiracetam500MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|830845-24HRDiltiazemHydrochloride180MGExtendedReleaseOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Brand|205921-1MLEpoetinAlfa3000UNT/MLInjection[Epogen]|EXPANSION 632|1001|N|N|N||Preferred Generic|997229-Donepezilhydrochloride5MGOralTablet|EXPANSION 632|1001|Y|N|Y||Preferred Generic|312084-Ondansetron24MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|205918-1MLEpoetinAlfa2000UNT/MLInjection[Procrit]|EXPANSION 632|1001|N|Y|Y||Preferred Generic|483450-pregabalin75MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|856720-AmitriptylineHydrochloride10MG/Perphenazine4MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Brand|863841-amylase60000UNT/lipase12000UNT/protease38000UNTDelayedReleaseOralCapsule[Creon]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1441418-0.4MLMethotrexate50MG/MLAuto-Injector[Otrexup]|EXPANSION 632|1001|Y|N|Y||Preferred Generic|891888-MorphineSulfate30MGExtendedReleaseOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|312087-Ondansetron8MGDisintegratingOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|313428-Toremifene60MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|198202-Rifampin300MGOralCapsule|EXPANSION 632|1001|N|N|N||Preferred Generic|562704-ropinirole4MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|2058950-0.5MLomalizumab150MG/MLPrefilledSyringe[Xolair]|EXPANSION 632|1001|N|N|N||Preferred Generic|1094543-Briellyn28DayPack|EXPANSION 632|1001|N|N|N||Preferred Brand|630475-SodiumFluoride5.56MG/MLOralSolution[FluoraDay]|EXPANSION 632|1001|Y|N|N||Preferred Brand|2058946-1MLomalizumab150MG/MLPrefilledSyringe[Xolair]|EXPANSION 632|1001|N|N|N||Preferred Brand|404476-Azathioprine100MGOralTablet[Azasan]|EXPANSION 632|1001|N|N|N||Preferred Generic|855302-WarfarinSodium2MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|995278-HydroxyzinePamoate50MGOralCapsule|EXPANSION 632|1001|Y|N|N||Preferred Brand|2058877-1MLgalcanezumab-gnlm120MG/MLAuto-Injector[Emgality]|EXPANSION 632|1001|Y|N|N||Preferred Brand|1441530-0.9MLtocilizumab180MG/MLPrefilledSyringe[Actemra]|EXPANSION 632|1001|Y|N|N||Preferred Brand|2057216-0.8MLfilgrastim-aafi0.6MG/MLPrefilledSyringe[Nivestym]|EXPANSION 632|1001|Y|N|N||Preferred Brand|2057205-0.5MLfilgrastim-aafi0.6MG/MLPrefilledSyringe[Nivestym]|EXPANSION 632|1001|N|N|N||Preferred Generic|251322-Ethosuximide50MG/MLOralSolution|EXPANSION 632|1001|Y|N|N||Preferred Brand|2056670-AimovigAutoinjector2-Pack(140MGDose)|EXPANSION 632|1001|N|N|N||Preferred Generic|1094107-Phenazopyridinehydrochloride100MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1482513-eslicarbazepineacetate200MGOralTablet[Aptiom]|EXPANSION 632|1001|N|N|N||Preferred Generic|995258-HydroxyzineHydrochloride25MGOralTablet|EXPANSION 632|1001|N|N|Y||Preferred Generic|541892-Amphetamineaspartate2.5MG/AmphetamineSulfate2.5MG/Dextroamphetaminesaccharate2.5MG/DextroamphetamineSulfate2.5MGOralTa|EXPANSION 632|1001|N|N|N||Preferred Generic|993518-12HRBupropionHydrochloride150MGExtendedReleaseOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|861748-Glyburide2.5MG/Metforminhydrochloride500MGOralTablet|EXPANSION 632|1001|N|N|N||Preferred Generic|582926-podofilox5MG/MLTopicalSolution|EXPANSION 632|1001|Y|N|N||Preferred Brand|2053519-ivacaftor188MG/lumacaftor150MGOralGranules[ORKAMBI]|EXPANSION 632|1001|N|N|N||Preferred Generic|198175-Propylthiouracil50MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|727705-0.8MLadalimumab50MG/MLPrefilledSyringe[Humira]|EXPANSION 632|1001|N|N|N||Preferred Generic|309054-cefdinir25MG/MLOralSuspension|EXPANSION 632|1001|Y|N|N||Preferred Brand|2048568-tofacitinib10MGOralTablet[Xeljanz]|EXPANSION 632|1001|N|N|N||Preferred Generic|854905-BisoprololFumarate5MGOralTablet|EXPANSION 632|1001|Y|N|N||Preferred Brand|1441424-0.4MLMethotrexate62.5MG/MLAuto-Injector[Otrexup]|EXPANSION 632|1001|N|N|Y||Preferred Generic|238003-168HREstradiol0.00208MG/HRTransdermalSystem|EXPANSION 632|1001|Y|N|N||Preferred Generic|1092357-rufinamide40MG/MLOralSuspension|EXPANSION 632|1001|Y|N|N||Preferred Brand|2047614-1MLepoetinalfa-epbx4000UNT/MLInjection[Retacrit]|SPD 632|1001|N|N|N||Preferred Generic|854801-DiclofenacSodium1MG/MLOphthalmicSolution|SPD 632|1001|N|N|N||Preferred Brand|753482-Apri28DayPack|SPD 632|1001|Y|N|N||Preferred Brand|2047602-1MLepoetinalfa-epbx2000UNT/MLInjection[Retacrit]|SPD 632|1001|N|N|N||Preferred Generic|852913-QuinidineSulfate300MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|198153-Colchicine0.5MG/Probenecid500MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|197541-Colchicine0.6MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|1099870-DivalproexSodium500MGDelayedReleaseOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|2045638-1MLerenumab-aooe70MG/MLAuto-Injector[Aimovig]|SPD 632|1001|N|N|N||Preferred Generic|198152-Probenecid500MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|849515-DesmopressinAcetate0.1MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|995281-HydroxyzineHydrochloride50MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|2003767-1.14MLsarilumab175MG/MLAuto-Injector[Kevzara]|SPD 632|1001|N|N|N||Preferred Generic|849506-DesmopressinAcetate0.01MG/ACTUATNasalSpray|SPD 632|1001|Y|N|N||Preferred Brand|2001321-Roflumilast0.25MGOralTablet[Daliresp]|SPD 632|1001|Y|N|N||Preferred Brand|1486977-dapagliflozin10MGOralTablet[Farxiga]|SPD 632|1001|N|N|N||Preferred Generic|309686-Dexamethasone0.1MG/MLOralSolution|SPD 632|1001|N|N|N||Preferred Generic|198148-Prednisone50MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1999389-symdeko100MG/150MGand150MGPack|SPD 632|1001|Y|N|N||Preferred Brand|1726846-0.4MLadalimumab100MG/MLPrefilledSyringe[Humira]|SPD 632|1001|Y|N|N||Preferred Brand|1990869-0.85MLexenatide2.35MG/MLAuto-Injector[Bydureon]|SPD 632|1001|N|N|N||Preferred Generic|848176-AugmentedBetamethasone0.5MG/MLTopicalCream|SPD 632|1001|Y|N|N||Preferred Brand|1989109-1MLbenralizumab30MG/MLPrefilledSyringe[Fasenra]|SPD 632|1001|N|N|N||Preferred Brand|352210-Mesna400MGOralTablet[Mesnex]|SPD 632|1001|Y|N|N||Preferred Brand|1989085-bosentan32MGTabletforOralSuspension[Tracleer]|SPD 632|1001|N|N|N||Preferred Generic|847121-CalciumCitrate1500MG/Cholecalciferol250UNTOralTablet|SPD 632|1001|N|N|N||Preferred Generic|198146-Prednisone2.5MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|995599-EthambutolHydrochloride100MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1945048-30ACTUATfluticasonefuroate0.1MG/ACTUAT/umeclidinium0.0625MG/ACTUAT/vilanterol0.025MG/ACTUATDryPowderInhaler[Trelegy]|SPD 632|1001|N|N|N||Preferred Generic|252732-Melatonin5MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1927290-infliximab-abda100MGInjection[Renflexis]|SPD 632|1001|N|N|N||Preferred Generic|198145-Prednisone10MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|835925-cyclosporine,modified50MGOralCapsule|SPD 632|1001|Y|N|N||Preferred Brand|1925257-0.7MLabatacept125MG/MLPrefilledSyringe[Orencia]|SPD 632|1001|Y|N|N||Preferred Brand|1923347-1.14MLsarilumab175MG/MLPrefilledSyringe[Kevzara]|SPD 632|1001|Y|N|N||Preferred Brand|1923338-1.14MLsarilumab132MG/MLPrefilledSyringe[Kevzara]|SPD 632|1001|N|N|Y||Preferred Generic|312086-Ondansetron8MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|1085686-TriamcinoloneAcetonide5MG/MLTopicalCream|SPD 632|1001|Y|N|N||Preferred Brand|1921468-HumiraPen80MG/0.8MLand40MG/0.4ML-Psoriasis/UveitisStarterPackage(3count)|SPD 632|1001|N|N|N||Preferred Brand|1989117-0.3MLEpinephrine1MG/MLPrefilledSyringe[Symjepi]|SPD 632|1001|Y|N|N||Preferred Brand|1921245-HumiraPen80MG/0.8ML-StarterPackageforCrohn'sDisease,UlcerativeColitisorHidradenitisSuppurativa(3count)|SPD 632|1001|N|N|N||Preferred Generic|835886-cyclosporine,modified100MG/MLOralSolution|SPD 632|1001|Y|N|N||Preferred Brand|1921081-1.56MLabaloparatide2MG/MLPenInjector[Tymlos]|SPD 632|1001|N|N|N||Preferred Generic|309045-Cefaclor250MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|835593-ImipramineHydrochloride10MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|198141-Prazosin5MGOralCapsule|SPD 632|1001|Y|N|N||Preferred Brand|1876609-naldemedine0.2MGOralTablet[Symproic]|SPD 632|1001|N|N|N||Preferred Generic|310594-Gramicidin0.025MG/ML/Neomycin1.75MG/ML/PolymyxinB10000UNT/MLOphthalmicSolution|SPD 632|1001|Y|N|N||Preferred Brand|1873765-plecanatide3MGOralTablet[Trulance]|SPD 632|1001|N|N|N||Preferred Generic|198116-PotassiumChloride20MEQExtendedReleaseOralTablet|SPD 632|1001|N|N|N||Preferred Generic|835564-ImipramineHydrochloride25MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1873704-Mibelas24FeChewable28DayPack|SPD 632|1001|N|N|N||Preferred Brand|201337-Nadolol40MGOralTablet[Corgard]|SPD 632|1001|N|N|N||Preferred Generic|834127-chlorhexidinegluconate1.2MG/MLMouthwash|SPD 632|1001|Y|N|N||Preferred Brand|1872980-0.4MLadalimumab100MG/MLAuto-Injector[Humira]|SPD 632|1001|N|N|N||Preferred Generic|309952-Dipyridamole25MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|198108-Piroxicam20MGOralCapsule|SPD 632|1001|Y|N|N||Preferred Brand|1871467-lisdexamfetaminedimesylate60MGChewableTablet[Vyvanse]|SPD 632|1001|Y|N|N||Preferred Brand|1871465-lisdexamfetaminedimesylate10MGChewableTablet[Vyvanse]|SPD 632|1001|N|N|N||Preferred Generic|834061-PenicillinVPotassium250MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1871463-lisdexamfetaminedimesylate20MGChewableTablet[Vyvanse]|SPD 632|1001|N|N|Y||Preferred Generic|197590-Diazepam2MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1871461-lisdexamfetaminedimesylate30MGChewableTablet[Vyvanse]|SPD 632|1001|N|N|N||Preferred Generic|834046-PenicillinVPotassium25MG/MLOralSolution|SPD 632|1001|N|N|N||Preferred Generic|198107-Piroxicam10MGOralCapsule|SPD 632|1001|N|N|Y||Preferred Generic|197591-Diazepam5MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1870960-deflazacort36MGOralTablet[Emflaza]|SPD 632|1001|N|N|N||Preferred Generic|1367436-21DAYEthinylEstradiol0.000625MG/HR/Etonogestrel0.005MG/HRVaginalSystem|SPD 632|1001|Y|N|N||Preferred Brand|1870956-deflazacort18MGOralTablet[Emflaza]|SPD 632|1001|N|N|N||Preferred Generic|198105-Pindolol5MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|833528-Amiodaronehydrochloride200MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1870952-deflazacort30MGOralTablet[Emflaza]|SPD 632|1001|N|N|N||Preferred Generic|833217-DiltiazemHydrochloride30MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1868020-pirfenidone801MGOralTablet[Esbriet]|SPD 632|1001|Y|N|N||Preferred Brand|1868016-pirfenidone267MGOralTablet[Esbriet]|SPD 632|1001|N|N|N||Preferred Generic|1085636-TriamcinoloneAcetonide0.001MG/MGTopicalOintment|SPD 632|1001|N|N|N||Preferred Generic|198104-Pindolol10MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1858833-12HRTreprostinil5MGExtendedReleaseOralTablet[Orenitram]|SPD 632|1001|Y|N|N||Preferred Brand|1855527-HumiraPediatricCrohn'sDiseaseStarterPackage(2count)|SPD 632|1001|N|N|N||Preferred Generic|832909-CalciumCarbonate1250MG/Cholecalciferol100UNTChewableTablet|SPD 632|1001|Y|N|N||Preferred Brand|1813112-Rajani28DayPack|SPD 632|1001|N|N|N||Preferred Generic|313423-Tolnaftate10MG/MLTopicalSolution|SPD 632|1001|Y|N|N||Preferred Brand|1812470-ivacaftor125MG/lumacaftor100MGOralTablet[ORKAMBI]|SPD 632|1001|N|N|N||Preferred Generic|831261-CromolynSodium20MG/MLOralSolution|SPD 632|1001|N|N|N||Preferred Generic|198102-vitaminK15MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|995632-MeclizineHydrochloride25MGChewableTablet|SPD 632|1001|Y|N|N||Preferred Brand|1801519-Methylnaltrexonebromide150MGOralTablet[Relistor]|SPD 632|1001|Y|N|N||Preferred Brand|825170-HumiraPen40MG/0.8ML-Crohn'sDiseaseStarterPack|SPD 632|1001|Y|N|N||Preferred Brand|1801322-3.5MLevolocumab120MG/MLCartridge[Repatha]|SPD 632|1001|N|N|N||Preferred Generic|860981-24HRMetforminhydrochloride750MGExtendedReleaseOralTablet|SPD 632|1001|N|N|N||Preferred Generic|198089-Phenobarbital60MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|831103-DiltiazemHydrochloride60MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1801278-HumiraPsoriasisStarterPack40MG/0.8MLPen(4count)|SPD 632|1001|Y|N|N||Preferred Brand|1796096-24HRLinagliptin5MG/Metforminhydrochloride1000MGExtendedReleaseOralTablet[Jentadueto]|SPD 632|1001|N|N|N||Preferred Generic|198086-Phenobarbital16.2MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|859424-Rosuvastatincalcium5MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1747194-0.4MLMethotrexate56.3MG/MLAuto-Injector[Otrexup]|SPD 632|1001|N|N|N||Preferred Generic|830882-24HRDiltiazemHydrochloride300MGExtendedReleaseOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1747187-0.4MLMethotrexate43.8MG/MLAuto-Injector[Otrexup]|SPD 632|1001|N|N|N||Preferred Generic|309955-Dipyridamole75MGOralTablet|SPD 632|1001|N|N|N||Preferred Brand|351487-thyroid(USP)130MGOralTablet[Westhroid]|SPD 632|1001|Y|N|N||Preferred Brand|1747181-0.4MLMethotrexate31.3MG/MLAuto-Injector[Otrexup]|SPD 632|1001|N|N|N||Preferred Brand|1358765-JunelFe1/2028DayPack|SPD 632|1001|N|N|N||Preferred Generic|253039-Melatonin1MG/MLOralSolution|SPD 632|1001|N|N|N||Preferred Generic|198083-Phenobarbital100MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|1049909-DiphenhydramineHydrochloride25MGOralCapsule|SPD 632|1001|Y|N|N||Preferred Brand|1745114-1MLixekizumab80MG/MLPrefilledSyringe[Taltz]|SPD 632|1001|Y|N|N||Preferred Brand|1745108-1MLixekizumab80MG/MLAuto-Injector[Taltz]|SPD 632|1001|Y|N|N||Preferred Brand|1741049-24HRtofacitinib11MGExtendedReleaseOralTablet[Xeljanz]|SPD 632|1001|N|N|N||Preferred Generic|198049-Ofloxacin300MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|801054-POLYETHYLENEGLYCOL3350420000MG/PotassiumChloride1480MG/SodiumBicarbonate5720MG/SodiumChloride11200MGPowderforOralSolut|SPD 632|1001|N|N|N||Preferred Generic|253059-Levocarnitine500MGOralCapsule|SPD 632|1001|N|N|Y||Preferred Generic|197738-Glycopyrrolate1MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|763185-{21(Prednisone10MGOralTablet)}Pack|SPD 632|1001|Y|N|N||Preferred Brand|1732161-incobotulinumtoxinA100UNTInjection[Xeomin]|SPD 632|1001|Y|N|N||Preferred Brand|1732157-incobotulinumtoxinA50UNTInjection[Xeomin]|SPD 632|1001|N|N|N||Preferred Generic|106351-SilverSulfadiazine10MG/MLTopicalCream|SPD 632|1001|N|N|N||Preferred Generic|198047-Nortriptyline75MGOralCapsule|SPD 632|1001|Y|N|N||Preferred Brand|1729065-selexipag0.8MGOralTablet[Uptravi]|SPD 632|1001|N|N|N||Preferred Generic|762675-{21(Methylprednisolone4MGOralTablet)}Pack|SPD 632|1001|Y|N|N||Preferred Brand|1729061-selexipag0.6MGOralTablet[Uptravi]|SPD 632|1001|N|N|N||Preferred Generic|311288-Levetiracetam250MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1729057-selexipag0.4MGOralTablet[Uptravi]|SPD 632|1001|N|N|N||Preferred Generic|756209-Zidovudine10MG/MLOralSolution|SPD 632|1001|N|N|N||Preferred Generic|198046-Nortriptyline50MGOralCapsule|SPD 632|1001|N|N|Y||Preferred Generic|197739-Glycopyrrolate2MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|617309-Amoxicillin200MG/Clavulanate28.5MGChewableTablet|SPD 632|1001|Y|N|N||Preferred Brand|1729029-selexipag1.2MGOralTablet[Uptravi]|SPD 632|1001|N|N|N||Preferred Generic|198045-Nortriptyline10MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|312055-Nystatin100000UNT/MLOralSuspension|SPD 632|1001|N|N|N||Preferred Generic|751901-{84(EthinylEstradiol0.03MG/Levonorgestrel0.15MGOralTablet)/7(InertIngredients1MGOralTablet)}Pack|SPD 632|1001|Y|N|N||Preferred Brand|1729013-selexipag1MGOralTablet[Uptravi]|SPD 632|1001|N|N|Y||Preferred Brand|998666-carboxymethylcellulosesodium0.01MG/MGOphthalmicGel[TheraTears]|SPD 632|1001|N|N|N||Preferred Generic|1923428-Timolol2.5MG/MLOphthalmicSolution|SPD 632|1001|N|N|N||Preferred Generic|749860-{21(EthinylEstradiol0.035MG/norgestimate0.25MGOralTablet)/7(InertIngredients1MGOralTablet)}Pack|SPD 632|1001|Y|N|N||Preferred Brand|1728095-romiplostim0.25MGInjection[Nplate]|SPD 632|1001|N|N|N||Preferred Generic|310015-dorzolamide20MG/MLOphthalmicSolution|SPD 632|1001|N|N|N||Preferred Generic|198040-Nitroglycerin0.6MGSublingualTablet|SPD 632|1001|Y|N|N||Preferred Brand|1544386-0.25MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|SPD 632|1001|Y|N|N||Preferred Brand|1726639-ponatinib30MGOralTablet[Iclusig]|SPD 632|1001|Y|N|N||Preferred Brand|1721690-1MLEpoetinAlfa10000UNT/MLInjection[Procrit]|SPD 632|1001|N|N|N||Preferred Generic|749783-{6(Azithromycin250MGOralTablet)}Pack|SPD 632|1001|Y|N|N||Preferred Brand|1721685-1MLEpoetinAlfa10000UNT/MLInjection[Epogen]|SPD 632|1001|Y|N|N||Preferred Brand|1720606-mepolizumab100MGInjection[Nucala]|SPD 632|1001|N|N|N||Preferred Generic|242446-Ofloxacin3MG/MLOticSolution|SPD 632|1001|N|N|N||Preferred Generic|749780-{3(Azithromycin500MGOralTablet)}Pack|SPD 632|1001|N|N|N||Preferred Generic|198039-Nitroglycerin0.4MGSublingualTablet|SPD 632|1001|N|N|N||Preferred Brand|207588-Procarbazine50MGOralCapsule[Matulane]|SPD 632|1001|N|N|Y||Preferred Generic|197877-Lidocaine25MG/ML/Prilocaine25MG/MLTopicalCream|SPD 632|1001|N|N|N||Preferred Generic|996561-Memantinehydrochloride10MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1665900-1MLevolocumab140MG/MLAuto-Injector[Repatha]|SPD 632|1001|N|N|N||Preferred Generic|2532159-PMDDfluoxetine10MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1663728-Isotretinoin30MGOralCapsule[Myorisan]|SPD 632|1001|N|N|N||Preferred Generic|198038-Nitroglycerin0.3MGSublingualTablet|SPD 632|1001|N|N|N||Preferred Generic|748961-{28(Norethindrone0.35MGOralTablet)}Pack|SPD 632|1001|Y|N|N||Preferred Brand|1661567-TOBIPodhalerDailyKit,8|SPD 632|1001|Y|N|N||Preferred Brand|1660938-60ACTUATformoterolfumarate0.005MG/ACTUAT/mometasonefuroate0.2MG/ACTUATMeteredDoseInhaler[Dulera]|SPD 632|1001|N|N|N||Preferred Generic|996520-DextromethorphanHydrobromide2MG/ML/Guaifenesin20MG/MLOralSolution|SPD 632|1001|N|N|N||Preferred Generic|748868-{21(EthinylEstradiol0.02MG/Levonorgestrel0.1MGOralTablet)/7(InertIngredients1MGOralTablet)}Pack|SPD 632|1001|Y|N|N||Preferred Brand|1660934-60ACTUATformoterolfumarate0.005MG/ACTUAT/mometasonefuroate0.1MG/ACTUATMeteredDoseInhaler[Dulera]|SPD 632|1001|N|N|N||Preferred Brand|1998772-Breath-Actuated120ACTUATBeclomethasoneDipropionate0.08MG/ACTUATMeteredDoseInhaler[Qvar]|SPD 632|1001|Y|N|N||Preferred Brand|1657982-20MLtocilizumab20MG/MLInjection[Actemra]|SPD 632|1001|N|N|N||Preferred Generic|105585-Methotrexate2.5MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|198033-Nifedipine20MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|748800-{21(drospirenone3MG/EthinylEstradiol0.03MGOralTablet)/7(InertIngredients1MGOralTablet)}Pack|SPD 632|1001|Y|N|N||Preferred Brand|1657980-10MLtocilizumab20MG/MLInjection[Actemra]|SPD 632|1001|Y|N|N||Preferred Brand|1657976-4MLtocilizumab20MG/MLInjection[Actemra]|SPD 632|1001|N|N|N||Preferred Generic|727316-NDA0194300.3MLEpinephrine0.5MG/MLAuto-Injector|SPD 632|1001|Y|N|N||Preferred Brand|1655934-ivacaftor125MG/lumacaftor200MGOralTablet[ORKAMBI]|SPD 632|1001|N|N|N||Preferred Generic|198032-Nifedipine10MGOralCapsule|SPD 632|1001|Y|N|N||Preferred Brand|1654630-1MLglatirameracetate20MG/MLPrefilledSyringe[Glatopa]|SPD 632|1001|Y|N|N||Preferred Brand|1654079-0.5MLustekinumab90MG/MLInjection[Stelara]|SPD 632|1001|Y|N|N||Preferred Brand|1653243-1MLsecukinumab150MG/MLAuto-Injector[Cosentyx]|SPD 632|1001|N|N|N||Preferred Generic|198024-Niacin500MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|722131-Amlodipine10MG/valsartan320MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1653225-1MLEtanercept50MG/MLAuto-Injector[Enbrel]|SPD 632|1001|N|N|N||Preferred Generic|722126-Amlodipine10MG/valsartan160MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1653144-0.5MLgolimumab100MG/MLAuto-Injector[Simponi]|SPD 632|1001|N|N|N||Preferred Generic|310154-Erythromycin250MGDelayedReleaseOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|198014-Naproxen500MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1650282-RebifRebidoseTitrationPack|SPD 632|1001|Y|N|N||Preferred Brand|1650004-0.5MLInterferonbeta-1a0.088MG/MLAuto-Injector[Rebif]|SPD 632|1001|N|N|N||Preferred Generic|702249-ferroussulfate44MG/MLOralSolution|SPD 632|1001|Y|N|N||Preferred Brand|1649996-0.5MLInterferonbeta-1a0.044MG/MLAuto-Injector[Rebif]|SPD 632|1001|N|N|Y||Preferred Generic|197900-Lorazepam0.5MGOralTablet|SPD 632|1001|N|N|N||Preferred Brand|284551-nilutamide150MGOralTablet[Nilandron]|SPD 632|1001|Y|N|N||Preferred Brand|1649605-PlegridyPenStarterPack|SPD 632|1001|N|N|N||Preferred Generic|692783-Loratadine1MG/MLOralSolution|SPD 632|1001|N|N|N||Preferred Generic|1053753-Nystatin100000UNT/ML/TriamcinoloneAcetonide1MG/MLTopicalCream|SPD 632|1001|N|N|N||Preferred Generic|198013-Naproxen250MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|197902-Lorazepam2MGOralTablet|SPD 632|1001|N|N|N||Preferred Brand|260409-prednisolone1MG/MLOralSolution[Pediapred]|SPD 632|1001|Y|N|N||Preferred Brand|1648789-30ACTUATfluticasonefuroate0.2MG/ACTUAT/vilanterol0.025MG/ACTUATDryPowderInhaler[Breo]|SPD 632|1001|N|N|N||Preferred Generic|198012-Naproxen375MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|686418-ErythromycinEthylsuccinate80MG/MLOralSuspension|SPD 632|1001|N|N|Y||Preferred Brand|901644-0.5MLStreptococcuspneumoniaeserotype1capsularantigendiphtheriaCRM197proteinconjugatevaccine0.0044MG/ML/Streptococcuspn|SPD 632|1001|N|N|N||Preferred Generic|686405-ErythromycinEthylsuccinate400MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1605455-Otezla28-DayStarterPack|SPD 632|1001|Y|N|N||Preferred Brand|1605172-0.4MLdarbepoetinalfa0.025MG/MLPrefilledSyringe[Aranesp]|SPD 632|1001|N|N|N||Preferred Generic|1053697-Nystatin100UNT/MG/TriamcinoloneAcetonide0.001MG/MGTopicalOintment|SPD 632|1001|N|N|N||Preferred Generic|197987-Minoxidil2.5MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|1801289-SmokingCessation12HRBupropionHydrochloride150MGExtendedReleaseOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1605071-0.5MLFILGRASTIM-SNDZ0.6MG/MLPrefilledSyringe[Zarxio]|SPD 632|1001|N|N|N||Preferred Generic|647121-5MLLevetiracetam100MG/MLInjection|SPD 632|1001|Y|N|N||Preferred Brand|1601373-naloxegol25MGOralTablet[Movantik]|SPD 632|1001|Y|N|N||Preferred Brand|1599797-1MLsecukinumab150MG/MLPrefilledSyringe[Cosentyx]|SPD 632|1001|N|N|N||Preferred Generic|646456-Nystatin100UNT/MGTopicalPowder|SPD 632|1001|N|N|N||Preferred Generic|197986-Minoxidil10MGOralTablet|SPD 632|1001|N|N|N||Preferred Brand|105590-Thioguanine40MGOralTablet[Tabloid]|SPD 632|1001|N|N|N||Preferred Generic|1376336-prednisoloneacetate10MG/MLOphthalmicSuspension|SPD 632|1001|Y|N|N||Preferred Brand|1596023-ferriccitrate1000MGOralTablet[Auryxia]|SPD 632|1001|N|N|N||Preferred Brand|1293864-ErgotamineTartrate2MGSublingualTablet[Ergomar]|SPD 632|1001|Y|N|N||Preferred Brand|1594358-HumiraPediatricCrohn'sDiseaseStarterPackage(3count)|SPD 632|1001|Y|N|N||Preferred Brand|854836-lisdexamfetaminedimesylate30MGOralCapsule[Vyvanse]|SPD 632|1001|Y|N|N||Preferred Brand|849599-1MLcertolizumabpegol200MG/MLPrefilledSyringe[Cimzia]|SPD 632|1001|Y|N|N||Preferred Brand|1593858-lisdexamfetaminedimesylate10MGOralCapsule[Vyvanse]|SPD 632|1001|N|N|N||Preferred Generic|197973-Methylprednisolone8MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|643102-Ibuprofen200MGOralTablet[Wal-Profen]|SPD 632|1001|N|N|N||Preferred Brand|1995479-amylase168000UNT/lipase40000UNT/protease126000UNTDelayedReleaseOralCapsule[Zenpep]|SPD 632|1001|Y|N|N||Preferred Brand|1593831-24HRdapagliflozin5MG/Metforminhydrochloride500MGExtendedReleaseOralTablet[Xigduo]|SPD 632|1001|N|N|N||Preferred Generic|197971-Methylprednisolone32MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1592748-nintedanib100MGOralCapsule[Ofev]|SPD 632|1001|N|N|N||Preferred Generic|617993-Amoxicillin120MG/ML/Clavulanate8.58MG/MLOralSuspension|SPD 632|1001|N|N|N||Preferred Generic|310155-Erythromycin250MGDelayedReleaseOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1551923-naloxegol12.5MGOralTablet[Movantik]|SPD 632|1001|N|N|N||Preferred Generic|309044-Cefaclor25MG/MLOralSuspension|SPD 632|1001|N|N|N||Preferred Generic|617430-Amoxicillin80MG/ML/Clavulanate11.4MG/MLOralSuspension|SPD 632|1001|N|N|N||Preferred Generic|197963-Hydrochlorothiazide15MG/Methyldopa250MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1666334-Ticagrelor60MGOralTablet[Brilinta]|SPD 632|1001|N|N|N||Preferred Generic|312440-pioglitazone30MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|997220-Donepezilhydrochloride10MGDisintegratingOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1546198-PlegridyStarterPack|SPD 632|1001|N|N|N||Preferred Brand|209531-Acetaminophen80MGRectalSuppository[Feverall]|SPD 632|1001|Y|N|N||Preferred Brand|1546189-0.5MLpeginterferonbeta-1a0.25MG/MLPrefilledSyringe[Plegridy]|SPD 632|1001|Y|N|N||Preferred Brand|1545174-hydrocortisoneacetate100MG/MLRectalFoam[Cortifoam]|SPD 632|1001|N|N|N||Preferred Generic|197960-Hydrochlorothiazide25MG/Methyldopa250MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|617322-Amoxicillin50MG/ML/Clavulanate12.5MG/MLOralSuspension|SPD 632|1001|N|N|N||Preferred Generic|259966-Methylprednisolone4MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|198035-24HRNifedipine60MGExtendedReleaseOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1544918-0.65MLexenatide3.08MG/MLPenInjector[Bydureon]|SPD 632|1001|N|N|N||Preferred Generic|617316-Amoxicillin400MG/Clavulanate57MGChewableTablet|SPD 632|1001|Y|N|N||Preferred Brand|1544404-0.15MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|SPD 632|1001|Y|N|N||Preferred Brand|1544402-0.6MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|SPD 632|1001|N|N|N||Preferred Generic|1050077-DiphenhydramineHydrochloride20MG/MLTopicalCream|SPD 632|1001|N|N|N||Preferred Generic|197958-Methyldopa500MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|617312-atorvastatin10MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1544398-0.5MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|SPD 632|1001|Y|N|N||Preferred Brand|1544396-0.45MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|SPD 632|1001|N|N|N||Preferred Generic|617311-atorvastatin40MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1544394-0.4MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|SPD 632|1001|Y|N|N||Preferred Brand|1544390-0.35MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|SPD 632|1001|Y|N|N||Preferred Generic|999967-Amlodipine5MG/Hydrochlorothiazide12.5MG/Olmesartanmedoxomil20MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|617310-atorvastatin20MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1544388-0.3MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|SPD 632|1001|N|N|N||Preferred Generic|197956-Methyldopa250MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|198036-24HRNifedipine90MGExtendedReleaseOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|854840-lisdexamfetaminedimesylate40MGOralCapsule[Vyvanse]|SPD 632|1001|Y|N|N||Preferred Brand|1544383-0.2MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|SPD 632|1001|Y|N|N||Preferred Brand|1541928-sunitinib37.5MGOralCapsule[Sutent]|SPD 632|1001|N|N|N||Preferred Generic|617423-Amoxicillin40MG/ML/Clavulanate5.7MG/MLOralSuspension|SPD 632|1001|N|N|N||Preferred Generic|197944-Methocarbamol750MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|617296-Amoxicillin500MG/Clavulanate125MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|997223-Donepezilhydrochloride10MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1539893-30ACTUATfluticasonefuroate0.1MG/ACTUAT/vilanterol0.025MG/ACTUATDryPowderInhaler[Breo]|SPD 632|1001|Y|N|N||Preferred Brand|153324-Interferonbeta-1a0.03MGInjection[Avonex]|SPD 632|1001|N|N|N||Preferred Generic|598025-Amoxicillin250MGChewableTablet|SPD 632|1001|Y|N|N||Preferred Brand|1551886-lanthanumcarbonate750MGOralPowder[Fosrenol]|SPD 632|1001|Y|N|N||Preferred Brand|1492746-apremilast30MGOralTablet[Otezla]|SPD 632|1001|N|N|N||Preferred Generic|1000070-DoxepinHydrochloride25MGOralCapsule|SPD 632|1001|Y|N|N||Preferred Brand|1488679-12HRTreprostinil2.5MGExtendedReleaseOralTablet[Orenitram]|SPD 632|1001|N|N|N||Preferred Generic|310157-Erythromycin500MGDelayedReleaseOralTablet|SPD 632|1001|N|N|N||Preferred Generic|197943-Methocarbamol500MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|598006-Erythromycin250MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1488675-12HRTreprostinil1MGExtendedReleaseOralTablet[Orenitram]|SPD 632|1001|N|N|N||Preferred Brand|856467-Tri-Lo-Sprintec28DayPack|SPD 632|1001|Y|N|N||Preferred Brand|1488671-12HRTreprostinil0.25MGExtendedReleaseOralTablet[Orenitram]|SPD 632|1001|N|N|N||Preferred Generic|597852-anagrelide1MGOralCapsule|SPD 632|1001|Y|N|N||Preferred Brand|1488667-12HRTreprostinil0.125MGExtendedReleaseOralTablet[Orenitram]|SPD 632|1001|N|N|N||Preferred Brand|2564406-influenzaAvirusA/Tasmania/503/2020(H3N2)antigen158000000UNT/ML/influenzaAvirusA/Victoria/1/2020(H1N1)antigen158000000|SPD 632|1001|Y|N|N||Preferred Brand|1487076-DiclofenacSodium20MG/MLTopicalSolution[Pennsaid]|SPD 632|1001|N|N|N||Preferred Generic|596843-lansoprazole15MGDelayedReleaseOralCapsule|SPD 632|1001|Y|N|N||Preferred Brand|1486981-dapagliflozin5MGOralTablet[Farxiga]|SPD 632|1001|N|N|N||Preferred Generic|1049906-DiphenhydramineHydrochloride2.5MG/MLOralSolution|SPD 632|1001|N|N|N||Preferred Generic|197942-Methimazole5MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|854848-lisdexamfetaminedimesylate60MGOralCapsule[Vyvanse]|SPD 632|1001|N|N|N||Preferred Generic|997226-Donepezilhydrochloride5MGDisintegratingOralTablet|SPD 632|1001|N|N|N||Preferred Generic|583170-Salsalate750MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1484296-sucroferricoxyhydroxide500MGChewableTablet[Velphoro]|SPD 632|1001|N|N|N||Preferred Generic|312515-PotassiumChloride1.33MEQ/MLOralSolution|SPD 632|1001|N|N|N||Preferred Generic|260243-Progesterone100MGOralCapsule|SPD 632|1001|Y|N|N||Preferred Brand|1482814-1MLgolimumab100MG/MLPrefilledSyringe[Simponi]|SPD 632|1001|N|N|N||Preferred Generic|197941-Methimazole10MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|582926-podofilox5MG/MLTopicalSolution|SPD 632|1001|Y|N|N||Preferred Brand|1482513-eslicarbazepineacetate200MGOralTablet[Aptiom]|SPD 632|1001|Y|N|N||Preferred Brand|1442143-Macitentan10MGOralTablet[Opsumit]|SPD 632|1001|Y|N|N||Preferred Brand|1441530-0.9MLtocilizumab180MG/MLPrefilledSyringe[Actemra]|SPD 632|1001|Y|N|N||Preferred Brand|1551888-0.2MLadalimumab50MG/MLPrefilledSyringe[Humira]|SPD 632|1001|Y|N|N||Preferred Brand|1441424-0.4MLMethotrexate62.5MG/MLAuto-Injector[Otrexup]|SPD 632|1001|N|N|Y||Preferred Generic|311918-naratriptan1MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|1049630-DiphenhydramineHydrochloride25MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|197940-Methazolamide50MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1441418-0.4MLMethotrexate50MG/MLAuto-Injector[Otrexup]|SPD 632|1001|N|N|Y||Preferred Generic|351297-insulinaspartprotamine,human70UNT/ML/insulinaspart,human30UNT/MLInjectableSuspension|SPD 632|1001|N|N|N||Preferred Generic|197409-Betamethasone0.001MG/MGTopicalOintment|SPD 632|1001|Y|N|N||Preferred Brand|1441413-0.4MLMethotrexate37.5MG/MLAuto-Injector[Otrexup]|SPD 632|1001|N|N|N||Preferred Generic|562524-12HRAcetazolamide500MGExtendedReleaseOralCapsule|SPD 632|1001|Y|N|N||Preferred Brand|1441407-0.4MLMethotrexate25MG/MLAuto-Injector[Otrexup]|SPD 632|1001|Y|N|N||Preferred Brand|1439903-riociguat2.5MGOralTablet[Adempas]|SPD 632|1001|Y|N|N||Preferred Brand|1592285-pirfenidone267MGOralCapsule[Esbriet]|SPD 632|1001|N|N|N||Preferred Generic|197939-Methazolamide25MGOralTablet|SPD 632|1001|N|N|N||Preferred Brand|2110516-60ACTUATFluticasonepropionate0.5MG/ACTUAT/salmeterol0.05MG/ACTUATDryPowderInhaler[Wixela]|SPD 632|1001|N|N|N||Preferred Generic|861010-Metforminhydrochloride850MGOralTablet|SPD 632|1001|N|N|N||Preferred Brand|905379-HydralazineHydrochloride37.5MG/IsosorbideDinitrate20MGOralTablet[Bidil]|SPD 632|1001|N|N|N||Preferred Generic|562508-Amoxicillin875MG/Clavulanate125MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1439896-riociguat1MGOralTablet[Adempas]|SPD 632|1001|N|N|N||Preferred Generic|1052760-magnesiumcitrate58.2MG/MLOralSolution|SPD 632|1001|Y|N|N||Preferred Brand|1439894-riociguat0.5MGOralTablet[Adempas]|SPD 632|1001|N|N|N||Preferred Generic|197931-mercaptopurine50MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|894780-MorphineSulfate4MG/MLOralSolution|SPD 632|1001|N|N|N||Preferred Generic|562251-Amoxicillin250MG/Clavulanate125MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1431647-4MLgolimumab12.5MG/MLInjection[Simponi]|SPD 632|1001|Y|N|N||Preferred Brand|1429367-lenalidomide20MGOralCapsule[Revlimid]|SPD 632|1001|N|N|N||Preferred Generic|544455-Lactulose667MG/MLOralSolution[Generlac]|SPD 632|1001|Y|N|N||Preferred Brand|1429284-NeostigmineMethylsulfate1MG/MLInjectableSolution[Bloxiverz]|SPD 632|1001|Y|N|N||Preferred Brand|1429282-NeostigmineMethylsulfate0.5MG/MLInjectableSolution[Bloxiverz]|SPD 632|1001|N|N|N||Preferred Generic|1923809-thyroid(USP)120MGOralTablet[NPThyroid]|SPD 632|1001|N|N|N||Preferred Generic|310169-Estradiol0.1MG/MLVaginalCream|SPD 632|1001|N|N|N||Preferred Generic|197919-Melphalan2MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|543546-Nystatin100000UNT/MLTopicalCream|SPD 632|1001|Y|N|N||Preferred Brand|1375922-bromfenac0.7MG/MLOphthalmicSolution[Prolensa]|SPD 632|1001|Y|N|N||Preferred Brand|1374574-TOBIPodhalerKit,224|SPD 632|1001|N|N|N||Preferred Generic|486152-24HRNitroglycerin0.4MG/HRTransdermalSystem|SPD 632|1001|N|N|Y||Preferred Brand|901518-0.5MLNeisseriameningitidisserogroupAoligosaccharidediphtheriaCRM197proteinconjugatevaccine0.02MG/ML/Neisseriameningiti|SPD 632|1001|Y|N|N||Preferred Brand|1373337-Isotretinoin40MGOralCapsule[Zenatane]|SPD 632|1001|N|N|Y||Preferred Generic|198052-Ondansetron4MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|858040-saxagliptin5MGOralTablet[Onglyza]|SPD 632|1001|Y|N|N||Preferred Brand|1373335-Isotretinoin20MGOralCapsule[Zenatane]|SPD 632|1001|N|N|N||Preferred Generic|486148-24HRNitroglycerin0.2MG/HRTransdermalSystem|SPD 632|1001|N|N|N||Preferred Generic|104884-Metoclopramide1MG/MLOralSolution|SPD 632|1001|N|N|N||Preferred Generic|197905-Lovastatin40MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|198188-Ramipril2.5MGOralCapsule|SPD 632|1001|Y|N|N||Preferred Brand|1365866-nepafenac3MG/MLOphthalmicSuspension[Ilevro]|SPD 632|1001|N|N|N||Preferred Generic|486146-24HRNitroglycerin0.6MG/HRTransdermalSystem|SPD 632|1001|Y|N|N||Preferred Brand|1364515-Bedaquiline100MGOralTablet[Sirturo]|SPD 632|1001|N|N|N||Preferred Generic|142034-BenzoylPeroxide100MG/MLMedicatedLiquidSoap|SPD 632|1001|Y|N|N||Preferred Brand|1364477-teduglutide5MGInjection[Gattex]|SPD 632|1001|N|N|N||Preferred Generic|197904-Lovastatin20MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|486131-BenzoylPeroxide0.1MG/MGTopicalGel|SPD 632|1001|Y|N|N||Preferred Brand|1364362-ponatinib45MGOralTablet[Iclusig]|SPD 632|1001|N|N|N||Preferred Generic|476809-Mirtazapine7.5MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|198034-24HRNifedipine30MGExtendedReleaseOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1357547-tofacitinib5MGOralTablet[Xeljanz]|SPD 632|1001|N|N|N||Preferred Generic|628953-PotassiumChloride10MEQExtendedReleaseOralTablet|SPD 632|1001|N|N|N||Preferred Brand|198467-Aspirin325MGDelayedReleaseOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1313061-24HRPhentermine11.25MG/topiramate69MGExtendedReleaseOralCapsule[Qsymia]|SPD 632|1001|N|N|N||Preferred Brand|1293639-Caffeine100MG/ErgotamineTartrate2MGRectalSuppository[Migergot]|SPD 632|1001|N|N|N||Preferred Brand|2564021-0.5MLinfluenzaAvirusA/Cambodia/e0826360/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.|SPD 632|1001|N|N|N||Preferred Generic|1047905-HyoscyamineSulfate0.125MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|197903-Lovastatin10MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|476576-cefdinir50MG/MLOralSuspension|SPD 632|1001|Y|N|N||Preferred Brand|1310535-teriflunomide7MGOralTablet[Aubagio]|SPD 632|1001|Y|N|N||Preferred Brand|1310531-teriflunomide14MGOralTablet[Aubagio]|SPD 632|1001|N|N|N||Preferred Generic|432402-cinacalcet30MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1310147-everolimus5MGTabletforOralSuspension[Afinitor]|SPD 632|1001|Y|N|N||Preferred Brand|1310144-everolimus3MGTabletforOralSuspension[Afinitor]|SPD 632|1001|N|N|N||Preferred Generic|432401-cinacalcet60MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|197887-Hydrochlorothiazide25MG/Lisinopril20MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1307635-bosutinib500MGOralTablet[Bosulif]|SPD 632|1001|N|N|N||Preferred Generic|997491-Fexofenadinehydrochloride6MG/MLOralSuspension|SPD 632|1001|N|N|N||Preferred Generic|432400-cinacalcet90MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1307630-bosutinib100MGOralTablet[Bosulif]|SPD 632|1001|Y|N|N||Preferred Brand|858366-KetorolacTromethamine4.5MG/MLOphthalmicSolution[Acuvail]|SPD 632|1001|Y|N|N||Preferred Brand|1302856-24HRPhentermine15MG/topiramate92MGExtendedReleaseOralCapsule[Qsymia]|SPD 632|1001|N|N|N||Preferred Generic|1116758-chloroquinephosphate500MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|197886-Hydrochlorothiazide12.5MG/Lisinopril20MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|429503-Hydrochlorothiazide12.5MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1302845-24HRPhentermine3.75MG/topiramate23MGExtendedReleaseOralCapsule[Qsymia]|SPD 632|1001|Y|N|N||Preferred Generic|992395-gatifloxacin5MG/MLOphthalmicSolution|SPD 632|1001|Y|N|N||Preferred Brand|1302833-24HRPhentermine7.5MG/topiramate46MGExtendedReleaseOralCapsule[Qsymia]|SPD 632|1001|Y|N|N||Preferred Brand|1300803-24HRmirabegron50MGExtendedReleaseOralTablet[Myrbetriq]|SPD 632|1001|Y|N|N||Preferred Brand|1300797-24HRmirabegron25MGExtendedReleaseOralTablet[Myrbetriq]|SPD 632|1001|N|N|N||Preferred Generic|197885-Hydrochlorothiazide12.5MG/Lisinopril10MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|403966-zonisamide25MGOralCapsule|SPD 632|1001|Y|N|N||Preferred Brand|1291092-hydrocortisoneacetate30MGRectalSuppository[Proctocort]|SPD 632|1001|Y|N|N||Preferred Brand|1245003-eltrombopag12.5MGOralTablet[Promacta]|SPD 632|1001|N|N|N||Preferred Generic|403855-Hydrochlorothiazide25MG/Olmesartanmedoxomil40MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1244632-AmethiaLo91DayPack|SPD 632|1001|N|N|N||Preferred Generic|310261-exemestane25MGOralTablet|SPD 632|1001|N|N|N||Preferred Brand|2563039-0.5MLinfluenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.03MG/|SPD 632|1001|Y|N|N||Preferred Brand|1244064-0.4MLMethylnaltrexonebromide20MG/MLPrefilledSyringe[Relistor]|SPD 632|1001|N|N|N||Preferred Generic|260376-Terazosin10MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|403854-Hydrochlorothiazide12.5MG/Olmesartanmedoxomil40MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|1047881-HyoscyamineSulfate0.025MG/MLOralSolution|SPD 632|1001|N|N|N||Preferred Generic|197884-Lisinopril40MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1243848-24HRMetforminhydrochloride500MG/sitagliptin50MGExtendedReleaseOralTablet[Janumet]|SPD 632|1001|Y|N|N||Preferred Brand|1243843-24HRMetforminhydrochloride1000MG/sitagliptin50MGExtendedReleaseOralTablet[Janumet]|SPD 632|1001|N|N|N||Preferred Generic|310537-Glyburide5MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1243833-24HRMetforminhydrochloride1000MG/sitagliptin100MGExtendedReleaseOralTablet[Janumet]|SPD 632|1001|N|N|N||Preferred Generic|105292-isoniazid10MG/MLOralSolution|SPD 632|1001|N|N|N||Preferred Generic|197863-Leucovorin5MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|402698-24HRFelodipine2.5MGExtendedReleaseOralTablet|SPD 632|1001|N|N|N||Preferred Generic|282401-lamotrigine25MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|198241-Temazepam15MGOralCapsule|SPD 632|1001|Y|N|N||Preferred Brand|1243040-Linagliptin2.5MG/Metforminhydrochloride850MGOralTablet[Jentadueto]|SPD 632|1001|N|N|N||Preferred Brand|261353-Trimethoprim10MG/MLOralSolution[Primsol]|SPD 632|1001|N|N|N||Preferred Generic|312635-Prochlorperazine5MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|402696-24HRFelodipine5MGExtendedReleaseOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1243033-Linagliptin2.5MG/Metforminhydrochloride500MGOralTablet[Jentadueto]|SPD 632|1001|Y|N|N||Preferred Brand|1593835-24HRdapagliflozin10MG/Metforminhydrochloride500MGExtendedReleaseOralTablet[Xigduo]|SPD 632|1001|Y|N|N||Preferred Brand|1243026-Linagliptin2.5MG/Metforminhydrochloride1000MGOralTablet[Jentadueto]|SPD 632|1001|N|N|N||Preferred Generic|1046985-HyoscyamineSulfate0.125MGDisintegratingOralTablet|SPD 632|1001|N|N|N||Preferred Generic|197862-Leucovorin25MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|402695-24HRFelodipine10MGExtendedReleaseOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1242968-exenatide2MGInjection[Bydureon]|SPD 632|1001|Y|N|N||Preferred Brand|1242615-Isotretinoin40MGOralCapsule[Myorisan]|SPD 632|1001|N|N|N||Preferred Generic|393245-Digoxin0.05MG/MLOralSolution|SPD 632|1001|Y|N|N||Preferred Brand|1242613-Isotretinoin20MGOralCapsule[Myorisan]|SPD 632|1001|Y|N|N||Preferred Brand|1242611-Isotretinoin10MGOralCapsule[Myorisan]|SPD 632|1001|N|N|N||Preferred Generic|646333-Capsaicin1MG/MLTopicalCream|SPD 632|1001|N|N|N||Preferred Generic|391937-Lactulose667MG/MLOralSolution|SPD 632|1001|N|N|Y||Preferred Generic|899557-dexmethylphenidatehydrochloride2.5MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1242233-lenalidomide2.5MGOralCapsule[Revlimid]|SPD 632|1001|N|N|N||Preferred Generic|197861-Leucovorin15MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1235267-CamreseLo91DayPack|SPD 632|1001|Y|N|N||Preferred Brand|1235157-azilsartanmedoxomil40MG/Chlorthalidone25MGOralTablet[Edarbyclor]|SPD 632|1001|N|N|Y||Preferred Generic|311759-montelukast4MGChewableTablet|SPD 632|1001|N|N|N||Preferred Brand|2563032-0.5MLinfluenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.03MG/|SPD 632|1001|Y|N|N||Preferred Brand|1235150-azilsartanmedoxomil40MG/Chlorthalidone12.5MGOralTablet[Edarbyclor]|SPD 632|1001|N|N|N||Preferred Generic|197860-Leucovorin10MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|381056-IsosorbideDinitrate10MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1232204-Zolpidemtartrate3.5MGSublingualTablet[Intermezzo]|SPD 632|1001|N|N|N||Preferred Brand|1797880-Nafarelin0.2MG/ACTUATMeteredDoseNasalSpray[Synarel]|SPD 632|1001|N|N|N||Preferred Generic|1946772-Methotrexate25MG/MLInjectableSolution|SPD 632|1001|Y|N|N||Preferred Brand|1232200-Zolpidemtartrate1.75MGSublingualTablet[Intermezzo]|SPD 632|1001|N|N|N||Preferred Generic|360110-Sirolimus2MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1232190-asparaginaseErwiniachrysanthemi10000UNTInjection[Erwinaze]|SPD 632|1001|Y|N|N||Preferred Brand|1191128-EdrophoniumChloride10MG/MLInjectableSolution[Enlon]|SPD 632|1001|N|N|N||Preferred Generic|310273-Famotidine20MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|197856-Ketoprofen75MGOralCapsule|SPD 632|1001|Y|N|N||Preferred Generic|990982-2MLphysostigminesalicylate1MG/MLInjection|SPD 632|1001|Y|N|N||Preferred Brand|1149667-Camrese91DayPack|SPD 632|1001|N|N|N||Preferred Generic|308989-Carbidopa50MG/Levodopa200MGExtendedReleaseOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1149617-COLLAGENASE0.25UNT/MGTopicalOintment[Santyl]|SPD 632|1001|N|N|N||Preferred Generic|359296-calciumacetate667MGOralCapsule|SPD 632|1001|Y|N|N||Preferred Brand|1596778-14ACTUATBudesonide2MG/ACTUATRectalFoam[Uceris]|SPD 632|1001|Y|N|N||Preferred Brand|1148506-crizotinib250MGOralCapsule[Xalkori]|SPD 632|1001|Y|N|N||Preferred Brand|1148502-crizotinib200MGOralCapsule[Xalkori]|SPD 632|1001|N|N|N||Preferred Generic|353538-24HRIsosorbideMononitrate60MGExtendedReleaseOralTablet|SPD 632|1001|N|N|N||Preferred Generic|103951-Tolnaftate10MG/MLTopicalCream|SPD 632|1001|N|N|N||Preferred Generic|197855-Ketoprofen50MGOralCapsule|SPD 632|1001|Y|N|N||Preferred Brand|867506-pazopanib200MGOralTablet[Votrient]|SPD 632|1001|Y|N|N||Preferred Brand|1116639-Ticagrelor90MGOralTablet[Brilinta]|SPD 632|1001|N|N|Y||Preferred Generic|198250-tetracyclinehydrochloride250MGOralCapsule|SPD 632|1001|N|N|Y||Preferred Brand|1037181-dabigatranetexilate75MGOralCapsule[Pradaxa]|SPD 632|1001|N|N|N||Preferred Generic|351250-Escitalopram20MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1115473-1.5MLLeuprolideAcetate7.5MG/MLPrefilledSyringe[Lupron]|SPD 632|1001|N|N|N||Preferred Generic|282755-telmisartan20MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1115468-1.5MLLeuprolideAcetate15MG/MLPrefilledSyringe[Lupron]|SPD 632|1001|N|N|N||Preferred Generic|197854-Ketoprofen25MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|351249-Escitalopram5MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1115464-1MLLeuprolideAcetate7.5MG/MLPrefilledSyringe[Lupron]|SPD 632|1001|N|N|N||Preferred Generic|1437702-Albuterol0.833MG/ML/IpratropiumBromide0.167MG/MLInhalationSolution|SPD 632|1001|Y|N|N||Preferred Brand|1115459-1MLLeuprolideAcetate3.75MG/MLPrefilledSyringe[Lupron]|SPD 632|1001|N|N|N||Preferred Generic|999613-SulfacetamideSodium100MG/ML/Sulfur50MG/MLMedicatedLiquidSoap|SPD 632|1001|N|N|N||Preferred Generic|351172-Dutasteride0.5MGOralCapsule|SPD 632|1001|Y|N|N||Preferred Brand|1115456-1MLLeuprolideAcetate15MG/MLPrefilledSyringe[Lupron]|SPD 632|1001|Y|N|N||Preferred Brand|1115449-1MLLeuprolideAcetate11.25MG/MLPrefilledSyringe[Lupron]|SPD 632|1001|N|N|N||Preferred Brand|2563031-influenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.03MG/ML/in|SPD 632|1001|N|N|N||Preferred Generic|103457-Fluocinonide0.0005MG/MGTopicalOintment|SPD 632|1001|N|N|N||Preferred Generic|197853-Ketoconazole200MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|351137-Albuterol0.21MG/MLInhalationSolution|SPD 632|1001|Y|N|N||Preferred Brand|1115259-1.5MLLeuprolideAcetate30MG/MLPrefilledSyringe[Lupron]|SPD 632|1001|Y|N|N||Preferred Brand|1114096-Vandetanib300MGOralTablet[Caprelsa]|SPD 632|1001|N|N|N||Preferred Generic|351136-Albuterol0.417MG/MLInhalationSolution|SPD 632|1001|Y|N|N||Preferred Brand|1114074-Vandetanib100MGOralTablet[Caprelsa]|SPD 632|1001|Y|N|N||Preferred Brand|1112687-Amethia91DayPack|SPD 632|1001|N|N|N||Preferred Generic|197839-IsosorbideDinitrate30MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|861200-Brimonidinetartrate2MG/MLOphthalmicSolution|SPD 632|1001|Y|N|N||Preferred Brand|1091843-Roflumilast0.5MGOralTablet[Daliresp]|SPD 632|1001|Y|N|N||Preferred Brand|1091654-azilsartanmedoxomil80MGOralTablet[Edarbi]|SPD 632|1001|Y|N|N||Preferred Brand|1091650-azilsartanmedoxomil40MGOralTablet[Edarbi]|SPD 632|1001|Y|N|N||Preferred Generic|903857-PyridostigmineBromide60MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|197832-isoniazid300MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|349401-Olmesartanmedoxomil20MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1046402-1.7MLdenosumab70MG/MLInjection[Xgeva]|SPD 632|1001|Y|N|N||Preferred Brand|1045408-dasatinib80MGOralTablet[Sprycel]|SPD 632|1001|N|N|N||Preferred Generic|349373-Olmesartanmedoxomil5MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1045404-dasatinib140MGOralTablet[Sprycel]|SPD 632|1001|N|N|N||Preferred Brand|644304-Tamoxifen2MG/MLOralSolution[Soltamox]|SPD 632|1001|N|N|N||Preferred Generic|310539-Glyburide6MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1043582-24HRMetforminhydrochloride500MG/saxagliptin5MGExtendedReleaseOralTablet[Kombiglyze]|SPD 632|1001|N|N|N||Preferred Generic|310324-ferroussulfate325MGDelayedReleaseOralTablet|SPD 632|1001|N|N|N||Preferred Generic|197818-Indomethacin50MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|349332-Escitalopram10MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1043574-24HRMetforminhydrochloride1000MG/saxagliptin5MGExtendedReleaseOralTablet[Kombiglyze]|SPD 632|1001|N|N|Y||Preferred Generic|198242-Temazepam30MGOralCapsule|SPD 632|1001|Y|N|N||Preferred Brand|1593775-24HRdapagliflozin10MG/Metforminhydrochloride1000MGExtendedReleaseOralTablet[Xigduo]|SPD 632|1001|Y|N|N||Preferred Brand|861966-Iloprost0.02MG/MLInhalationSolution[Ventavis]|SPD 632|1001|N|N|N||Preferred Brand|105553-Chlorambucil2MGOralTablet[Leukeran]|SPD 632|1001|Y|N|N||Preferred Brand|1043567-24HRMetforminhydrochloride1000MG/saxagliptin2.5MGExtendedReleaseOralTablet[Kombiglyze]|SPD 632|1001|N|N|N||Preferred Generic|349208-Sirolimus1MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1040058-DextromethorphanHydrobromide20MG/QuinidineSulfate10MGOralCapsule[Nuedexta]|SPD 632|1001|N|N|N||Preferred Brand|1005928-ulipristalacetate30MGOralTablet[Ella]|SPD 632|1001|N|N|Y||Preferred Generic|198252-tetracyclinehydrochloride500MGOralCapsule|SPD 632|1001|N|N|N||Preferred Brand|2563020-influenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Washington/19/2020(H1N1)antigen0.03MG/ML/in|SPD 632|1001|Y|N|N||Preferred Brand|1037185-LoLoestrinFe28DayPack|SPD 632|1001|N|N|N||Preferred Brand|1250090-Nonoxynol-90.03MG/MGVaginalGel[GynolII]|SPD 632|1001|N|N|N||Preferred Generic|348472-Theophylline600MGExtendedReleaseOralTablet|SPD 632|1001|N|N|N||Preferred Generic|103403-Hydrocortisone10MG/MLTopicalLotion|SPD 632|1001|N|N|N||Preferred Generic|197817-Indomethacin25MGOralCapsule|SPD 632|1001|N|N|Y||Preferred Generic|198317-Triazolam0.125MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1011755-aliskiren300MG/Hydrochlorothiazide25MGOralTablet[TekturnaHCT]|SPD 632|1001|N|N|N||Preferred Generic|343033-Dexamethasone0.75MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1011752-aliskiren300MG/Hydrochlorothiazide12.5MGOralTablet[TekturnaHCT]|SPD 632|1001|Y|N|N||Preferred Brand|1011715-aliskiren150MG/Hydrochlorothiazide25MGOralTablet[TekturnaHCT]|SPD 632|1001|N|N|N||Preferred Generic|197816-Indapamide2.5MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|328161-Methylprednisolone16MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1011712-aliskiren150MG/Hydrochlorothiazide12.5MGOralTablet[TekturnaHCT]|SPD 632|1001|N|N|Y||Preferred Brand|864650-Ganciclovir0.0015MG/MGOphthalmicGel[Zirgan]|SPD 632|1001|Y|N|N||Preferred Brand|1002300-nilotinib150MGOralCapsule[Tasigna]|SPD 632|1001|N|N|Y||Preferred Generic|311265-lamotrigine5MGChewableTablet|SPD 632|1001|N|N|N||Preferred Generic|328160-Cyclosporine100MGOralCapsule|SPD 632|1001|Y|N|N||Preferred Brand|1000089-alcaftadine2.5MG/MLOphthalmicSolution[Lastacaft]|SPD 632|1001|N|N|N||Preferred Generic|309313-Citalopram2MG/MLOralSolution|SPD 632|1001|N|Y|Y||Preferred Generic|998679-168HRClonidine0.0125MG/HRTransdermalSystem|SPD 632|1001|N|N|N||Preferred Generic|103401-Hydrocortisone0.025MG/MGTopicalOintment|SPD 632|1001|N|N|N||Preferred Generic|197815-Indapamide1.25MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|318272-Aspirin81MGChewableTablet|SPD 632|1001|N|Y|Y||Preferred Generic|998675-168HRClonidine0.00833MG/HRTransdermalSystem|SPD 632|1001|N|Y|Y||Preferred Generic|998671-168HRClonidine0.00417MG/HRTransdermalSystem|SPD 632|1001|N|N|N||Preferred Generic|317769-Theophylline300MGExtendedReleaseOralTablet|SPD 632|1001|N|Y|Y||Preferred Generic|860654-epinastinehydrochloride0.5MG/MLOphthalmicSolution|SPD 632|1001|N|Y|Y||Preferred Generic|856569-24HRPropranololHydrochloride80MGExtendedReleaseOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|259255-atorvastatin80MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|317573-pioglitazone15MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|197807-Ibuprofen800MGOralTablet|SPD 632|1001|N|Y|Y||Preferred Generic|856481-24HRPropranololHydrochloride160MGExtendedReleaseOralCapsule|SPD 632|1001|N|N|Y||Preferred Brand|106892-insulinisophane,human70UNT/ML/insulin,regular,human30UNT/MLInjectableSuspension[Humulin]|SPD 632|1001|N|N|N||Preferred Generic|317173-Captopril25MGOralTablet|SPD 632|1001|N|Y|Y||Preferred Generic|856460-24HRPropranololHydrochloride120MGExtendedReleaseOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|686400-ErythromycinEthylsuccinate40MG/MLOralSuspension|SPD 632|1001|N|Y|Y||Preferred Generic|854868-Rabeprazolesodium20MGDelayedReleaseOralTablet|SPD 632|1001|N|N|N||Preferred Generic|197806-Ibuprofen600MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|317136-Nortriptyline25MGOralCapsule|SPD 632|1001|N|Y|Y||Preferred Generic|798133-Erythromycin20MG/MLMedicatedPad[Ery]|SPD 632|1001|N|Y|Y||Preferred Generic|797274-Clindamycin10MG/MLMedicatedPad|SPD 632|1001|N|Y|Y||Preferred Generic|606726-Esomeprazole20MGDelayedReleaseOralCapsule|SPD 632|1001|N|Y|Y||Preferred Generic|577127-pregabalin225MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|197805-Ibuprofen400MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|317110-24HRIsosorbideMononitrate30MGExtendedReleaseOralTablet|SPD 632|1001|N|Y|Y||Preferred Generic|483450-pregabalin75MGOralCapsule|SPD 632|1001|Y|N|N||Preferred Brand|1606870-ivacaftor75MGOralGranules[Kalydeco]|SPD 632|1001|N|N|N||Preferred Generic|311264-lamotrigine25MGChewableTablet|SPD 632|1001|N|Y|Y||Preferred Generic|483448-pregabalin50MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|315187-Prednisone1MG/MLOralSolution|SPD 632|1001|N|Y|Y||Preferred Generic|483446-pregabalin200MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|310325-ferroussulfate325MGOralTablet|SPD 632|1001|N|Y|Y||Preferred Generic|483444-pregabalin300MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|315183-PotassiumChloride8MEQExtendedReleaseOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|197803-Ibuprofen20MG/MLOralSuspension|SPD 632|1001|N|N|Y||Preferred Brand|1115892-MineralOil0.15MG/MG/Petrolatum0.85MG/MGOphthalmicOintment[Puralube]|SPD 632|1001|N|N|N||Preferred Brand|759469-Quasense91DayPack|SPD 632|1001|N|Y|Y||Preferred Generic|483438-pregabalin100MGOralCapsule|SPD 632|1001|N|Y|Y||Preferred Generic|351134-zolmitriptan5MGDisintegratingOralTablet|SPD 632|1001|N|N|N||Preferred Generic|197797-hydroxyurea500MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|315107-24HRGlipizide10MGExtendedReleaseOralTablet|SPD 632|1001|N|N|N||Preferred Generic|283406-Mirtazapine15MGDisintegratingOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|198342-Urea400MG/MLTopicalCream|SPD 632|1001|N|Y|Y||Preferred Generic|314227-Sumatriptan20MG/ACTUATNasalSpray|SPD 632|1001|N|N|N||Preferred Generic|315102-SodiumFluoride1.1MG/MLOralSolution|SPD 632|1001|N|Y|Y||Preferred Generic|313189-Tacrolimus0.0003MG/MGTopicalOintment|SPD 632|1001|Y|N|N||Preferred Brand|1606866-ivacaftor50MGOralGranules[Kalydeco]|SPD 632|1001|N|N|N||Preferred Brand|1595478-amylase84000UNT/lipase20000UNT/protease63000UNTDelayedReleaseOralCapsule[Zenpep]|SPD 632|1001|N|Y|Y||Preferred Generic|313159-Sumatriptan5MG/ACTUATNasalSpray|SPD 632|1001|N|N|N||Preferred Brand|2563002-0.5MLinfluenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.09MG/ML/influenzaAvirusA/Wisconsin/588/2019(H1N1)antigen0.09MG/|SPD 632|1001|N|N|N||Preferred Generic|1014676-cetirizinehydrochloride5MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|197787-Hydrocortisone5MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|315090-Erythromycin333MGDelayedReleaseOralTablet|SPD 632|1001|N|Y|Y||Preferred Generic|311671-Metolazone5MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|686924-carvedilol3.125MGOralTablet|SPD 632|1001|N|Y|Y||Preferred Generic|309333-Clindamycin10MG/MLTopicalSolution|SPD 632|1001|Y|N|N||Preferred Brand|1649491-ivabradine5MGOralTablet[Corlanor]|SPD 632|1001|N|N|N||Preferred Generic|314277-venlafaxine50MGOralTablet|SPD 632|1001|N|Y|Y||Preferred Generic|309332-Clindamycin0.01MG/MGTopicalGel|SPD 632|1001|N|N|N||Preferred Brand|207864-crotamiton100MG/MLTopicalCream[Eurax]|SPD 632|1001|N|Y|Y||Preferred Generic|284201-zolmitriptan2.5MGDisintegratingOralTablet|SPD 632|1001|N|N|N||Preferred Brand|1101778-Monobasicpotassiumphosphate0.0408MEQ/MLOralSolution[K-Phos]|SPD 632|1001|N|N|N||Preferred Generic|314241-Theophylline450MGExtendedReleaseOralTablet|SPD 632|1001|N|Y|Y||Preferred Generic|244374-BenzoylPeroxide0.05MG/MG/Erythromycin0.03MG/MGTopicalGel|SPD 632|1001|N|N|N||Preferred Generic|197785-Hydrocortisone25MG/MLTopicalLotion|SPD 632|1001|N|N|Y||Preferred Generic|199206-Riluzole50MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|978950-Natazia28DayPack|SPD 632|1001|N|N|N||Preferred Generic|1190568-AtropineSulfate0.005MG/ML/DiphenoxylateHydrochloride0.5MG/MLOralSolution|SPD 632|1001|N|N|N||Preferred Generic|314238-Tropicamide10MG/MLOphthalmicSolution|SPD 632|1001|N|Y|Y||Preferred Generic|200193-zolmitriptan2.5MGOralTablet|SPD 632|1001|N|Y|Y||Preferred Generic|2001568-BXRating24HRMethylphenidateHydrochloride54MGExtendedReleaseOralTablet|SPD 632|1001|N|N|N||Preferred Generic|197783-Hydrocortisone20MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1649495-ivabradine7.5MGOralTablet[Corlanor]|SPD 632|1001|N|N|N||Preferred Generic|314234-Sucralfate1000MGOralTablet|SPD 632|1001|N|Y|Y||Preferred Generic|2001566-BXRating24HRMethylphenidateHydrochloride36MGExtendedReleaseOralTablet|SPD 632|1001|N|Y|Y||Preferred Generic|2001565-BXRating24HRMethylphenidateHydrochloride27MGExtendedReleaseOralTablet|SPD 632|1001|N|N|N||Preferred Generic|314231-Simvastatin10MGOralTablet|SPD 632|1001|N|Y|Y||Preferred Generic|2001564-BXRating24HRMethylphenidateHydrochloride18MGExtendedReleaseOralTablet|SPD 632|1001|N|Y|Y||Preferred Generic|197979-Metolazone2.5MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|310346-Finasteride5MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|283858-ropinirole3MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|197782-Hydrocortisone10MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|314208-ropinirole1MGOralTablet|SPD 632|1001|N|Y|Y||Preferred Generic|197978-Metolazone10MGOralTablet|SPD 632|1001|N|Y|Y||Preferred Generic|197519-Clindamycin10MG/MLTopicalLotion|SPD 632|1001|Y|N|N||Preferred Brand|1649593-0.5MLpeginterferonbeta-1a0.25MG/MLAuto-Injector[Plegridy]|SPD 632|1001|N|N|N||Preferred Generic|314203-quinapril40MGOralTablet|SPD 632|1001|N|Y|Y||Preferred Generic|1806195-50/50Release24HRMethylphenidateHydrochloride10MGExtendedReleaseOralCapsule|SPD 632|1001|N|N|N||Preferred Brand|2562996-0.5MLinfluenzaAvirusA/Cambodia/e0826360/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.|SPD 632|1001|N|Y|Y||Preferred Generic|1806185-50/50Release24HRMethylphenidateHydrochloride60MGExtendedReleaseOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|314182-PotassiumChloride2.67MEQ/MLOralSolution|SPD 632|1001|N|N|N||Preferred Generic|1014571-12HRcetirizinehydrochloride5MG/PseudoephedrineHydrochloride120MGExtendedReleaseOralTablet|SPD 632|1001|N|N|N||Preferred Generic|197770-Hydrochlorothiazide50MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|847917-60ACTUATexenatide0.005MG/ACTUATPenInjector[Byetta]|SPD 632|1001|N|Y|Y||Preferred Generic|1111343-olopatadine2MG/MLOphthalmicSolution|SPD 632|1001|N|N|Y||Preferred Brand|1190919-0.5MLdiphtheriatoxoidvaccine,inactivated4UNT/ML/tetanustoxoidvaccine,inactivated10UNT/MLPrefilledSyringe[Tenivac]|SPD 632|1001|N|N|N||Preferred Generic|314165-prednisolone10MG/MLOphthalmicSolution|SPD 632|1001|N|Y|Y||Preferred Generic|1111339-olopatadine1MG/MLOphthalmicSolution|SPD 632|1001|N|N|N||Preferred Generic|283433-Melatonin10MGOralCapsule|SPD 632|1001|N|Y|Y||Preferred Brand|2200658-semaglutide7MGOralTablet[Rybelsus]|SPD 632|1001|N|N|N||Preferred Generic|197746-Guanfacine2MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|314131-Niacin250MGExtendedReleaseOralCapsule|SPD 632|1001|N|Y|Y||Preferred Brand|2200654-semaglutide3MGOralTablet[Rybelsus]|SPD 632|1001|N|Y|Y||Preferred Brand|2200650-semaglutide14MGOralTablet[Rybelsus]|SPD 632|1001|N|N|N||Preferred Generic|314111-Mirtazapine30MGOralTablet|SPD 632|1001|N|Y|Y||Preferred Brand|1716223-patiromer25200MGPowderforOralSuspension[Veltassa]|SPD 632|1001|N|Y|Y||Preferred Brand|1716219-patiromer16800MGPowderforOralSuspension[Veltassa]|SPD 632|1001|N|N|Y||Preferred Generic|311237-Ketotifen0.25MG/MLOphthalmicSolution|SPD 632|1001|N|N|N||Preferred Generic|1014314-TriamcinoloneAcetonide1MG/MLTopicalCream|SPD 632|1001|N|N|N||Preferred Generic|197745-Guanfacine1MGOralTablet|SPD 632|1001|N|Y|Y||Preferred Brand|1716215-patiromer8400MGPowderforOralSuspension[Veltassa]|SPD 632|1001|N|Y|N||Preferred Generic|997406-12HRFexofenadinehydrochloride60MG/PseudoephedrineHydrochloride120MGExtendedReleaseOralTablet|SPD 632|1001|N|N|N||Preferred Generic|314077-Lisinopril20MGOralTablet|SPD 632|1001|N|Y|N||Preferred Generic|996615-24HRMemantinehydrochloride7MGExtendedReleaseOralCapsule|SPD 632|1001|N|Y|N||Preferred Generic|996609-24HRMemantinehydrochloride28MGExtendedReleaseOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|308988-Carbidopa25MG/Levodopa100MGExtendedReleaseOralTablet|SPD 632|1001|N|N|N||Preferred Generic|197741-Guaifenesin200MGOralTablet|SPD 632|1001|N|Y|N||Preferred Generic|996594-24HRMemantinehydrochloride14MGExtendedReleaseOralCapsule|SPD 632|1001|N|N|N||Preferred Brand|1233850-Vestura28DayPack|SPD 632|1001|N|N|N||Preferred Generic|314072-latanoprost0.05MG/MLOphthalmicSolution|SPD 632|1001|N|Y|N||Preferred Generic|857564-24HRtrospiumchloride60MGExtendedReleaseOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|310536-Glyburide3MGOralTablet|SPD 632|1001|N|N|N||Preferred Brand|2562995-0.5MLinfluenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Washington/19/2020(H1N1)antigen0.03MG/|SPD 632|1001|N|Y|N||Preferred Generic|857560-trospiumchloride20MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|197737-Glyburide1.25MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|314055-IsosorbideDinitrate5MGOralTablet|SPD 632|1001|N|Y|N||Preferred Generic|855194-tolterodinetartrate2MGOralTablet|SPD 632|1001|N|N|N||Preferred Brand|1595473-amylase63000UNT/lipase15000UNT/protease47000UNTDelayedReleaseOralCapsule[Zenpep]|SPD 632|1001|N|N|N||Preferred Brand|150840-Estrogens,Conjugated(USP)0.625MGOralTablet[Premarin]|SPD 632|1001|N|Y|N||Preferred Generic|855189-24HRtolterodinetartrate4MGExtendedReleaseOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|314006-24HRGlipizide5MGExtendedReleaseOralTablet|SPD 632|1001|N|Y|N||Preferred Generic|855182-24HRtolterodinetartrate2MGExtendedReleaseOralCapsule|SPD 632|1001|N|N|N||Preferred Brand|210000-AluminumHydroxide80MG/ML/MagnesiumHydroxide80MG/ML/Simethicone8MG/MLOralSuspension[Almacone]|SPD 632|1001|N|Y|N||Preferred Generic|855178-tolterodinetartrate1MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|197304-Acetazolamide250MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|310352-Fluconazole10MG/MLOralSuspension|SPD 632|1001|N|N|N||Preferred Generic|197732-Furosemide80MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|314000-Glyburide1.5MGOralTablet|SPD 632|1001|N|Y|N||Preferred Generic|825130-24HRmesalamine375MGExtendedReleaseOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|1797913-TriamcinoloneAcetonide0.055MG/ACTUATMeteredDoseNasalSpray|SPD 632|1001|N|Y|N||Preferred Generic|810090-Carbidopa18.75MG/entacapone200MG/Levodopa75MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|702519-Phenobarbital4MG/MLOralSolution|SPD 632|1001|N|N|N||Preferred Generic|313989-Fluoxetine40MGOralCapsule|SPD 632|1001|N|N|Y||Preferred Brand|847213-3MLInsulinLispro50UNT/ML/insulinlisproprotamine,human50UNT/MLPenInjector[HumalogMix]|SPD 632|1001|N|Y|N||Preferred Generic|810083-Carbidopa31.25MG/entacapone200MG/Levodopa125MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|199376-potassiumcitrate5MEQExtendedReleaseOralTablet|SPD 632|1001|N|Y|N||Preferred Generic|749206-sevelamercarbonate800MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|313988-Furosemide40MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|1011852-LidocaineHydrochloride0.02MG/MGTopicalGel|SPD 632|1001|N|N|N||Preferred Generic|197726-Flutamide125MGOralCapsule|SPD 632|1001|N|N|Y||Preferred Generic|199381-potassiumcitrate10MEQExtendedReleaseOralTablet|SPD 632|1001|N|Y|N||Preferred Generic|730988-Carbidopa50MG/entacapone200MG/Levodopa200MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|313979-fludrocortisoneacetate0.1MGOralTablet|SPD 632|1001|N|Y|N||Preferred Generic|686429-mesalamine1200MGDelayedReleaseOralTablet|SPD 632|1001|N|N|N||Preferred Generic|151226-topiramate50MGOralTablet|SPD 632|1001|N|Y|N||Preferred Generic|606730-Esomeprazole40MGDelayedReleaseOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|197701-Fluconazole50MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1650901-0.5MLInterferonbeta-1a0.06MG/MLAuto-Injector[Avonex]|SPD 632|1001|N|N|N||Preferred Generic|313919-salmoncalcitonin200UNT/ACTUATNasalSpray|SPD 632|1001|N|Y|N||Preferred Generic|562806-Pimecrolimus10MG/MLTopicalCream|SPD 632|1001|N|Y|N||Preferred Generic|403852-Carbidopa37.5MG/entacapone200MG/Levodopa150MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|313888-Cefaclor50MG/MLOralSuspension|SPD 632|1001|N|Y|N||Preferred Generic|403851-Carbidopa25MG/entacapone200MG/Levodopa100MGOralTablet|SPD 632|1001|N|Y|N||Preferred Generic|403850-Carbidopa12.5MG/entacapone200MG/Levodopa50MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|1010878-LidocaineHydrochloride40MG/MLMucousMembraneTopicalSolution|SPD 632|1001|N|N|N||Preferred Generic|197700-Fluconazole200MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|313850-Amoxicillin40MG/MLOralSuspension|SPD 632|1001|N|Y|N||Preferred Generic|349590-Levalbuterol0.103MG/MLInhalationSolution|SPD 632|1001|N|N|N||Preferred Generic|310812-Hydrochlorothiazide25MG/Triamterene37.5MGOralTablet|SPD 632|1001|N|Y|N||Preferred Generic|349556-ezetimibe10MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|313797-Amoxicillin25MG/MLOralSuspension|SPD 632|1001|N|Y|N||Preferred Generic|317094-entacapone200MGOralTablet|SPD 632|1001|N|Y|N||Preferred Generic|313921-calcipotriene0.05MG/MLTopicalCream|SPD 632|1001|N|N|N||Preferred Generic|313786-AceticAcid20MG/ML/Hydrocortisone10MG/MLOticSolution|SPD 632|1001|N|N|N||Preferred Generic|197699-Fluconazole150MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1653166-1MLgolimumab100MG/MLAuto-Injector[Simponi]|SPD 632|1001|N|Y|N||Preferred Generic|311347-linezolid600MGOralTablet|SPD 632|1001|N|N|Y||Preferred Brand|1300370-0.5MLBordetellapertussisfilamentoushemagglutininvaccine,inactivated0.016MG/ML/Bordetellapertussispertactinvaccine,ina|SPD 632|1001|N|N|N||Preferred Generic|313586-venlafaxine75MGOralTablet|SPD 632|1001|N|Y|N||Preferred Generic|311345-linezolid20MG/MLOralSuspension|SPD 632|1001|Y|N|N||Preferred Generic|1013629-{24(drospirenone3MG/EthinylEstradiol0.02MG/levomefolatecalcium0.451MGOralTablet)/4(levomefolatecalcium0.451MGOralTabl|SPD 632|1001|N|Y|N||Preferred Generic|311286-Levalbuterol0.21MG/MLInhalationSolution|SPD 632|1001|N|N|N||Preferred Generic|1190570-AtropineSulfate0.01MG/MGOphthalmicOintment|SPD 632|1001|N|N|N||Preferred Generic|197698-Fluconazole100MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|313585-24HRvenlafaxine75MGExtendedReleaseOralCapsule|SPD 632|1001|N|Y|N||Preferred Generic|310600-Griseofulvin500MGOralTablet|SPD 632|1001|N|Y|N||Preferred Generic|308865-calcipotriene0.05MG/MLTopicalSolution|SPD 632|1001|N|Y|N||Preferred Generic|284008-travoprost0.04MG/MLOphthalmicSolution|SPD 632|1001|N|Y|N||Preferred Generic|242831-Griseofulvin125MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|197686-Etodolac400MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|313583-24HRvenlafaxine37.5MGExtendedReleaseOralCapsule|SPD 632|1001|N|Y|N||Preferred Generic|242754-Levalbuterol0.417MG/MLInhalationSolution|SPD 632|1001|N|N|N||Preferred Generic|861487-ClobetasolPropionate0.5MG/MLTopicalSolution|SPD 632|1001|N|Y|N||Preferred Generic|239239-Griseofulvin250MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|313582-venlafaxine25MGOralTablet|SPD 632|1001|N|Y|N||Preferred Generic|204119-Malathion5MG/MLTopicalLotion|SPD 632|1001|N|N|N||Preferred Generic|310353-Fluconazole40MG/MLOralSuspension|SPD 632|1001|N|N|N||Preferred Brand|2561270-0.5MLinfluenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.03MG/|SPD 632|1001|N|N|N||Preferred Brand|688242-Estrogens,Conjugated(USP)0.625MG/MLVaginalCream[Premarin]|SPD 632|1001|N|Y|N||Preferred Generic|198373-calcipotriene0.00005MG/MGTopicalOintment|SPD 632|1001|N|N|N||Preferred Generic|283485-Mirtazapine45MGDisintegratingOralTablet|SPD 632|1001|N|N|N||Preferred Generic|313581-24HRvenlafaxine150MGExtendedReleaseOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|1006120-SulfacetamideSodium100MG/MLOphthalmicSolution|SPD 632|1001|N|N|N||Preferred Generic|197685-Etodolac300MGOralCapsule|SPD 632|1001|N|Y|N||Preferred Generic|197551-Cycloserine250MGOralCapsule|SPD 632|1001|N|Y|N||Preferred Generic|197508-Cimetidine800MGOralTablet|SPD 632|1001|N|Y|N||Preferred Generic|197507-Cimetidine400MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|197684-Etodolac200MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|313565-valacyclovir500MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|283523-gabapentin50MG/MLOralSolution|SPD 632|1001|N|N|Y||Preferred Generic|200095-irbesartan150MGOralTablet|SPD 632|1001|N|Y|N||Preferred Generic|197505-Cimetidine200MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|313564-valacyclovir1000MGOralTablet|SPD 632|1001|N|Y|N||Preferred Generic|197419-Bumetanide2MGOralTablet|SPD 632|1001|N|Y|N||Preferred Generic|197418-Bumetanide1MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|1005856-SulfacetamideSodium100MG/ML/Sulfur50MG/MLTopicalLotion|SPD 632|1001|N|N|N||Preferred Generic|197682-Ethosuximide250MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|313521-Tropicamide5MG/MLOphthalmicSolution|SPD 632|1001|N|Y|N||Preferred Generic|197417-Bumetanide0.5MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|313761-zaleplon10MGOralCapsule|SPD 632|1001|N|Y|N||Preferred Generic|1855389-Levalbuterol2.5MG/MLInhalationSolution|SPD 632|1001|N|N|N||Preferred Generic|722134-Amlodipine5MG/valsartan160MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|313477-Trifluridine10MG/MLOphthalmicSolution|SPD 632|1001|N|Y|N||Preferred Generic|1797863-flunisolide0.025MG/ACTUATMeteredDoseNasalSpray|SPD 632|1001|N|N|N||Preferred Generic|311197-IsosorbideMononitrate20MGOralTablet|SPD 632|1001|N|Y|N||Preferred Generic|1368954-mesalamine400MGDelayedReleaseOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|313428-Toremifene60MGOralTablet|SPD 632|1001|N|Y|N||Preferred Generic|1368438-alogliptin25MG/pioglitazone45MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|197670-Estrogens,Esterified(USP)1.25MG/Methyltestosterone2.5MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|200096-irbesartan300MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|1098608-24HRlamotrigine300MGExtendedReleaseOralTablet|SPD 632|1001|N|N|N||Preferred Generic|860225-MegestrolAcetate40MG/MLOralSuspension|SPD 632|1001|N|Y|N||Preferred Generic|1368424-alogliptin25MG/pioglitazone15MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|313123-Sucralfate100MG/MLOralSuspension|SPD 632|1001|N|N|N||Preferred Brand|2178792-0.3MLEpinephrine0.5MG/MLPrefilledSyringe[Symjepi]|SPD 632|1001|N|Y|N||Preferred Generic|1368417-alogliptin12.5MG/pioglitazone45MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|197659-Estradiol2MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|313306-Theophylline5.33MG/MLOralSolution|SPD 632|1001|N|Y|N||Preferred Generic|1368410-alogliptin12.5MG/pioglitazone30MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|197305-AceticAcid20MG/MLOticSolution|SPD 632|1001|N|Y|N||Preferred Generic|1368403-alogliptin12.5MG/pioglitazone15MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|313291-Theophylline400MGExtendedReleaseOralTablet|SPD 632|1001|N|Y|N||Preferred Generic|1368392-alogliptin12.5MG/Metforminhydrochloride500MGOralTablet|SPD 632|1001|N|Y|N||Preferred Generic|1368385-alogliptin12.5MG/Metforminhydrochloride1000MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|310362-Fluocinonide0.0005MG/MGTopicalGel|SPD 632|1001|N|N|N||Preferred Generic|197658-Estradiol1MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|1100075-abirateroneacetate250MGOralTablet|SPD 632|1001|N|Y|N||Preferred Generic|1368034-alogliptin12.5MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|722137-Amlodipine5MG/valsartan320MGOralTablet|SPD 632|1001|N|Y|N||Preferred Generic|1368018-alogliptin6.25MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|313226-terconazole4MG/MLVaginalCream|SPD 632|1001|N|Y|N||Preferred Generic|1368006-alogliptin25MGOralTablet|SPD 632|1001|N|Y|N||Preferred Generic|1246673-Ivermectin5MG/MLTopicalLotion|SPD 632|1001|Y|N|N||Preferred Brand|1654955-1MLdarbepoetinalfa0.2MG/MLInjection[Aranesp]|SPD 632|1001|N|N|N||Preferred Generic|313219-Terazosin5MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|1000862-PilocarpineHydrochloride20MG/MLOphthalmicSolution|SPD 632|1001|N|N|N||Preferred Generic|197657-Estradiol0.5MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|1111641-1MLglatirameracetate20MG/MLPrefilledSyringe|SPD 632|1001|N|Y|N||Preferred Brand|996633-NamendaXR28DayTitrationPack|SPD 632|1001|N|N|Y||Preferred Generic|200224-montelukast10MGOralTablet|SPD 632|1001|N|N|Y||Preferred Brand|1363484-hypromellose0.003MG/MGOphthalmicGel[SystaneOvernightTherapy]|SPD 632|1001|N|N|N||Preferred Generic|313217-Terazosin2MGOralCapsule|SPD 632|1001|N|Y|N||Preferred Brand|856666-rifaximin550MGOralTablet[XIFAXAN]|SPD 632|1001|N|N|N||Preferred Generic|283672-Citalopram10MGOralTablet|SPD 632|1001|N|Y|N||Preferred Brand|835721-Ethionamide250MGOralTablet[Trecator]|SPD 632|1001|N|N|N||Preferred Generic|197650-Erythromycin500MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|313215-Terazosin1MGOralCapsule|SPD 632|1001|N|Y|N||Preferred Brand|833151-Savella4-WeekTitrationPack|SPD 632|1001|N|N|N||Preferred Brand|105551-Busulfan2MGOralTablet[Myleran]|SPD 632|1001|N|N|N||Preferred Generic|105583-Fluorouracil50MG/MLTopicalCream|SPD 632|1001|N|Y|N||Preferred Brand|833149-Milnacipranhydrochloride25MGOralTablet[Savella]|SPD 632|1001|N|N|Y||Preferred Brand|1300468-0.5MLHaemophilusinfluenzaetypebstrain1482,capsularpolysaccharideinactivatedtetanustoxoidconjugatevaccine0.068MG/MLInj|SPD 632|1001|N|N|N||Preferred Generic|313195-Tamoxifen20MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|1000001-Amlodipine5MG/Hydrochlorothiazide25MG/Olmesartanmedoxomil40MGOralTablet|SPD 632|1001|N|Y|N||Preferred Brand|833146-Milnacipranhydrochloride50MGOralTablet[Savella]|SPD 632|1001|N|N|N||Preferred Brand|1595457-amylase24000UNT/lipase5000UNT/protease17000UNTDelayedReleaseOralCapsule[Zenpep]|SPD 632|1001|N|Y|N||Preferred Brand|833143-Milnacipranhydrochloride12.5MGOralTablet[Savella]|SPD 632|1001|N|N|N||Preferred Brand|1190225-120ACTUATAlbuterol0.1MG/ACTUAT/IpratropiumBromide0.02MG/ACTUATInhalationSpray[Combivent]|SPD 632|1001|N|N|N||Preferred Brand|2173508-Nonoxynol-91000MGVaginalSponge[TodaySponge]|SPD 632|1001|N|N|N||Preferred Generic|1000673-SulfacetamideSodium0.1MG/MGOphthalmicOintment|SPD 632|1001|N|N|N||Preferred Generic|197628-Doxazosin8MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|313190-Tacrolimus0.5MGOralCapsule|SPD 632|1001|N|Y|N||Preferred Brand|833139-Milnacipranhydrochloride100MGOralTablet[Savella]|SPD 632|1001|N|Y|N||Preferred Brand|539789-rifaximin200MGOralTablet[XIFAXAN]|SPD 632|1001|N|N|N||Preferred Generic|313142-Sulfasalazine500MGDelayedReleaseOralTablet|SPD 632|1001|N|Y|N||Preferred Brand|402092-Cyclosporine0.5MG/MLOphthalmicSuspension[Restasis]|SPD 632|1001|N|Y|N||Preferred Brand|2398842-3MLsemaglutide1.34MG/MLPenInjector[Ozempic]|SPD 632|1001|Y|N|N||Preferred Brand|1657212-omalizumab150MGInjection[Xolair]|SPD 632|1001|N|N|N||Preferred Generic|313134-Sulfamethoxazole40MG/ML/Trimethoprim8MG/MLOralSuspension|SPD 632|1001|N|Y|N||Preferred Brand|2395785-0.5MLdulaglutide9MG/MLAuto-Injector[Trulicity]|SPD 632|1001|N|N|N||Preferred Generic|197627-Doxazosin4MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|863619-24HROxybutyninchloride10MGExtendedReleaseOralTablet|SPD 632|1001|N|Y|N||Preferred Brand|2395779-0.5MLdulaglutide6MG/MLAuto-Injector[Trulicity]|SPD 632|1001|Y|N|N||Preferred Generic|1146690-24HRlamotrigine250MGExtendedReleaseOralTablet|SPD 632|1001|N|Y|N||Preferred Brand|213307-Ciprofloxacin0.003MG/MGOphthalmicOintment[Ciloxan]|SPD 632|1001|N|Y|N||Preferred Brand|212381-aminosalicylicacid4000MGOralGranules[PaserD/R]|SPD 632|1001|N|N|N||Preferred Generic|197626-Doxazosin2MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|1000647-PilocarpineHydrochloride10MG/MLOphthalmicSolution|SPD 632|1001|N|N|N||Preferred Generic|313096-Spironolactone25MGOralTablet|SPD 632|1001|N|Y|N||Preferred Brand|1992821-ertugliflozin15MGOralTablet[Steglatro]|SPD 632|1001|N|Y|N||Preferred Brand|1992816-ertugliflozin5MGOralTablet[Steglatro]|SPD 632|1001|N|N|N||Preferred Generic|313092-Sorbitol700MG/MLOralSolution|SPD 632|1001|N|Y|N||Preferred Brand|1992703-ertugliflozin7.5MG/Metforminhydrochloride500MGOralTablet[Segluromet]|SPD 632|1001|N|Y|N||Preferred Brand|1992700-ertugliflozin7.5MG/Metforminhydrochloride1000MGOralTablet[Segluromet]|SPD 632|1001|N|N|N||Preferred Generic|310364-Fluocinonide0.5MG/MLTopicalSolution|SPD 632|1001|N|N|N||Preferred Generic|197625-Doxazosin1MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|312997-SodiumChloride9MG/MLInhalationSolution|SPD 632|1001|N|Y|N||Preferred Brand|1992695-ertugliflozin2.5MG/Metforminhydrochloride500MGOralTablet[Segluromet]|SPD 632|1001|N|N|N||Preferred Generic|197388-Azathioprine50MGOralTablet|SPD 632|1001|N|Y|N||Preferred Brand|1992691-ertugliflozin2.5MG/Metforminhydrochloride1000MGOralTablet[Segluromet]|SPD 632|1001|N|N|N||Preferred Generic|312962-Simvastatin5MGOralTablet|SPD 632|1001|N|Y|N||Preferred Brand|1991317-1MGDose1.5MLsemaglutide1.34MG/MLPenInjector[Ozempic]|SPD 632|1001|N|N|Y||Preferred Generic|200284-Hydrochlorothiazide12.5MG/valsartan80MGOralTablet|SPD 632|1001|N|N|N||Preferred Brand|213621-Bacitracin0.5UNT/MG/PolymyxinB10UNT/MGOphthalmicOintment[Polycin]|SPD 632|1001|N|Y|N||Preferred Brand|1991311-0.25MG,0.5MGDose1.5MLsemaglutide1.34MG/MLPenInjector[Ozempic]|SPD 632|1001|N|N|N||Preferred Generic|312961-Simvastatin20MGOralTablet|SPD 632|1001|N|Y|N||Preferred Brand|1801840-lifitegrast50MG/MLOphthalmicSolution[Xiidra]|SPD 632|1001|N|N|N||Preferred Generic|1000141-medroxyprogesteroneacetate5MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|197624-Disulfiram500MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|200285-Hydrochlorothiazide12.5MG/valsartan160MGOralTablet|SPD 632|1001|N|Y|N||Preferred Brand|1551306-0.5MLdulaglutide3MG/MLAuto-Injector[Trulicity]|SPD 632|1001|N|N|N||Preferred Generic|312941-Sertraline50MGOralTablet|SPD 632|1001|N|Y|N||Preferred Brand|1551300-0.5MLdulaglutide1.5MG/MLAuto-Injector[Trulicity]|SPD 632|1001|N|Y|N||Preferred Brand|1356673-BenzylAlcohol0.05ML/MLTopicalLotion[Ulesfia]|SPD 632|1001|N|N|N||Preferred Generic|197623-Disulfiram250MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|312940-Sertraline25MGOralTablet|SPD 632|1001|N|Y|N||Preferred Brand|1190334-24HRFexofenadinehydrochloride180MG/PseudoephedrineHydrochloride240MGExtendedReleaseOralTablet[Wal-FexD]|SPD 632|1001|N|N|Y||Preferred Brand|847189-3MLinsulinisophane,human70UNT/ML/insulin,regular,human30UNT/MLPenInjector[Humulin]|SPD 632|1001|N|N|Y||Preferred Generic|996757-CodeinePhosphate2MG/ML/PhenylephrineHydrochloride1MG/ML/PromethazineHydrochloride1.25MG/MLOralSolution|SPD 632|1001|N|N|Y||Preferred Generic|310793-Hydrochlorothiazide12.5MG/irbesartan300MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|312938-Sertraline100MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|995868-CodeinePhosphate2MG/ML/Guaifenesin20MG/MLOralSolution|SPD 632|1001|N|N|Y||Preferred Generic|993890-Acetaminophen300MG/CodeinePhosphate60MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|1000135-medroxyprogesteroneacetate2.5MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|197622-Dipyridamole50MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|312899-Salsalate500MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|993781-Acetaminophen300MG/CodeinePhosphate30MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|310534-Glyburide2.5MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|993770-Acetaminophen300MG/CodeinePhosphate15MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|312849-ropinirole5MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|993755-Acetaminophen24MG/ML/CodeinePhosphate2.4MG/MLOralSolution|SPD 632|1001|N|N|Y||Preferred Generic|993470-midodrinehydrochloride5MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|312847-ropinirole2MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|993466-midodrinehydrochloride2.5MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|197606-Digoxin0.25MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|152695-meloxicam15MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|993462-midodrinehydrochloride10MGOralTablet|SPD 632|1001|N|N|Y||Preferred Brand|1547582-0.5MLStreptococcuspneumoniaetype1capsularpolysaccharideantigen0.05MG/ML/Streptococcuspneumoniaetype10Acapsularpolysac|SPD 632|1001|N|N|N||Preferred Generic|312846-ropinirole0.5MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|992668-homatropinemethylbromide0.3MG/ML/HydrocodoneBitartrate1MG/MLOralSolution|SPD 632|1001|N|N|N||Preferred Brand|312018-Nitroglycerin6.5MGExtendedReleaseOralCapsule|SPD 632|1001|Y|N|N||Preferred Generic|1299911-Tiagabinehydrochloride2MGOralTablet|SPD 632|1001|N|N|N||Preferred Brand|213510-Auranofin3MGOralCapsule[Ridaura]|SPD 632|1001|N|N|Y||Preferred Generic|991528-DextromethorphanHydrobromide3MG/ML/PromethazineHydrochloride1.25MG/MLOralSolution|SPD 632|1001|N|N|N||Preferred Generic|197604-Digoxin0.125MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|1000114-medroxyprogesteroneacetate10MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|312845-ropinirole0.25MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|991486-CodeinePhosphate2MG/ML/PromethazineHydrochloride1.25MG/MLOralSolution|SPD 632|1001|N|N|N||Preferred Brand|1595292-amylase14000UNT/lipase3000UNT/protease10000UNTDelayedReleaseOralCapsule[Zenpep]|SPD 632|1001|N|N|N||Preferred Generic|199224-anastrozole1MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|977880-AmilorideHydrochloride5MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|312750-quinapril5MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|905516-ChlordiazepoxideHydrochloride5MGOralCapsule|SPD 632|1001|N|N|Y||Preferred Generic|905495-ChlordiazepoxideHydrochloride25MGOralCapsule|SPD 632|1001|N|N|Y||Preferred Generic|349483-valsartan40MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|197596-Dicloxacillin500MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|312749-quinapril20MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|905369-ChlordiazepoxideHydrochloride10MGOralCapsule|SPD 632|1001|N|N|Y||Preferred Generic|904589-SotalolHydrochloride240MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|312748-quinapril10MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|904447-Alendronicacid0.933MG/MLOralSolution|SPD 632|1001|N|N|N||Preferred Generic|310377-Fluorometholone1MG/MLOphthalmicSuspension|SPD 632|1001|N|N|Y||Preferred Generic|904419-Alendronicacid10MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|308979-Carbamazepine200MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|312641-Progesterone200MGOralCapsule|SPD 632|1001|N|N|Y||Preferred Generic|904405-Alendronicacid40MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|1000097-DoxepinHydrochloride75MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|197595-Dicloxacillin250MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|863664-Oxybutyninchloride5MGOralTablet|SPD 632|1001|N|N|Y||Preferred Brand|1547664-14ACTUATfluticasonefuroate0.1MG/ACTUATDryPowderInhaler[Arnuity]|SPD 632|1001|Y|N|N||Preferred Generic|1307427-sildenafil10MG/MLOralSuspension|SPD 632|1001|N|N|Y||Preferred Generic|899548-dexmethylphenidatehydrochloride10MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|899518-dexmethylphenidatehydrochloride5MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|197583-Dexamethasone6MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|312617-Prednisone5MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|897749-HydromorphoneHydrochloride3MGRectalSuppository|SPD 632|1001|N|N|N||Preferred Generic|284184-Didanosine250MGDelayedReleaseOralCapsule|SPD 632|1001|N|N|Y||Preferred Generic|200329-Omeprazole40MGDelayedReleaseOralCapsule|SPD 632|1001|N|N|Y||Preferred Generic|897710-HydromorphoneHydrochloride8MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|200311-Fenofibrate67MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|312615-Prednisone20MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|897702-HydromorphoneHydrochloride4MGOralTablet|SPD 632|1001|N|Y|N||Preferred Generic|1085816-spinosad9MG/MLMedicatedShampoo|SPD 632|1001|N|N|Y||Preferred Generic|897696-HydromorphoneHydrochloride2MGOralTablet|SPD 632|1001|N|N|N||Preferred Brand|213291-ParoxetineHydrochloride2MG/MLOralSuspension[Paxil]|SPD 632|1001|N|N|N||Preferred Generic|1000076-DoxepinHydrochloride50MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|308962-Captopril100MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|197582-Dexamethasone4MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|312594-Prazosin2MGOralCapsule|SPD 632|1001|N|N|Y||Preferred Generic|897659-Verapamilhydrochloride120MGExtendedReleaseOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|897640-Verapamilhydrochloride180MGExtendedReleaseOralTablet|SPD 632|1001|N|N|N||Preferred Generic|312593-Prazosin1MGOralCapsule|SPD 632|1001|N|N|Y||Preferred Generic|897630-24HRVerapamilhydrochloride360MGExtendedReleaseOralCapsule|SPD 632|1001|Y|N|N||Preferred Generic|1308569-24HRrivastigmine0.554MG/HRTransdermalSystem|SPD 632|1001|N|N|Y||Preferred Generic|897618-24HRVerapamilhydrochloride180MGExtendedReleaseOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|312529-PotassiumChloride8MEQExtendedReleaseOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|897612-24HRVerapamilhydrochloride120MGExtendedReleaseOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|197581-Dexamethasone2MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|200345-Simvastatin80MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1665906-1MLevolocumab140MG/MLPrefilledSyringe[Repatha]|SPD 632|1001|Y|N|N||Preferred Generic|1359861-Budesonide0.16MG/ACTUAT/formoterolfumarate0.0045MG/ACTUATMeteredDoseInhaler|SPD 632|1001|N|N|N||Preferred Generic|1190655-AtropineSulfate10MG/MLOphthalmicSolution|SPD 632|1001|N|N|N||Preferred Generic|310796-Hydrochlorothiazide12.5MG/quinapril10MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|892672-MorphineSulfate30MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|749157-{7(EthinylEstradiol0.025MG/norgestimate0.18MGOralTablet)/7(EthinylEstradiol0.025MG/norgestimate0.215MGOralTablet)/7(Et|SPD 632|1001|N|N|Y||Preferred Generic|892625-MorphineSulfate20MG/MLOralSolution|SPD 632|1001|N|N|N||Preferred Generic|197580-Dexamethasone1.5MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|312504-PotassiumChloride10MEQExtendedReleaseOralCapsule|SPD 632|1001|N|N|Y||Preferred Brand|1547672-30ACTUATfluticasonefuroate0.2MG/ACTUATDryPowderInhaler[Arnuity]|SPD 632|1001|N|N|Y||Preferred Generic|892589-MorphineSulfate2MG/MLOralSolution|SPD 632|1001|N|N|N||Preferred Generic|106258-Hydrocortisone10MG/MLTopicalCream|SPD 632|1001|N|N|Y||Preferred Generic|892582-MorphineSulfate15MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|312441-pioglitazone45MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|884386-DextroamphetamineSulfate5MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|884385-DextroamphetamineSulfate10MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|310379-Fluorouracil20MG/MLTopicalSolution|SPD 632|1001|N|N|Y||Preferred Generic|349514-celecoxib400MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|197579-Dexamethasone1MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|1360304-Budesonide0.08MG/ACTUAT/formoterolfumarate0.0045MG/ACTUATMeteredDoseInhaler|SPD 632|1001|N|N|Y||Preferred Generic|866042-NeomycinSulfate500MGOralTablet|SPD 632|1001|N|N|N||Preferred Brand|863836-amylase30000UNT/lipase6000UNT/protease19000UNTDelayedReleaseOralCapsule[Creon]|SPD 632|1001|N|N|Y||Preferred Generic|863559-valganciclovir50MG/MLOralSolution|SPD 632|1001|N|N|N||Preferred Generic|312362-Phenobarbital30MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|862025-24HRGuanfacine4MGExtendedReleaseOralTablet|SPD 632|1001|N|N|N||Preferred Brand|1594673-amylase105000UNT/lipase25000UNT/protease79000UNTDelayedReleaseOralCapsule[Zenpep]|SPD 632|1001|N|N|N||Preferred Brand|213284-hydroxyurea400MGOralCapsule[Droxia]|SPD 632|1001|N|N|N||Preferred Generic|313227-terconazole8MG/MLVaginalCream|SPD 632|1001|N|N|Y||Preferred Generic|862019-24HRGuanfacine3MGExtendedReleaseOralTablet|SPD 632|1001|N|N|N||Preferred Brand|1148646-28ACTUATFluticasonepropionate0.25MG/ACTUATDryPowderInhaler[Flovent]|SPD 632|1001|N|N|N||Preferred Generic|312357-Phenobarbital15MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|862013-24HRGuanfacine2MGExtendedReleaseOralTablet|SPD 632|1001|N|N|N||Preferred Generic|1000064-DoxepinHydrochloride150MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|197577-Dexamethasone0.5MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|862006-24HRGuanfacine1MGExtendedReleaseOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|203088-Ketoconazole20MG/MLTopicalCream|SPD 632|1001|N|N|Y||Preferred Brand|1547950-CarboxymethylcelluloseSodium2.5MG/MLOphthalmicSolution[TheraTears]|SPD 632|1001|N|N|N||Preferred Generic|312301-Pentoxifylline400MGExtendedReleaseOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|861237-24HRAmphetamineaspartate1.25MG/AmphetamineSulfate1.25MG/Dextroamphetaminesaccharate1.25MG/DextroamphetamineSulfate1.25|SPD 632|1001|N|N|N||Preferred Generic|284185-Didanosine200MGDelayedReleaseOralCapsule|SPD 632|1001|N|N|Y||Preferred Generic|861232-24HRAmphetamineaspartate7.5MG/AmphetamineSulfate7.5MG/Dextroamphetaminesaccharate7.5MG/DextroamphetamineSulfate7.5MGEx|SPD 632|1001|N|N|N||Preferred Generic|197575-Desoximetasone0.0025MG/MGTopicalOintment|SPD 632|1001|N|N|N||Preferred Generic|312289-Naloxone0.5MG/Pentazocine50MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|861227-24HRAmphetamineaspartate6.25MG/AmphetamineSulfate6.25MG/Dextroamphetaminesaccharate6.25MG/DextroamphetamineSulfate6.25|SPD 632|1001|N|N|Y||Preferred Generic|861225-24HRAmphetamineaspartate5MG/AmphetamineSulfate5MG/Dextroamphetaminesaccharate5MG/DextroamphetamineSulfate5MGExtendedRe|SPD 632|1001|N|N|N||Preferred Generic|312138-oxcarbazepine600MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|861223-24HRAmphetamineaspartate3.75MG/AmphetamineSulfate3.75MG/Dextroamphetaminesaccharate3.75MG/DextroamphetamineSulfate3.75|SPD 632|1001|N|N|Y||Preferred Generic|861221-24HRAmphetamineaspartate2.5MG/AmphetamineSulfate2.5MG/Dextroamphetaminesaccharate2.5MG/DextroamphetamineSulfate2.5MGEx|SPD 632|1001|N|N|Y||Preferred Generic|310792-Hydrochlorothiazide12.5MG/irbesartan150MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|1000058-DoxepinHydrochloride100MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|197558-Dapsone25MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|312137-oxcarbazepine300MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|857366-EconazoleNitrate10MG/MLTopicalCream|SPD 632|1001|N|N|N||Preferred Generic|992447-PromethazineHydrochloride25MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|857005-Acetaminophen325MG/HydrocodoneBitartrate7.5MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|1000897-PilocarpineHydrochloride40MG/MLOphthalmicSolution|SPD 632|1001|N|N|N||Preferred Generic|312136-oxcarbazepine150MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|857002-Acetaminophen325MG/HydrocodoneBitartrate5MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|856999-Acetaminophen325MG/HydrocodoneBitartrate10MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|312059-Nystatin500000UNTOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|856940-Acetaminophen21.7MG/ML/HydrocodoneBitartrate0.5MG/MLOralSolution|SPD 632|1001|N|N|N||Preferred Generic|197557-Dapsone100MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|866083-buspironehydrochloride10MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|855633-DiclofenacSodium0.01MG/MGTopicalGel|SPD 632|1001|Y|N|N||Preferred Generic|1373491-dimethylfumarate240MGDelayedReleaseOralCapsule|SPD 632|1001|N|N|Y||Preferred Generic|854876-Zolpidemtartrate5MGOralTablet|SPD 632|1001|N|N|N||Preferred Brand|213283-hydroxyurea300MGOralCapsule[Droxia]|SPD 632|1001|N|N|Y||Preferred Generic|854873-Zolpidemtartrate10MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|197553-Cyclosporine25MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|1000054-DoxepinHydrochloride10MG/MLOralSolution|SPD 632|1001|N|N|N||Preferred Generic|312036-Nortriptyline2MG/MLOralSolution|SPD 632|1001|N|N|Y||Preferred Generic|854252-1MLEnoxaparinsodium150MG/MLPrefilledSyringe|SPD 632|1001|Y|N|N||Preferred Generic|999986-Amlodipine10MG/Hydrochlorothiazide12.5MG/Olmesartanmedoxomil40MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|854248-1MLEnoxaparinsodium100MG/MLPrefilledSyringe|SPD 632|1001|N|N|Y||Preferred Generic|349353-Hydrochlorothiazide25MG/valsartan160MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|312013-Nitroglycerin2.5MGExtendedReleaseOralCapsule|SPD 632|1001|N|N|Y||Preferred Generic|854245-0.8MLEnoxaparinsodium150MG/MLPrefilledSyringe|SPD 632|1001|N|N|Y||Preferred Generic|854241-0.8MLEnoxaparinsodium100MG/MLPrefilledSyringe|SPD 632|1001|N|N|N||Preferred Generic|197311-Acyclovir400MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|310380-Fluorouracil50MG/MLTopicalSolution|SPD 632|1001|N|N|N||Preferred Generic|197518-Clindamycin150MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|749784-{7(EthinylEstradiol0.035MG/norgestimate0.18MGOralTablet)/7(EthinylEstradiol0.035MG/norgestimate0.215MGOralTablet)/7(Et|SPD 632|1001|N|N|N||Preferred Generic|311995-NITROFURANTOIN,MACROCRYSTALS50MGOralCapsule|SPD 632|1001|N|N|Y||Preferred Generic|854238-0.6MLEnoxaparinsodium100MG/MLPrefilledSyringe|SPD 632|1001|N|N|Y||Preferred Generic|854235-0.4MLEnoxaparinsodium100MG/MLPrefilledSyringe|SPD 632|1001|N|N|N||Preferred Generic|311994-NITROFURANTOIN,MACROCRYSTALS25MGOralCapsule|SPD 632|1001|N|Y|N||Preferred Generic|1368431-alogliptin25MG/pioglitazone30MGOralTablet|SPD 632|1001|N|N|Y||Preferred Brand|836634-1MLhepatitisAvirusstrainCR326Fantigen,inactivated50UNT/MLPrefilledSyringe[Vaqta]|SPD 632|1001|N|N|Y||Preferred Generic|854228-0.3MLEnoxaparinsodium100MG/MLPrefilledSyringe|SPD 632|1001|N|N|Y||Preferred Generic|2047882-1MLtestosteronecypionate200MG/MLInjection|SPD 632|1001|N|N|Y||Preferred Generic|847252-3MLInsulinLispro25UNT/ML/insulinlisproprotamine,human75UNT/MLPenInjector|SPD 632|1001|N|N|N||Preferred Generic|311989-Nitrofurantoin5MG/MLOralSuspension|SPD 632|1001|N|N|Y||Preferred Generic|847191-3MLinsulinaspartprotamine,human70UNT/ML/insulinaspart,human30UNT/MLPenInjector|SPD 632|1001|N|N|N||Preferred Generic|1000048-DoxepinHydrochloride10MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|197517-Clarithromycin500MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|847913-60ACTUATexenatide0.01MG/ACTUATPenInjector[Byetta]|SPD 632|1001|N|N|Y||Preferred Generic|205322-celecoxib100MGOralCapsule|SPD 632|1001|N|N|Y||Preferred Generic|846378-24HRLevetiracetam750MGExtendedReleaseOralTablet|SPD 632|1001|N|N|N||Preferred Generic|311963-Niacin750MGExtendedReleaseOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|845488-Ramipril1.25MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|1648755-NITROFURANTOIN,MACROCRYSTALS25MG/Nitrofurantoin,Monohydrate75MGOralCapsule|SPD 632|1001|N|N|Y||Preferred Generic|835829-testosteronecypionate100MG/MLInjectableSolution|SPD 632|1001|N|N|N||Preferred Generic|197516-Clarithromycin250MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|311960-Niacin500MGExtendedReleaseOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|835603-tramadolhydrochloride50MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|1095229-FlavoxateHydrochloride100MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|834022-KetorolacTromethamine10MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|284215-Clindamycin300MGOralCapsule|SPD 632|1001|N|N|Y||Preferred Generic|830861-24HRDiltiazemHydrochloride120MGExtendedReleaseOralCapsule|SPD 632|1001|N|N|N||Preferred Brand|206216-2MLIron-DextranComplex50MG/MLInjection[InFed]|SPD 632|1001|N|N|N||Preferred Generic|311196-24HRIsosorbideMononitrate120MGExtendedReleaseOralTablet|SPD 632|1001|N|N|N||Preferred Brand|207949-Succimer100MGOralCapsule[Chemet]|SPD 632|1001|Y|N|N||Preferred Generic|1426600-{24(EthinylEstradiol0.02MG/norethindroneacetate1MGChewableTablet)/4(Ferrousfumarate75MGOralTablet)}Pack|SPD 632|1001|N|N|N||Preferred Generic|197500-Chlorthalidone50MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|1191013-Proparacainehydrochloride5MG/MLOphthalmicSolution|SPD 632|1001|N|N|N||Preferred Generic|310384-Fluoxetine10MGOralCapsule|SPD 632|1001|Y|N|N||Preferred Brand|1728099-romiplostim0.5MGInjection[Nplate]|SPD 632|1001|N|N|Y||Preferred Brand|1596445-7ACTUATumeclidinium0.0625MG/ACTUATDryPowderInhaler[Incruse]|SPD 632|1001|N|N|N||Preferred Generic|310490-Glipizide5MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|106336-Ketoconazole20MG/MLMedicatedShampoo|SPD 632|1001|N|N|N||Preferred Generic|284245-Famotidine40MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|2123111-NDA020503200ACTUATAlbuterol0.09MG/ACTUATMeteredDoseInhaler|SPD 632|1001|N|N|N||Preferred Brand|312020-Nitroglycerin9MGExtendedReleaseOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|866111-buspironehydrochloride7.5MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|728113-Oseltamivir45MGOralCapsule|SPD 632|1001|N|N|N||Preferred Brand|992759-Homatropinehydrobromide50MG/MLOphthalmicSolution[Homatropaire]|SPD 632|1001|N|N|N||Preferred Generic|310385-Fluoxetine20MGOralCapsule|SPD 632|1001|N|N|Y||Preferred Brand|1597103-0.5MLL1protein,Humanpapillomavirustype11Vaccine0.08MG/ML/L1protein,Humanpapillomavirustype16Vaccine0.12MG/ML/L1protei|SPD 632|1001|N|N|N||Preferred Brand|2110510-60ACTUATFluticasonepropionate0.1MG/ACTUAT/salmeterol0.05MG/ACTUATDryPowderInhaler[Wixela]|SPD 632|1001|N|N|Y||Preferred Generic|238003-168HREstradiol0.00208MG/HRTransdermalSystem|SPD 632|1001|N|N|N||Preferred Generic|197313-Acyclovir800MGOralTablet|SPD 632|1001|N|N|Y||Preferred Brand|830263-1MLHepatitisBSurfaceAntigenVaccine0.04MG/MLInjection[Recombivax]|SPD 632|1001|N|N|N||Preferred Generic|755497-Albuterol0.4MG/MLOralSolution|SPD 632|1001|N|N|N||Preferred Generic|308976-Carbamazepine20MG/MLOralSuspension|SPD 632|1001|Y|N|N||Preferred Brand|1729047-selexipag1.6MGOralTablet[Uptravi]|SPD 632|1001|Y|N|N||Preferred Brand|828703-1.2MLPlerixafor20MG/MLInjection[Mozobil]|SPD 632|1001|Y|N|N||Preferred Generic|153823-candesartancilexetil8MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1729033-selexipag1.4MGOralTablet[Uptravi]|SPD 632|1001|Y|N|N||Preferred Generic|153822-candesartancilexetil4MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|197449-Cefaclor500MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|284988-Didanosine400MGDelayedReleaseOralCapsule|SPD 632|1001|N|N|Y||Preferred Generic|238004-168HREstradiol0.00417MG/HRTransdermalSystem|SPD 632|1001|N|N|N||Preferred Generic|1648759-NITROFURANTOIN,MACROCRYSTALS100MGOralCapsule|SPD 632|1001|Y|N|N||Preferred Brand|1729053-selexipag0.2MGOralTablet[Uptravi]|SPD 632|1001|N|N|Y||Preferred Brand|1601407-0.5MLmeningococcalgroupBvaccine0.1MG/ML/NeisseriameningitidisserogroupBrecombinantFHBPfusionproteinantigen0.1MG/ML/Ne|SPD 632|1001|N|N|N||Preferred Brand|212039-Estrogens,Esterified(USP)0.3MGOralTablet[Menest]|SPD 632|1001|N|N|N||Preferred Generic|240029-Cholecalciferol0.125MGOralCapsule|SPD 632|1001|N|N|N||Preferred Brand|992481-PromethazineHydrochloride50MGRectalSuppository[Promethegan]|SPD 632|1001|N|N|Y||Preferred Generic|241527-168HREstradiol0.00312MG/HRTransdermalSystem|SPD 632|1001|N|N|N||Preferred Generic|310386-Fluoxetine4MG/MLOralSolution|SPD 632|1001|N|N|Y||Preferred Generic|577957-Amphetamineaspartate3.75MG/AmphetamineSulfate3.75MG/Dextroamphetaminesaccharate3.75MG/DextroamphetamineSulfate3.75MGOr|SPD 632|1001|N|N|N||Preferred Brand|705008-Cefixime40MG/MLOralSuspension[Suprax]|SPD 632|1001|N|N|Y||Preferred Generic|241946-84HREstradiol0.00156MG/HRTransdermalSystem|SPD 632|1001|N|N|Y||Preferred Generic|310465-Gentamicin0.001MG/MGTopicalOintment|SPD 632|1001|N|N|N||Preferred Generic|307675-Acetaminophen32MG/MLOralSolution|SPD 632|1001|N|N|N||Preferred Brand|896031-28ACTUATFluticasonepropionate0.1MG/ACTUATDryPowderInhaler[Flovent]|SPD 632|1001|Y|N|N||Preferred Brand|1729076-UptraviTitrationPack|SPD 632|1001|N|N|N||Preferred Generic|866419-24HRmetoprololsuccinate200MGExtendedReleaseOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|828696-Zolpidemtartrate5MG/ACTUATOralSpray[Zolpimist]|SPD 632|1001|N|N|N||Preferred Generic|197444-Carbidopa25MG/Levodopa100MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|310410-FolicAcid1MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|349201-valsartan160MGOralTablet|SPD 632|1001|N|N|Y||Preferred Brand|1656356-sacubitril97MG/valsartan103MGOralTablet[Entresto]|SPD 632|1001|N|N|N||Preferred Generic|311194-IsosorbideDinitrate40MGExtendedReleaseOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|1607617-24HRdesvenlafaxinesuccinate25MGExtendedReleaseOralTablet|SPD 632|1001|N|N|N||Preferred Generic|307718-Acetylcysteine100MG/MLInhalationSolution|SPD 632|1001|N|N|Y||Preferred Generic|242438-montelukast5MGChewableTablet|SPD 632|1001|N|N|Y||Preferred Brand|1658060-1MLHepatitisAVaccine(Inactivated)StrainHM1751440UNT/MLInjection[Havrix]|SPD 632|1001|N|N|N||Preferred Generic|992438-PromethazineHydrochloride12.5MGOralTablet|SPD 632|1001|N|N|N||Preferred Brand|762007-Nortrel7/7/728DayPack|SPD 632|1001|N|N|Y||Preferred Generic|403923-168HREstradiol0.0025MG/HRTransdermalSystem|SPD 632|1001|N|N|N||Preferred Brand|1114135-amylase16000UNT/lipase3000UNT/protease10000UNTDelayedReleaseOralCapsule[Zenpep]|SPD 632|1001|N|N|N||Preferred Generic|763181-{21(Prednisone5MGOralTablet)}Pack|SPD 632|1001|N|N|N||Preferred Brand|967012-POLYETHYLENEGLYCOL3350236000MG/PotassiumChloride2970MG/SodiumBicarbonate6740MG/SodiumChloride5860MG/sodiumsulfate22740|SPD 632|1001|N|N|N||Preferred Generic|995278-HydroxyzinePamoate50MGOralCapsule|SPD 632|1001|N|N|Y||Preferred Generic|197529-Clonazepam2MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|310429-Furosemide20MGOralTablet|SPD 632|1001|N|N|Y||Preferred Brand|1658102-1MLhepatitisAvirusstrainCR326Fantigen,inactivated50UNT/MLInjection[Vaqta]|SPD 632|1001|N|N|Y||Preferred Generic|242461-cilostazol100MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1734642-elbasvir50MG/grazoprevir100MGOralTablet[Zepatier]|SPD 632|1001|N|N|N||Preferred Generic|866511-MetoprololTartrate100MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|197362-ammoniumlactate120MG/MLTopicalLotion|SPD 632|1001|N|N|N||Preferred Generic|197411-Bromocriptine2.5MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|307719-Acetylcysteine200MG/MLInhalationSolution|SPD 632|1001|N|N|N||Preferred Generic|313580-venlafaxine100MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|1607990-{24(EthinylEstradiol0.025MG/Norethindrone0.8MGChewableTablet)/4(Ferrousfumarate75MGChewableTablet)}Pack|SPD 632|1001|N|N|Y||Preferred Brand|1658106-0.5MLhepatitisAvirusstrainCR326Fantigen,inactivated50UNT/MLInjection[Vaqta]|SPD 632|1001|N|N|N||Preferred Generic|828320-Cyclobenzaprinehydrochloride5MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|1657160-0.5MLSumatriptan12MG/MLCartridge|SPD 632|1001|N|N|N||Preferred Generic|308973-Carbamazepine100MGChewableTablet|SPD 632|1001|N|N|Y||Preferred Generic|310289-Fenofibrate200MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|197318-Albuterol4MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|861743-Glyburide1.25MG/Metforminhydrochloride250MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|860107-KetorolacTromethamine5MG/MLOphthalmicSolution|SPD 632|1001|N|N|N||Preferred Generic|310430-gabapentin100MGOralCapsule|SPD 632|1001|N|N|Y||Preferred Generic|349200-valsartan320MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|349592-atomoxetine18MGOralCapsule|SPD 632|1001|N|N|Y||Preferred Brand|830245-1MLHepatitisBSurfaceAntigenVaccine0.01MG/MLPrefilledSyringe[Recombivax]|SPD 632|1001|Y|N|N||Preferred Brand|1746898-10MLreslizumab10MG/MLInjection[Cinqair]|SPD 632|1001|N|N|N||Preferred Generic|106387-Permethrin50MG/MLTopicalCream|SPD 632|1001|Y|N|N||Preferred Generic|1728055-5MLpalonosetron0.05MG/MLInjection|SPD 632|1001|N|N|N||Preferred Generic|1659263-1MLheparinsodium,porcine5000UNT/MLInjection|SPD 632|1001|N|N|N||Preferred Generic|828348-Cyclobenzaprinehydrochloride10MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|242892-84HREstradiol0.00417MG/HRTransdermalSystem|SPD 632|1001|N|N|N||Preferred Generic|307730-Acyclovir40MG/MLOralSuspension|SPD 632|1001|N|N|N||Preferred Generic|310489-24HRGlipizide2.5MGExtendedReleaseOralTablet|SPD 632|1001|N|N|N||Preferred Brand|617333-Amoxicillin25MG/ML/Clavulanate6.25MG/MLOralSuspension[Augmentin]|SPD 632|1001|N|N|N||Preferred Generic|197407-Betamethasone1MG/MLTopicalCream|SPD 632|1001|N|N|N||Preferred Generic|310431-gabapentin300MGOralCapsule|SPD 632|1001|N|N|Y||Preferred Brand|1658157-1MLHepatitisBSurfaceAntigenVaccine0.02MG/MLInjection[Engerix-B]|SPD 632|1001|N|N|N||Preferred Generic|876193-POLYETHYLENEGLYCOL335017000MGPowderforOralSolution|SPD 632|1001|N|N|N||Preferred Generic|308078-AluminumHydroxide64MG/MLOralSuspension|SPD 632|1001|N|N|Y||Preferred Generic|251872-pantoprazole20MGDelayedReleaseOralTablet|SPD 632|1001|N|N|N||Preferred Brand|209002-prednisolone1.2MG/MLOphthalmicSuspension[PredMild]|SPD 632|1001|N|N|N||Preferred Brand|1595462-amylase42000UNT/lipase10000UNT/protease32000UNTDelayedReleaseOralCapsule[Zenpep]|SPD 632|1001|N|N|Y||Preferred Generic|349195-Clonazepam0.25MGDisintegratingOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|1793916-0.5MLSumatriptan8MG/MLAuto-Injector|SPD 632|1001|N|N|N||Preferred Generic|831054-DiltiazemHydrochloride120MGOralTablet|SPD 632|1001|N|N|N||Preferred Brand|1998774-Breath-Actuated120ACTUATBeclomethasoneDipropionate0.04MG/ACTUATMeteredDoseInhaler[Qvar]|SPD 632|1001|N|N|N||Preferred Brand|896019-60ACTUATFluticasonepropionate0.05MG/ACTUATDryPowderInhaler[Flovent]|SPD 632|1001|Y|N|N||Preferred Brand|1790546-infliximab-dyyb100MGInjection[Inflectra]|SPD 632|1001|N|N|N||Preferred Generic|310432-gabapentin400MGOralCapsule|SPD 632|1001|N|N|Y||Preferred Brand|1667882-60ACTUATtiotropium0.00125MG/ACTUATInhalationSpray[Spiriva]|SPD 632|1001|N|N|Y||Preferred Generic|252559-Budesonide0.5MG/MLInhalationSuspension|SPD 632|1001|N|N|N||Preferred Generic|1191315-FluocinoloneAcetonide0.25MG/MLTopicalCream|SPD 632|1001|N|N|Y||Preferred Brand|804186-0.5MLMeaslesVirusVaccineLive,Enders'attenuatedEdmonstonstrain2000UNT/ML/MumpsVirusVaccineLive,JerylLynnStrain25000UNT/|SPD 632|1001|N|N|N||Preferred Generic|197391-Baclofen10MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|308135-Amlodipine10MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|259081-12HRAspirin25MG/Dipyridamole200MGExtendedReleaseOralCapsule|SPD 632|1001|N|N|N||Preferred Brand|208513-Estrogens,Conjugated(USP)0.3MGOralTablet[Premarin]|SPD 632|1001|N|N|N||Preferred Generic|831102-DiltiazemHydrochloride90MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1799230-1MLabatacept125MG/MLAuto-Injector[Orencia]|SPD 632|1001|N|N|N||Preferred Generic|1665050-Cefazolin1000MGInjection|SPD 632|1001|N|N|Y||Preferred Brand|1723478-dabigatranetexilate110MGOralCapsule[Pradaxa]|SPD 632|1001|N|N|N||Preferred Generic|310818-Hydrochlorothiazide50MG/Triamterene75MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|313762-zaleplon5MGOralCapsule|SPD 632|1001|N|N|N||Preferred Brand|707333-SodiumChloride0.111MEQ/MLNasalSolution[AyrSalineNasal]|SPD 632|1001|N|N|N||Preferred Generic|311192-IsosorbideMononitrate10MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|884189-ClonidineHydrochloride0.3MGOralTablet|SPD 632|1001|N|Y|N||Preferred Generic|197984-Minocycline100MGOralCapsule|SPD 632|1001|N|N|N||Preferred Brand|896006-120ACTUATFluticasonepropionate0.22MG/ACTUATMeteredDoseInhaler[Flovent]|SPD 632|1001|N|N|Y||Preferred Generic|261962-Ramipril10MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|310433-gabapentin600MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|313570-Vancomycin125MGOralCapsule|SPD 632|1001|Y|N|N||Preferred Generic|1860137-Abuse-Deterrent12HROxycodoneHydrochloride40MGExtendedReleaseOralTablet|SPD 632|1001|N|N|N||Preferred Generic|1100457-PyridoxineHydrochloride25MGOralTablet|SPD 632|1001|N|N|Y||Preferred Brand|803371-1MLHepatitisAVaccine(Inactivated)StrainHM175720UNT/ML/HepatitisBSurfaceAntigenVaccine0.02MG/MLPrefilledSyringe[Twinrix|SPD 632|1001|N|N|Y||Preferred Generic|283407-Mirtazapine30MGDisintegratingOralTablet|SPD 632|1001|N|N|N||Preferred Generic|309054-cefdinir25MG/MLOralSuspension|SPD 632|1001|N|N|N||Preferred Generic|831109-CromolynSodium40MG/MLOphthalmicSolution|SPD 632|1001|N|N|N||Preferred Generic|308136-Amlodipine2.5MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|1797867-Azelastinehydrochloride0.137MG/ACTUATMeteredDoseNasalSpray|SPD 632|1001|N|N|N||Preferred Generic|310488-Glipizide10MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|892342-24HRMorphineSulfate30MGExtendedReleaseOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|197382-Atenolol100MG/Chlorthalidone25MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|310434-gabapentin800MGOralTablet|SPD 632|1001|N|N|N||Preferred Brand|208551-thyroid(USP)300MGOralTablet[ArmourThyroid]|SPD 632|1001|Y|N|N||Preferred Brand|1806942-carfilzomib60MGInjection[Kyprolis]|SPD 632|1001|Y|N|N||Preferred Generic|1860154-Abuse-Deterrent12HROxycodoneHydrochloride15MGExtendedReleaseOralTablet|SPD 632|1001|N|N|Y||Preferred Brand|1797888-Nicotine0.5MG/ACTUATMeteredDoseNasalSpray[Nicotrol]|SPD 632|1001|N|N|N||Preferred Brand|866049-60ACTUATsalmeterol0.05MG/ACTUATDryPowderInhaler[Serevent]|SPD 632|1001|N|N|N||Preferred Brand|1114041-DextromethorphanHydrobromide1MG/MLOralSolution[DayQuilCough]|SPD 632|1001|N|N|N||Preferred Generic|313584-venlafaxine37.5MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1811182-icosapentethyl500MGOralCapsule[Vascepa]|SPD 632|1001|N|N|N||Preferred Brand|2110513-60ACTUATFluticasonepropionate0.25MG/ACTUAT/salmeterol0.05MG/ACTUATDryPowderInhaler[Wixela]|SPD 632|1001|Y|N|N||Preferred Brand|825425-eltrombopag25MGOralTablet[Promacta]|SPD 632|1001|N|N|N||Preferred Generic|308964-Captopril50MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|308177-Amoxicillin125MGChewableTablet|SPD 632|1001|N|N|Y||Preferred Generic|309309-Ciprofloxacin500MGOralTablet|SPD 632|1001|N|N|Y||Preferred Brand|1986830-0.5MLVaricellazostervirusglycoproteinE,recombinant0.1MG/MLInjection[Shingrix]|SPD 632|1001|N|N|N||Preferred Generic|199885-Levofloxacin500MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|885857-Balsalazidedisodium750MGOralCapsule|SPD 632|1001|N|N|Y||Preferred Generic|311975-Nicotine4MGChewingGum|SPD 632|1001|Y|N|N||Preferred Generic|1860151-Abuse-Deterrent12HROxycodoneHydrochloride30MGExtendedReleaseOralTablet|SPD 632|1001|N|N|N||Preferred Brand|895996-120ACTUATFluticasonepropionate0.044MG/ACTUATMeteredDoseInhaler[Flovent]|SPD 632|1001|N|N|N||Preferred Generic|310442-Ganciclovir500MGInjection|SPD 632|1001|N|N|Y||Preferred Brand|1992169-InsulinLispro100UNT/MLInjectableSolution[Admelog]|SPD 632|1001|N|N|Y||Preferred Generic|309314-Citalopram40MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|1918042-abirateroneacetate500MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|197379-Atenolol100MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|308182-Amoxicillin250MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|993503-12HRBupropionHydrochloride100MGExtendedReleaseOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|1923822-deferasirox90MGOralGranules|SPD 632|1001|N|N|Y||Preferred Generic|313412-tizanidine2MGOralTablet|SPD 632|1001|N|N|Y||Preferred Brand|1992171-3MLInsulinLispro100UNT/MLPenInjector[Admelog]|SPD 632|1001|N|N|N||Preferred Generic|197405-Betamethasone0.0005MG/MGTopicalOintment|SPD 632|1001|N|N|N||Preferred Generic|1006688-SulfacetamideSodium100MG/MLTopicalLotion|SPD 632|1001|N|N|Y||Preferred Generic|310190-estradiolvalerate20MG/MLInjectableSolution|SPD 632|1001|N|N|Y||Preferred Generic|310152-Erythromycin0.02MG/MGTopicalGel|SPD 632|1001|N|N|N||Preferred Generic|197361-Amlodipine5MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|310459-Gemfibrozil600MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|349197-Clonazepam2MGDisintegratingOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|310191-estradiolvalerate40MG/MLInjectableSolution|SPD 632|1001|N|N|Y||Preferred Brand|798482-0.5MLHepatitisAVaccine(Inactivated)StrainHM1751440UNT/MLPrefilledSyringe[Havrix]|SPD 632|1001|N|N|N||Preferred Generic|886671-FlecainideAcetate150MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|311166-isoniazid100MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1870950-deflazacort6MGOralTablet[Emflaza]|SPD 632|1001|N|N|N||Preferred Generic|308189-Amoxicillin80MG/MLOralSuspension|SPD 632|1001|Y|N|N||Preferred Brand|1732165-incobotulinumtoxinA200UNTInjection[Xeomin]|SPD 632|1001|Y|N|N||Preferred Generic|197730-Furosemide10MG/MLOralSolution|SPD 632|1001|N|N|N||Preferred Brand|152854-Itraconazole10MG/MLOralSolution[Sporanox]|SPD 632|1001|N|N|N||Preferred Generic|1193360-100MLLevetiracetam15MG/MLInjection|SPD 632|1001|N|N|N||Preferred Generic|197320-Allopurinol300MGOralTablet|SPD 632|1001|N|N|Y||Preferred Brand|2000133-Vancomycin25MG/MLOralSolution[Firvanq]|SPD 632|1001|N|N|N||Preferred Generic|834040-PenicillinVPotassium50MG/MLOralSolution|SPD 632|1001|N|Y|N||Preferred Generic|311787-moxifloxacin400MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|310288-Fenofibrate134MGOralCapsule|SPD 632|1001|Y|N|N||Preferred Generic|198070-Penicillamine250MGOralCapsule|SPD 632|1001|N|N|Y||Preferred Generic|248478-84HREstradiol0.00104MG/HRTransdermalSystem|SPD 632|1001|N|N|N||Preferred Generic|1085640-TriamcinoloneAcetonide0.005MG/MGTopicalOintment|SPD 632|1001|Y|N|N||Preferred Brand|1871459-lisdexamfetaminedimesylate40MGChewableTablet[Vyvanse]|SPD 632|1001|N|N|N||Preferred Brand|864010-ammoniumlactate120MG/MLTopicalLotion[Geri-Hydrolac]|SPD 632|1001|N|N|N||Preferred Generic|892255-LevothyroxineSodium0.3MGOralTablet|SPD 632|1001|N|N|Y||Preferred Brand|2045382-30ACTUATfluticasonefuroate0.05MG/ACTUATDryPowderInhaler[Arnuity]|SPD 632|1001|N|N|Y||Preferred Generic|242462-cilostazol50MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|308963-Captopril12.5MGOralTablet|SPD 632|1001|N|N|Y||Preferred Brand|999965-Glycopyrrolate0.2MG/MLOralSolution[Cuvposa]|SPD 632|1001|Y|N|N||Preferred Generic|198071-Penicillamine250MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|198243-Temazepam7.5MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|197316-Albuterol2MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|308194-Amoxicillin875MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|876524-Amlodipine5MG/telmisartan40MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|1724439-thyroid(USP)30MGOralTablet[NPThyroid]|SPD 632|1001|N|N|Y||Preferred Brand|2047639-sodiumzirconiumcyclosilicate5000MGPowderforOralSuspension[Lokelma]|SPD 632|1001|N|N|N||Preferred Generic|834102-PenicillinVPotassium500MGOralTablet|SPD 632|1001|N|N|N||Preferred Brand|863841-amylase60000UNT/lipase12000UNT/protease38000UNTDelayedReleaseOralCapsule[Creon]|SPD 632|1001|N|N|N||Preferred Generic|1193362-100MLLevetiracetam5MG/MLInjection|SPD 632|1001|N|N|Y||Preferred Generic|310467-Gentamicin3MG/MLOphthalmicSolution|SPD 632|1001|Y|N|N||Preferred Brand|1871469-lisdexamfetaminedimesylate50MGChewableTablet[Vyvanse]|SPD 632|1001|N|N|N||Preferred Generic|896209-60ACTUATFluticasonepropionate0.25MG/ACTUAT/salmeterol0.05MG/ACTUATDryPowderInhaler|SPD 632|1001|N|N|Y||Preferred Generic|205323-celecoxib200MGOralCapsule|SPD 632|1001|Y|N|N||Preferred Generic|199378-12HRCarbamazepine100MGExtendedReleaseOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|351133-Fenofibrate54MGOralTablet|SPD 632|1001|N|N|Y||Preferred Brand|798428-1MLHepatitisBSurfaceAntigenVaccine0.02MG/MLPrefilledSyringe[Engerix-B]|SPD 632|1001|N|N|N||Preferred Generic|308212-Ampicillin500MGOralCapsule|SPD 632|1001|Y|N|N||Preferred Generic|199521-Vigabatrin500MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|1085644-TriamcinoloneAcetonide0.25MG/MLTopicalCream|SPD 632|1001|Y|N|N||Preferred Generic|200220-tolcapone100MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|197310-Acyclovir200MGOralCapsule|SPD 632|1001|N|N|N||Preferred Brand|351901-Sirolimus1MG/MLOralSolution[Rapamune]|SPD 632|1001|N|N|N||Preferred Brand|2561275-0.5MLinfluenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.03MG/|SPD 632|1001|N|N|Y||Preferred Brand|2059017-rivaroxaban2.5MGOralTablet[Xarelto]|SPD 632|1001|Y|N|N||Preferred Generic|200327-capecitabine150MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|810002-lacosamide50MGOralTablet[Vimpat]|SPD 632|1001|N|N|N||Preferred Generic|835568-ImipramineHydrochloride50MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|311207-Ivermectin3MGOralTablet|SPD 632|1001|N|N|Y||Preferred Brand|208821-Dexamethasone0.001MG/MG/Tobramycin0.003MG/MGOphthalmicOintment[Tobradex]|SPD 632|1001|N|N|N||Preferred Generic|896766-Labetalolhydrochloride300MGOralTablet|SPD 632|1001|N|N|N||Preferred Brand|748865-Trivora28DayPack|SPD 632|1001|N|N|N||Preferred Brand|797023-DexPakTaperPak13DayPack|SPD 632|1001|N|N|Y||Preferred Generic|200094-irbesartan75MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|308689-BenzoylPeroxide0.025MG/MGTopicalGel|SPD 632|1001|Y|N|N||Preferred Brand|1921017-0.2MLadalimumab100MG/MLPrefilledSyringe[Humira]|SPD 632|1001|Y|N|N||Preferred Generic|876514-Amlodipine10MG/telmisartan40MGOralTablet|SPD 632|1001|N|N|N||Preferred Brand|863829-amylase120000UNT/lipase24000UNT/protease76000UNTDelayedReleaseOralCapsule[Creon]|SPD 632|1001|N|N|Y||Preferred Brand|2106334-0.5MLdiphtheriatoxoidvaccine,inactivated4UNT/ML/tetanustoxoidvaccine,inactivated4UNT/MLInjection[Tdvax]|SPD 632|1001|N|N|Y||Preferred Generic|199370-Ciprofloxacin100MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|485485-tizanidine4MGOralCapsule|SPD 632|1001|Y|N|N||Preferred Brand|1921240-0.8MLadalimumab100MG/MLAuto-Injector[Humira]|SPD 632|1001|Y|N|N||Preferred Generic|2123194-PulmonaryHypertensiontadalafil20MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|197303-Acetazolamide125MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|991086-DicyclomineHydrochloride20MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|308416-Aspirin81MGDelayedReleaseOralTablet|SPD 632|1001|N|N|Y||Preferred Brand|211140-PentosanPolysulfate100MGOralCapsule[Elmiron]|SPD 632|1001|N|N|N||Preferred Generic|835894-cyclosporine,modified25MGOralCapsule|SPD 632|1001|N|N|N||Preferred Brand|208547-thyroid(USP)180MGOralTablet[ArmourThyroid]|SPD 632|1001|N|N|N||Preferred Brand|861834-amylase82000UNT/lipase15000UNT/protease51000UNTDelayedReleaseOralCapsule[Zenpep]|SPD 632|1001|N|N|N||Preferred Generic|198144-Prednisone1MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|897596-24HRVerapamilhydrochloride300MGExtendedReleaseOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|197380-Atenolol25MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|245134-72HRFentanyl0.025MG/HRTransdermalSystem|SPD 632|1001|N|N|Y||Preferred Generic|349194-Clonazepam0.125MGDisintegratingOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|198189-Ramipril5MGOralCapsule|SPD 632|1001|Y|N|N||Preferred Generic|245135-72HRFentanyl0.05MG/HRTransdermalSystem|SPD 632|1001|N|N|Y||Preferred Brand|797641-0.5MLNeisseriameningitidisserogroupAcapsularpolysaccharidediphtheriatoxoidproteinconjugatevaccine0.104MG/ML/Neisseriam|SPD 632|1001|N|N|N||Preferred Generic|1797851-CromolynSodium5.2MG/ACTUATMeteredDoseNasalSpray|SPD 632|1001|N|N|N||Preferred Generic|835913-MefloquineHydrochloride250MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|245136-72HRFentanyl0.1MG/HRTransdermalSystem|SPD 632|1001|N|N|N||Preferred Generic|1242786-Alyacen1/3528-DayKit|SPD 632|1001|N|N|Y||Preferred Generic|198051-Omeprazole20MGDelayedReleaseOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|308459-Azithromycin20MG/MLOralSuspension|SPD 632|1001|Y|N|N||Preferred Generic|260218-modafinil100MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|1923432-dorzolamide20MG/ML/Timolol5MG/MLOphthalmicSolution|SPD 632|1001|Y|N|N||Preferred Generic|283316-Hydrochlorothiazide12.5MG/telmisartan40MGOralTablet|SPD 632|1001|N|N|Y||Preferred Brand|213442-insulinisophane,human70UNT/ML/insulin,regular,human30UNT/MLInjectableSuspension[Novolin]|SPD 632|1001|N|N|N||Preferred Generic|836358-IpratropiumBromide0.2MG/MLInhalationSolution|SPD 632|1001|N|N|Y||Preferred Generic|312075-Ofloxacin3MG/MLOphthalmicSolution|SPD 632|1001|Y|N|N||Preferred Brand|1946520-3-Month1.5MLLeuprolideAcetate20MG/MLPrefilledSyringe[Lupron]|SPD 632|1001|N|N|N||Preferred Generic|897666-Verapamilhydrochloride120MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|310436-Galantamine4MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|197735-Gentamicin1MG/MLTopicalCream|SPD 632|1001|N|N|N||Preferred Generic|1085741-TriamcinoloneAcetonide0.25MG/MLTopicalLotion|SPD 632|1001|Y|N|N||Preferred Brand|1946522-4-Month1.5MLLeuprolideAcetate20MG/MLPrefilledSyringe[Lupron]|SPD 632|1001|N|N|Y||Preferred Generic|314200-pantoprazole40MGDelayedReleaseOralTablet|SPD 632|1001|N|N|N||Preferred Brand|855871-Phenytoinsodium30MGExtendedReleaseOralCapsule[Dilantin]|SPD 632|1001|N|N|Y||Preferred Brand|2166928-10ACTUATolodaterol0.0025MG/ACTUAT/tiotropium0.0025MG/ACTUATInhalationSpray[Stiolto]|SPD 632|1001|N|N|Y||Preferred Generic|197589-Diazepam10MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|311204-Itraconazole100MGOralCapsule|SPD 632|1001|N|N|Y||Preferred Brand|795737-ChantixStartingMonthPAK|SPD 632|1001|N|N|Y||Preferred Generic|349094-Budesonide0.125MG/MLInhalationSuspension|SPD 632|1001|N|N|N||Preferred Generic|1923424-SotalolHydrochloride160MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|197381-Atenolol50MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|308508-Bacitracin0.5UNT/MGOphthalmicOintment|SPD 632|1001|N|N|N||Preferred Generic|1242787-Alyacen7/7/7Kit|SPD 632|1001|N|N|N||Preferred Generic|1731350-deferoxaminemesylate500MGInjection|SPD 632|1001|N|N|N||Preferred Generic|197433-calciumacetate667MGOralTablet|SPD 632|1001|N|N|Y||Preferred Brand|2360588-0.5MLNeisseriameningitidisserogroupAcapsularpolysaccharidetetanustoxoidproteinconjugatevaccine0.02MG/ML/Neisseriameni|SPD 632|1001|Y|N|N||Preferred Brand|809990-lacosamide100MGOralTablet[Vimpat]|SPD 632|1001|N|N|Y||Preferred Generic|197511-Ciprofloxacin250MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|310965-Ibuprofen200MGOralTablet|SPD 632|1001|N|N|N||Preferred Brand|855205-docosanol100MG/MLTopicalCream[Abreva]|SPD 632|1001|N|N|N||Preferred Brand|749151-Tri-Norinyl28DayPack|SPD 632|1001|Y|N|N||Preferred Brand|2000013-1.1MLhydroxyprogesteronecaproate(USP)250MG/MLAuto-Injector[Makena]|SPD 632|1001|N|N|Y||Preferred Generic|312840-rizatriptan5MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|1011736-aliskiren150MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|898342-Amlodipine10MG/Benazeprilhydrochloride20MGOralCapsule|SPD 632|1001|N|N|Y||Preferred Generic|1918203-60ACTUATfluticasonepropionate0.232MG/ACTUAT/salmeterol0.014MG/ACTUATDryPowderInhaler|SPD 632|1001|Y|N|N||Preferred Generic|313210-temozolomide250MGOralCapsule|SPD 632|1001|Y|N|N||Preferred Generic|864769-MethadoneHydrochloride2MG/MLOralSolution|SPD 632|1001|N|N|Y||Preferred Brand|795735-ChantixContinuingMonthsOfTherapy1MGPack|SPD 632|1001|Y|N|N||Preferred Brand|2003757-1.14MLsarilumab132MG/MLAuto-Injector[Kevzara]|SPD 632|1001|N|N|N||Preferred Generic|308512-Bacitracin0.5UNT/MG/PolymyxinB10UNT/MGTopicalOintment|SPD 632|1001|Y|N|N||Preferred Generic|313211-temozolomide5MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|1085745-TriamcinoloneAcetonide1MG/MLTopicalLotion|SPD 632|1001|N|N|N||Preferred Generic|1860100-ferroussulfate324MGDelayedReleaseOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|318202-Erythromycin20MG/MLTopicalSolution|SPD 632|1001|N|N|Y||Preferred Brand|311027-insulinisophane,human100UNT/MLInjectableSuspension[NovolinN]|SPD 632|1001|N|N|N||Preferred Generic|852877-QuinidineSulfate200MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|2045959-Doptelet40MGDailyDoseCartonPack|SPD 632|1001|N|N|Y||Preferred Generic|1649990-DoxycyclineMonohydrate100MGOralCapsule|SPD 632|1001|Y|N|N||Preferred Generic|349253-bosentan62.5MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|308891-CalciumCarbonate250MG/MLOralSuspension|SPD 632|1001|Y|N|N||Preferred Brand|2045961-Doptelet60MGDailyDoseCartonPack|SPD 632|1001|N|N|Y||Preferred Generic|313222-terbinafine250MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|809159-0.5MLEtanercept50MG/MLPrefilledSyringe[Enbrel]|SPD 632|1001|N|N|Y||Preferred Brand|311033-insulin,regular,human100UNT/MLInjectableSolution[NovolinR]|SPD 632|1001|Y|N|N||Preferred Generic|349407-Treprostinil1MG/MLInjectableSolution|SPD 632|1001|N|N|Y||Preferred Generic|1550940-Colchicine0.6MGOralCapsule|SPD 632|1001|Y|N|N||Preferred Brand|2047596-1MLepoetinalfa-epbx10000UNT/MLInjection[Retacrit]|SPD 632|1001|N|N|N||Preferred Brand|854918-BisoprololFumarate2.5MG/Hydrochlorothiazide6.25MGOralTablet[Ziac]|SPD 632|1001|N|N|N||Preferred Generic|898353-Amlodipine5MG/Benazeprilhydrochloride10MGOralCapsule|SPD 632|1001|N|N|Y||Preferred Brand|311036-insulin,regular,human100UNT/MLInjectableSolution[HumulinR]|SPD 632|1001|Y|N|N||Preferred Brand|802652-1MLEtanercept50MG/MLPrefilledSyringe[Enbrel]|SPD 632|1001|N|N|Y||Preferred Generic|1298088-FlurazepamHydrochloride15MGOralCapsule|SPD 632|1001|Y|N|N||Preferred Generic|349409-Treprostinil2.5MG/MLInjectableSolution|SPD 632|1001|Y|N|N||Preferred Brand|2047608-1MLepoetinalfa-epbx3000UNT/MLInjection[Retacrit]|SPD 632|1001|N|N|N||Preferred Generic|1806187-30/70Release24HRMethylphenidateHydrochloride20MGExtendedReleaseOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|308493-Bacitracin0.4UNT/MG/Neomycin0.0035MG/MG/PolymyxinB10UNT/MGOphthalmicOintment|SPD 632|1001|N|N|N||Preferred Generic|308694-BenzoylPeroxide0.05MG/MGTopicalGel|SPD 632|1001|Y|N|N||Preferred Brand|809994-lacosamide150MGOralTablet[Vimpat]|SPD 632|1001|N|N|Y||Preferred Brand|351427-24HRNicotine0.583MG/HRTransdermalSystem[NicodermC-Q]|SPD 632|1001|N|N|N||Preferred Brand|854910-BisoprololFumarate10MG/Hydrochlorothiazide6.25MGOralTablet[Ziac]|SPD 632|1001|N|N|N||Preferred Generic|898367-Benazeprilhydrochloride20MG/Hydrochlorothiazide12.5MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|197383-Atenolol50MG/Chlorthalidone25MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|315223-Sumatriptan25MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|351114-5MLzoledronicacid0.8MG/MLInjection|SPD 632|1001|N|N|Y||Preferred Generic|106346-Mupirocin0.02MG/MGTopicalOintment|SPD 632|1001|N|N|Y||Preferred Brand|762602-SalmonellatyphiTy21aliveantigen2000000000UNTDelayedReleaseOralCapsule[Vivotif]|SPD 632|1001|N|N|Y||Preferred Generic|349591-atomoxetine10MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|310964-Ibuprofen200MGOralCapsule|SPD 632|1001|N|N|Y||Preferred Generic|830845-24HRDiltiazemHydrochloride180MGExtendedReleaseOralCapsule|SPD 632|1001|Y|N|N||Preferred Generic|402505-12HRCarbamazepine200MGExtendedReleaseOralTablet|SPD 632|1001|N|N|N||Preferred Generic|1738495-ParoxetineHydrochloride20MGOralTablet|SPD 632|1001|N|N|N||Preferred Brand|1020155-Introvale91DayPack|SPD 632|1001|N|N|N||Preferred Brand|206978-Ketoconazole20MG/MLMedicatedShampoo[Nizoral]|SPD 632|1001|N|N|N||Preferred Generic|308696-BenzoylPeroxide50MG/MLMedicatedLiquidSoap|SPD 632|1001|N|N|N||Preferred Brand|1422081-Enskyce28DayPack|SPD 632|1001|Y|N|N||Preferred Brand|2053519-ivacaftor188MG/lumacaftor150MGOralGranules[ORKAMBI]|SPD 632|1001|N|N|N||Preferred Brand|1426881-Levonorgestrel1.5MGOralTablet[MyWay]|SPD 632|1001|N|N|N||Preferred Brand|208549-thyroid(USP)240MGOralTablet[ArmourThyroid]|SPD 632|1001|N|N|N||Preferred Generic|1801294-MicroencapsulatedPotassiumChloride20MEQExtendedReleaseOralTablet|SPD 632|1001|N|N|Y||Preferred Brand|351859-insulin,regular,human500UNT/MLInjectableSolution[HumulinR]|SPD 632|1001|N|N|N||Preferred Generic|898687-Benazeprilhydrochloride10MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|855172-levocetirizinedihydrochloride5MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|403879-imatinib400MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|308714-Betamethasone0.5MG/ML/Clotrimazole10MG/MLTopicalCream|SPD 632|1001|N|N|Y||Preferred Generic|313571-Vancomycin250MGOralCapsule|SPD 632|1001|Y|N|N||Preferred Generic|864706-MethadoneHydrochloride10MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|1012021-Prednisolonesodiumphosphate2.5MG/ML/SulfacetamideSodium100MG/MLOphthalmicSolution|SPD 632|1001|N|N|Y||Preferred Brand|895756-PolyethyleneGlycol4000.004MG/MG/Propyleneglycol0.003MG/MGOphthalmicGel[Systane]|SPD 632|1001|Y|N|N||Preferred Brand|2056700-1.5MLfremanezumab-vfrm150MG/MLPrefilledSyringe[Ajovy]|SPD 632|1001|N|N|N||Preferred Brand|836368-200ACTUATIpratropiumBromide0.017MG/ACTUATMeteredDoseInhaler[Atrovent]|SPD 632|1001|N|N|Y||Preferred Brand|630981-PolyvinylAlcohol27MG/ML/Povidone20MG/MLOphthalmicSolution[Freshkote]|SPD 632|1001|Y|N|N||Preferred Brand|2057205-0.5MLfilgrastim-aafi0.6MG/MLPrefilledSyringe[Nivestym]|SPD 632|1001|N|N|Y||Preferred Brand|847199-3MLinsulinisophane,human100UNT/MLPenInjector[HumulinN]|SPD 632|1001|N|N|Y||Preferred Brand|752388-InsulinLispro25UNT/ML/insulinlisproprotamine,human75UNT/MLInjectableSuspension[HumalogMix]|SPD 632|1001|Y|N|N||Preferred Generic|465355-voriconazole40MG/MLOralSuspension|SPD 632|1001|N|N|N||Preferred Generic|1245468-DocusateSodium250MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|308868-Calcitriol0.0005MGOralCapsule|SPD 632|1001|N|N|N||Preferred Brand|153183-adapalene0.001MG/MGTopicalGel[Differin]|SPD 632|1001|N|N|N||Preferred Generic|238600-seleniumsulfide25MG/MLMedicatedShampoo|SPD 632|1001|N|N|N||Preferred Generic|1797907-Fluticasonepropionate0.05MG/ACTUATMeteredDoseNasalSpray|SPD 632|1001|Y|N|N||Preferred Brand|1925255-0.4MLabatacept125MG/MLPrefilledSyringe[Orencia]|SPD 632|1001|N|N|N||Preferred Generic|308725-bexarotene75MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|1738503-ParoxetineHydrochloride30MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|1731345-deferoxaminemesylate2000MGInjection|SPD 632|1001|N|N|Y||Preferred Brand|637188-varenicline0.5MGOralTablet[Chantix]|SPD 632|1001|N|N|N||Preferred Generic|903456-liothyroninesodium0.005MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|855302-WarfarinSodium2MGOralTablet|SPD 632|1001|N|N|N||Preferred Brand|830470-1MLrabiesvirusvaccinewistarstrainPM-1503-3M(Human),Inactivated2.5UNT/MLInjection[Imovax]|SPD 632|1001|Y|N|N||Preferred Generic|477367-solifenacinsuccinate5MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|314135-naratriptan2.5MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|477372-solifenacinsuccinate10MGOralTablet|SPD 632|1001|N|N|Y||Preferred Brand|798479-1MLHepatitisAVaccine(Inactivated)StrainHM1751440UNT/MLPrefilledSyringe[Havrix]|SPD 632|1001|N|N|N||Preferred Generic|310891-Hydrocortisone25MG/MLTopicalCream|SPD 632|1001|Y|N|N||Preferred Generic|485421-24HRdarifenacin15MGExtendedReleaseOralTablet|SPD 632|1001|N|N|N||Preferred Generic|979485-LosartanPotassium25MGOralTablet|SPD 632|1001|N|N|Y||Preferred Brand|731281-InsulinLispro50UNT/ML/insulinlisproprotamine,human50UNT/MLInjectableSuspension[HumalogMix]|SPD 632|1001|Y|N|N||Preferred Generic|485434-entecavir0.5MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|308867-Calcitriol0.00025MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|1094543-Briellyn28DayPack|SPD 632|1001|Y|N|N||Preferred Generic|864675-Atovaquone250MG/proguanilhydrochloride100MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|1738511-ParoxetineHydrochloride40MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|314209-rizatriptan10MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|314076-Lisinopril10MGOralTablet|SPD 632|1001|N|Y|N||Preferred Generic|996603-24HRMemantinehydrochloride21MGExtendedReleaseOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|903884-FluvoxamineMaleate100MGOralTablet|SPD 632|1001|N|N|Y||Preferred Brand|707566-PolyethyleneGlycol4004MG/ML/Propyleneglycol3MG/MLOphthalmicSolution[Systane]|SPD 632|1001|N|N|N||Preferred Brand|750244-Low-Ogestrel28DayPack|SPD 632|1001|N|N|N||Preferred Generic|855324-WarfarinSodium4MGOralTablet|SPD 632|1001|Y|N|Y||Preferred Generic|891888-MorphineSulfate30MGExtendedReleaseOralTablet|SPD 632|1001|N|N|Y||Preferred Brand|637190-varenicline1MGOralTablet[Chantix]|SPD 632|1001|Y|N|N||Preferred Generic|485436-entecavir1MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|861375-sevelamercarbonate800MGPowderforOralSuspension|SPD 632|1001|Y|N|N||Preferred Brand|205918-1MLEpoetinAlfa2000UNT/MLInjection[Procrit]|SPD 632|1001|N|N|Y||Preferred Generic|314285-zonisamide100MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|995258-HydroxyzineHydrochloride25MGOralTablet|SPD 632|1001|N|N|N||Preferred Brand|830463-1MLrabiesvirusvaccineflury-lepstrain2.5UNT/MLInjection[RabAvert]|SPD 632|1001|N|N|Y||Preferred Brand|404448-84HRoxybutynin0.162MG/HRTransdermalSystem[Oxytrol]|SPD 632|1001|N|Y|N||Preferred Generic|745791-200ACTUATLevalbuterol0.045MG/ACTUATMeteredDoseInhaler|SPD 632|1001|Y|N|N||Preferred Brand|2059189-amikacinliposomal70.3MG/MLInhalationSuspension[Arikayce]|SPD 632|1001|N|N|N||Preferred Brand|1112715-Amethyst28DayPack|SPD 632|1001|N|N|N||Preferred Brand|827713-MineralOil0.03MG/MG/Petrolatum0.94MG/MGOphthalmicOintment[SystaneNighttime]|SPD 632|1001|N|N|Y||Preferred Brand|351433-24HRNicotine0.292MG/HRTransdermalSystem[NicodermC-Q]|SPD 632|1001|N|N|Y||Preferred Brand|351429-24HRNicotine0.875MG/HRTransdermalSystem[NicodermC-Q]|SPD 632|1001|N|N|N||Preferred Generic|314106-Metronidazole250MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|1738483-ParoxetineHydrochloride10MGOralTablet|SPD 632|1001|N|N|N||Preferred Brand|1536586-168HREthinylEstradiol0.00146MG/HR/norelgestromin0.00625MG/HRTransdermalSystem[Xulane]|SPD 632|1001|N|N|Y||Preferred Brand|311026-insulinisophane,human100UNT/MLInjectableSuspension[HumulinN]|SPD 632|1001|N|N|Y||Preferred Generic|636042-Hydrochlorothiazide12.5MG/valsartan320MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|904170-PrimaquinePhosphate26.3MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|863038-bepotastinebesilate15MG/MLOphthalmicSolution|SPD 632|1001|N|N|Y||Preferred Brand|261315-Oseltamivir75MGOralCapsule[Tamiflu]|SPD 632|1001|N|N|N||Preferred Brand|808118-prednisolone5MGOralTablet[MILLIPRED]|SPD 632|1001|N|N|N||Preferred Generic|1250490-hydrocortisoneacetate5MG/MLTopicalCream|SPD 632|1001|N|N|N||Preferred Generic|197392-Baclofen20MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|578325-candesartancilexetil16MG/Hydrochlorothiazide12.5MGOralTablet|SPD 632|1001|N|N|Y||Preferred Brand|2166204-10ACTUATtiotropium0.0025MG/ACTUATInhalationSpray[Spiriva]|SPD 632|1001|Y|N|N||Preferred Generic|861960-armodafinil200MGOralTablet|SPD 632|1001|N|N|Y||Preferred Brand|211947-Atovaquone150MG/MLOralSuspension[Mepron]|SPD 632|1001|N|N|Y||Preferred Brand|211609-hypromellose5MG/MLOphthalmicSolution[IsoptoAlkaline]|SPD 632|1001|N|N|N||Preferred Generic|1724481-thyroid(USP)60MGOralTablet[NPThyroid]|SPD 632|1001|N|N|N||Preferred Generic|904458-PravastatinSodium10MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|597770-deferasirox250MGTabletforOralSuspension|SPD 632|1001|N|N|N||Preferred Generic|855664-DiclofenacSodium25MGDelayedReleaseOralTablet|SPD 632|1001|N|N|Y||Preferred Brand|2053927-sodiumzirconiumcyclosilicate10000MGPowderforOralSuspension[Lokelma]|SPD 632|1001|Y|N|N||Preferred Generic|597772-deferasirox500MGTabletforOralSuspension|SPD 632|1001|Y|N|N||Preferred Brand|2107351-prucalopride1MGOralTablet[Motegrity]|SPD 632|1001|N|N|Y||Preferred Brand|2050059-0.5MLHepatitisBSurfaceAntigenVaccine0.04MG/MLPrefilledSyringe[Heplisav-B]|SPD 632|1001|N|N|N||Preferred Generic|859044-Pramipexoledihydrochloride0.5MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|349196-Clonazepam1MGDisintegratingOralTablet|SPD 632|1001|N|N|Y||Preferred Brand|2000136-Vancomycin50MG/MLOralSolution[Firvanq]|SPD 632|1001|N|Y|Y||Preferred Generic|1797865-mometasonefuroate0.05MG/ACTUATMeteredDoseNasalSpray|SPD 632|1001|Y|N|N||Preferred Generic|603203-erlotinib100MGOralTablet|SPD 632|1001|N|N|N||Preferred Brand|201747-Primidone250MGOralTablet[Mysoline]|SPD 632|1001|N|N|N||Preferred Brand|762663-Jolessa91DayPack|SPD 632|1001|N|N|Y||Preferred Brand|1994352-0.5MLHepatitisBSurfaceAntigenVaccine0.04MG/MLInjection[Heplisav-B]|SPD 632|1001|N|N|N||Preferred Generic|1291082-hydrocortisoneacetate25MGRectalSuppository|SPD 632|1001|N|N|Y||Preferred Brand|1992428-Eliquis30-DayStarterPack|SPD 632|1001|N|N|N||Preferred Generic|308345-apraclonidine5MG/MLOphthalmicSolution|SPD 632|1001|N|N|N||Preferred Generic|310798-Hydrochlorothiazide25MGOralTablet|SPD 632|1001|N|N|N||Preferred Brand|750264-Necon7/7/728DayPack|SPD 632|1001|N|N|N||Preferred Generic|1665188-1MLLorazepam2MG/MLInjection|SPD 632|1001|N|N|Y||Preferred Generic|349198-Clonazepam0.5MGDisintegratingOralTablet|SPD 632|1001|N|N|N||Preferred Generic|904481-PravastatinSodium80MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|310982-imiquimod50MG/MLTopicalCream|SPD 632|1001|Y|N|Y||Preferred Generic|883826-TranexamicAcid650MGOralTablet|SPD 632|1001|N|N|Y||Preferred Brand|1736863-3MLInsulinGlargine100UNT/MLPenInjector[Basaglar]|SPD 632|1001|Y|N|N||Preferred Generic|616749-12HRranolazine500MGExtendedReleaseOralTablet|SPD 632|1001|N|N|Y||Preferred Brand|1731317-3MLinsulin,regular,human500UNT/MLPenInjector[HumulinR]|SPD 632|1001|Y|N|N||Preferred Brand|1921010-0.1MLadalimumab100MG/MLPrefilledSyringe[Humira]|SPD 632|1001|Y|N|N||Preferred Generic|577057-72HRFentanyl0.012MG/HRTransdermalSystem|SPD 632|1001|N|N|N||Preferred Brand|1373327-amylase180000UNT/lipase36000UNT/protease114000UNTDelayedReleaseOralCapsule[Creon]|SPD 632|1001|N|N|N||Preferred Brand|762334-Velivet28DayPack|SPD 632|1001|Y|N|N||Preferred Brand|2121100-siponimod2MGOralTablet[Mayzent]|SPD 632|1001|N|N|Y||Preferred Generic|349199-valsartan80MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|639537-candesartancilexetil32MGOralTablet|SPD 632|1001|N|N|N||Preferred Brand|616450-MycophenolicAcid180MGDelayedReleaseOralTablet[Myfortic]|SPD 632|1001|N|N|Y||Preferred Brand|1658472-0.5MLStreptococcuspneumoniaetype1capsularpolysaccharideantigen0.05MG/ML/Streptococcuspneumoniaetype10Acapsularpolysac|SPD 632|1001|Y|N|N||Preferred Generic|642452-lanthanumcarbonate750MGChewableTablet|SPD 632|1001|N|N|Y||Preferred Brand|1658155-0.5MLHepatitisBSurfaceAntigenVaccine0.01MG/MLInjection[Recombivax]|SPD 632|1001|Y|N|N||Preferred Generic|644088-aprepitant40MGOralCapsule|SPD 632|1001|N|N|Y||Preferred Brand|1658150-1MLHepatitisBSurfaceAntigenVaccine0.01MG/MLInjection[Recombivax]|SPD 632|1001|Y|N|N||Preferred Generic|861370-sevelamercarbonate2400MGPowderforOralSuspension|SPD 632|1001|N|N|N||Preferred Generic|855906-DiclofenacSodium50MGDelayedReleaseOralTablet|SPD 632|1001|N|N|N||Preferred Generic|1099288-DesipramineHydrochloride10MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|1655968-8MLMethotrexate25MG/MLInjection|SPD 632|1001|Y|N|N||Preferred Brand|2166401-ivacaftor25MGOralGranules[Kalydeco]|SPD 632|1001|N|N|N||Preferred Generic|905199-HydralazineHydrochloride10MGOralTablet|SPD 632|1001|N|N|Y||Preferred Brand|1656351-sacubitril49MG/valsartan51MGOralTablet[Entresto]|SPD 632|1001|N|N|Y||Preferred Brand|1656346-sacubitril24MG/valsartan26MGOralTablet[Entresto]|SPD 632|1001|Y|N|N||Preferred Generic|672149-lapatinib250MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1873087-HumiraPrefilledSyringe80MG/0.8MLStarterPack-PediatricCrohn'sDisease(3count)|SPD 632|1001|N|N|Y||Preferred Generic|313415-Tobramycin3MG/MLOphthalmicSolution|SPD 632|1001|N|N|Y||Preferred Generic|349287-Fenofibrate160MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|705824-100MLzoledronicacid0.05MG/MLInjection|SPD 632|1001|N|N|Y||Preferred Brand|1597099-0.5MLL1protein,Humanpapillomavirustype11Vaccine0.08MG/ML/L1protein,Humanpapillomavirustype16Vaccine0.12MG/ML/L1protei|SPD 632|1001|N|N|N||Preferred Generic|1014673-cetirizinehydrochloride1MG/MLOralSolution|SPD 632|1001|N|N|N||Preferred Brand|762001-Kariva28DayPack|SPD 632|1001|N|N|Y||Preferred Brand|1593140-0.5MLNeisseriameningitidisserogroupBrecombinantLP2086A05proteinvariantantigen0.12MG/ML/Neisseriameningitidisserogroup|SPD 632|1001|N|N|N||Preferred Generic|979471-Hydrochlorothiazide25MG/LosartanPotassium100MGOralTablet|SPD 632|1001|N|N|Y||Preferred Brand|1549683-Xarelto30-DayStarterPackKit|SPD 632|1001|N|N|N||Preferred Generic|856364-TrazodoneHydrochloride150MGOralTablet|SPD 632|1001|N|Y|Y||Preferred Generic|200194-zolmitriptan5MGOralTablet|SPD 632|1001|N|N|N||Preferred Brand|404509-CalciumCarbonate1000MG/Simethicone60MGChewableTablet[MaaloxMaxQuickDissolve]|SPD 632|1001|Y|N|N||Preferred Generic|724859-armodafinil150MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|1547771-Tetracainehydrochloride5MG/MLOphthalmicSolution|SPD 632|1001|Y|N|N||Preferred Generic|860901-galantaminehydrobromide4MG/MLOralSolution|SPD 632|1001|Y|N|N||Preferred Generic|724861-armodafinil250MGOralTablet|SPD 632|1001|N|N|Y||Preferred Brand|1364447-apixaban5MGOralTablet[Eliquis]|SPD 632|1001|N|N|N||Preferred Generic|1923426-SotalolHydrochloride80MGOralTablet|SPD 632|1001|N|N|Y||Preferred Brand|1364441-apixaban2.5MGOralTablet[Eliquis]|SPD 632|1001|N|N|N||Preferred Generic|905395-HydralazineHydrochloride50MGOralTablet|SPD 632|1001|N|N|N||Preferred Brand|759473-20ACTUATZanamivir5MG/ACTUATDryPowderInhaler[Relenza]|SPD 632|1001|N|N|N||Preferred Generic|1298070-Cyclopentolatehydrochloride20MG/MLOphthalmicSolution|SPD 632|1001|N|N|N||Preferred Generic|197408-Betamethasone1MG/MLTopicalLotion|SPD 632|1001|Y|N|N||Preferred Generic|725021-24HRrivastigmine0.192MG/HRTransdermalSystem|SPD 632|1001|N|N|Y||Preferred Brand|1300378-0.5MLBordetellapertussisfilamentoushemagglutininvaccine,inactivated0.016MG/ML/Bordetellapertussispertactinvaccine,ina|SPD 632|1001|N|N|N||Preferred Generic|995232-HydroxyzinePamoate100MGOralCapsule|SPD 632|1001|N|N|N||Preferred Brand|211633-AluminumHydroxide200MG/MagnesiumHydroxide200MG/Simethicone25MGChewableTablet[Gelusil]|SPD 632|1001|Y|N|N||Preferred Generic|725023-24HRrivastigmine0.396MG/HRTransdermalSystem|SPD 632|1001|N|N|Y||Preferred Brand|1300206-0.5MLBordetellapertussisfilamentoushemagglutininvaccine,inactivated0.01MG/ML/Bordetellapertussisfimbriae2/3vaccine,in|SPD 632|1001|N|N|Y||Preferred Brand|1292459-0.5MLVaricella-ZosterVirusVaccineLive(Oka-Merck)strain2700UNT/MLInjection[Varivax]|SPD 632|1001|N|N|N||Preferred Generic|856422-Hydrochlorothiazide25MG/PropranololHydrochloride40MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|727339-0.5MLSumatriptan12MG/MLPrefilledSyringe|SPD 632|1001|N|N|N||Preferred Generic|848943-CholestyramineResin4000MGPowderforOralSuspension|SPD 632|1001|N|N|N||Preferred Brand|1000499-Prempro0.625/2.528DayPack|SPD 632|1001|N|N|Y||Preferred Brand|1190916-0.5MLdiphtheriatoxoidvaccine,inactivated4UNT/ML/tetanustoxoidvaccine,inactivated10UNT/MLInjection[Tenivac]|SPD 632|1001|N|N|N||Preferred Brand|1359135-Tri-LegestFe28DayPack|SPD 632|1001|N|Y|N||Preferred Generic|197506-Cimetidine300MGOralTablet|SPD 632|1001|N|N|N||Preferred Brand|1039273-Hydrocortisone10MG/MLTopicalSolution[ScalpicinItchRelief]|SPD 632|1001|Y|N|N||Preferred Generic|724863-armodafinil50MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|1440184-hydrocortisoneacetate0.01MG/MGTopicalOintment|SPD 632|1001|Y|N|N||Preferred Brand|1605075-0.8MLFILGRASTIM-SNDZ0.6MG/MLPrefilledSyringe[Zarxio]|SPD 632|1001|Y|N|N||Preferred Brand|2257013-trikafta100MG/50MG/75MGand150MGPack|SPD 632|1001|N|N|N||Preferred Generic|1099296-DesipramineHydrochloride150MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|310809-Hydrochlorothiazide25MG/quinapril20MGOralTablet|SPD 632|1001|N|N|Y||Preferred Brand|1049216-Acetaminophen325MG/OxycodoneHydrochloride10MGOralTablet[Endocet]|SPD 632|1001|N|N|Y||Preferred Brand|1046920-Nicotine4MGInhalationSolution[Nicotrol]|SPD 632|1001|Y|N|N||Preferred Generic|802749-candesartancilexetil32MG/Hydrochlorothiazide25MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|349593-atomoxetine25MGOralCapsule|SPD 632|1001|N|N|Y||Preferred Generic|198318-Triazolam0.25MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|997501-Fexofenadinehydrochloride60MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|1298072-Cyclopentolatehydrochloride5MG/MLOphthalmicSolution|SPD 632|1001|Y|N|Y||Preferred Generic|313451-Tretinoin0.00025MG/MGTopicalGel|SPD 632|1001|N|N|N||Preferred Brand|754766-Metronidazole0.0075MG/MGVaginalGel[MetroGel]|SPD 632|1001|N|N|N||Preferred Generic|997420-Fexofenadinehydrochloride180MGOralTablet|SPD 632|1001|N|Y|Y||Preferred Generic|314266-Tacrolimus0.001MG/MGTopicalOintment|SPD 632|1001|N|N|N||Preferred Generic|997229-Donepezilhydrochloride5MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|966248-LevothyroxineSodium0.112MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|141963-Azithromycin40MG/MLOralSuspension|SPD 632|1001|Y|N|N||Preferred Generic|824301-rufinamide400MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|349595-atomoxetine60MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|996572-{21(Memantinehydrochloride10MGOralTablet)/28(Memantinehydrochloride5MGOralTablet)}Pack|SPD 632|1001|Y|N|N||Preferred Generic|833234-mesalamine800MGDelayedReleaseOralTablet|SPD 632|1001|N|N|N||Preferred Generic|315134-Levocarnitine100MG/MLOralSolution|SPD 632|1001|N|N|N||Preferred Generic|996571-Memantinehydrochloride5MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|238151-mesalamine66.7MG/MLEnema|SPD 632|1001|N|N|N||Preferred Brand|753543-Reclipsen28DayPack|SPD 632|1001|N|N|N||Preferred Generic|1099300-DesipramineHydrochloride25MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|351109-Budesonide0.25MG/MLInhalationSuspension|SPD 632|1001|N|N|N||Preferred Generic|861427-PropafenoneHydrochloride225MGOralTablet|SPD 632|1001|N|Y|Y||Preferred Generic|483440-pregabalin150MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|310687-Hydrocortisone10MG/ML/Neomycin3.5MG/ML/PolymyxinB10000UNT/MLOticSuspension|SPD 632|1001|N|N|N||Preferred Generic|995666-MeclizineHydrochloride25MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|1014678-cetirizinehydrochloride10MGOralTablet|SPD 632|1001|N|Y|Y||Preferred Generic|483442-pregabalin25MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|995624-MeclizineHydrochloride12.5MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|995607-EthambutolHydrochloride400MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1870968-deflazacort22.75MG/MLOralSuspension[Emflaza]|SPD 632|1001|N|N|N||Preferred Generic|308191-Amoxicillin500MGOralCapsule|SPD 632|1001|N|N|N||Preferred Brand|751870-Nortrel1/3528DayPack|SPD 632|1001|Y|N|N||Preferred Brand|2282414-bempedoicacid180MGOralTablet[Nexletol]|SPD 632|1001|N|N|N||Preferred Generic|237420-CalciumCarbonate1500MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|966270-LevothyroxineSodium0.137MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|251322-Ethosuximide50MG/MLOralSolution|SPD 632|1001|N|N|Y||Preferred Generic|351246-montelukast4MGOralGranules|SPD 632|1001|N|N|N||Preferred Generic|311289-Levetiracetam500MGOralTablet|SPD 632|1001|Y|N|Y||Preferred Generic|891881-MorphineSulfate15MGExtendedReleaseOralTablet|SPD 632|1001|N|N|N||Preferred Generic|995253-HydroxyzinePamoate25MGOralCapsule|SPD 632|1001|Y|N|Y||Preferred Generic|835809-testosteroneenanthate200MG/MLInjectableSolution|SPD 632|1001|N|N|N||Preferred Generic|1366116-bacitracinzinc0.5UNT/MGTopicalOintment|SPD 632|1001|Y|N|Y||Preferred Generic|313450-Tretinoin0.0001MG/MGTopicalGel|SPD 632|1001|N|N|N||Preferred Generic|1801298-MicroencapsulatedPotassiumChloride10MEQExtendedReleaseOralTablet|SPD 632|1001|N|N|N||Preferred Generic|995218-HydroxyzineHydrochloride10MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|2359285-24HRempagliflozin10MG/linagliptin5MG/metforminhydrochloride1000MGExtendedReleaseOralTablet[Trijardy]|SPD 632|1001|Y|N|Y||Preferred Generic|312084-Ondansetron24MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|966914-POLYETHYLENEGLYCOL3350240000MG/PotassiumChloride2980MG/SodiumBicarbonate6720MG/SodiumChloride5840MG/sodiumsulfate22720|SPD 632|1001|N|N|N||Preferred Generic|248109-Ribavirin200MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|966222-LevothyroxineSodium0.075MGOralTablet|SPD 632|1001|Y|N|Y||Preferred Generic|198300-Tretinoin1MG/MLTopicalCream|SPD 632|1001|N|N|N||Preferred Brand|1359134-TiliaFe28DayPack|SPD 632|1001|Y|N|Y||Preferred Generic|197635-dronabinol2.5MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|245314-Albuterol5MG/MLInhalationSolution|SPD 632|1001|N|N|N||Preferred Generic|993687-BupropionHydrochloride100MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|993557-24HRBupropionHydrochloride300MGExtendedReleaseOralTablet|SPD 632|1001|Y|N|Y||Preferred Generic|106302-Tretinoin0.25MG/MLTopicalCream|SPD 632|1001|N|N|N||Preferred Generic|317128-Misoprostol0.2MGOralTablet|SPD 632|1001|Y|N|Y||Preferred Brand|804547-difluprednate0.5MG/MLOphthalmicSuspension[Durezol]|SPD 632|1001|N|N|N||Preferred Generic|993536-12HRBupropionHydrochloride200MGExtendedReleaseOralTablet|SPD 632|1001|N|N|N||Preferred Generic|856724-PropranololHydrochloride4MG/MLOralSolution|SPD 632|1001|N|N|N||Preferred Generic|993518-12HRBupropionHydrochloride150MGExtendedReleaseOralTablet|SPD 632|1001|N|N|N||Preferred Generic|242590-ferrousgluconate240MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|359817-Nicotine2MGOralLozenge|SPD 632|1001|N|N|N||Preferred Generic|1020477-DiphenhydramineHydrochloride50MGOralCapsule|SPD 632|1001|Y|N|N||Preferred Generic|999991-Amlodipine10MG/Hydrochlorothiazide25MG/Olmesartanmedoxomil40MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|992780-MiconazoleNitrate100MGVaginalInsert|SPD 632|1001|N|N|N||Preferred Generic|311290-Levetiracetam750MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|978006-LoperamideHydrochloride2MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|992775-{1(MiconazoleNitrate1200MGVaginalInsert)/1(9000MG)(MiconazoleNitrate20MG/MLVaginalCream)}Pack|SPD 632|1001|Y|N|N||Preferred Generic|998189-everolimus2.5MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|1362712-MexiletineHydrochloride200MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|241834-cyclosporine,modified100MGOralCapsule|SPD 632|1001|Y|N|N||Preferred Generic|968766-PhentermineHydrochloride15MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|1724437-thyroid(USP)90MGOralTablet[NPThyroid]|SPD 632|1001|N|N|N||Preferred Generic|992475-PromethazineHydrochloride50MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|854880-Zolpidemtartrate12.5MGExtendedReleaseOralTablet|SPD 632|1001|N|N|N||Preferred Brand|2563004-0.7MLinfluenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.0857MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.085|SPD 632|1001|N|N|N||Preferred Generic|992454-PromethazineHydrochloride25MGRectalSuppository|SPD 632|1001|N|N|N||Preferred Generic|240209-Betamethasone0.5MG/MLTopicalLotion|SPD 632|1001|N|N|Y||Preferred Generic|359818-Nicotine4MGOralLozenge|SPD 632|1001|N|N|Y||Preferred Generic|104894-Ondansetron4MGDisintegratingOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|900156-24HRlamotrigine200MGExtendedReleaseOralTablet|SPD 632|1001|N|N|N||Preferred Generic|992441-PromethazineHydrochloride12.5MGRectalSuppository|SPD 632|1001|Y|N|N||Preferred Generic|900038-PhentermineHydrochloride30MGOralCapsule|SPD 632|1001|Y|N|N||Preferred Generic|854894-Zolpidemtartrate6.25MGExtendedReleaseOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|897021-12HRdalfampridine10MGExtendedReleaseOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|886634-ButorphanolTartrate1MG/ACTUATMeteredDoseNasalSpray|SPD 632|1001|N|Y|Y||Preferred Generic|856535-24HRPropranololHydrochloride60MGExtendedReleaseOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|992184-methenaminemandelate500MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|881341-adefovirdipivoxil10MGOralTablet|SPD 632|1001|N|N|N||Preferred Brand|751875-Necon0.5/3528DayPack|SPD 632|1001|N|N|N||Preferred Generic|992153-methenaminemandelate1000MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|239191-Amoxicillin50MG/MLOralSuspension|SPD 632|1001|N|N|Y||Preferred Generic|403884-Levetiracetam100MG/MLOralSolution|SPD 632|1001|N|N|Y||Preferred Generic|1049214-Acetaminophen325MG/OxycodoneHydrochloride10MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|864978-MethadoneHydrochloride40MGTabletforOralSuspension|SPD 632|1001|N|N|N||Preferred Generic|991061-DicyclomineHydrochloride10MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|311296-Levofloxacin750MGOralTablet|SPD 632|1001|N|N|N||Preferred Brand|153473-Altretamine50MGOralCapsule[Hexalen]|SPD 632|1001|N|N|N||Preferred Generic|979492-LosartanPotassium50MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|864718-MethadoneHydrochloride5MGOralTablet|SPD 632|1001|N|N|N||Preferred Brand|1000500-Prempro0.625/528DayPack|SPD 632|1001|N|N|N||Preferred Brand|212232-Estrogens,Esterified(USP)0.625MGOralTablet[Menest]|SPD 632|1001|N|N|N||Preferred Generic|1359779-Fluticasonepropionate0.1MG/ACTUAT/salmeterol0.05MG/ACTUATDryPowderInhaler|SPD 632|1001|Y|N|N||Preferred Generic|864681-Atovaquone62.5MG/proguanilhydrochloride25MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|979480-LosartanPotassium100MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|979475-MetaproterenolSulfate20MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|238154-Acetaminophen325MG/butalbital50MG/Caffeine40MGOralTablet|SPD 632|1001|N|N|N||Preferred Brand|1048452-ColestipolHydrochloride5000MGGranulesforOralSuspension[Colestid]|SPD 632|1001|N|N|Y||Preferred Generic|403922-168HREstradiol0.00156MG/HRTransdermalSystem|SPD 632|1001|Y|N|N||Preferred Generic|860715-24HRgalantaminehydrobromide8MGExtendedReleaseOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|856773-AmitriptylineHydrochloride150MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|979468-Hydrochlorothiazide12.5MG/LosartanPotassium50MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|860707-24HRgalantaminehydrobromide24MGExtendedReleaseOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|309110-Cephalexin25MG/MLOralSuspension|SPD 632|1001|N|N|N||Preferred Generic|979444-MetaproterenolSulfate2MG/MLOralSolution|SPD 632|1001|N|N|N||Preferred Generic|979464-Hydrochlorothiazide12.5MG/LosartanPotassium100MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|860103-KetorolacTromethamine4MG/MLOphthalmicSolution|SPD 632|1001|N|N|N||Preferred Brand|351750-podofilox0.005MG/MGTopicalGel[Condylox]|SPD 632|1001|Y|N|N||Preferred Brand|2463737-epoetinalfa-epbx20000UNT/MLInjectableSolution[Retacrit]|SPD 632|1001|N|N|N||Preferred Generic|238006-Estrogens,Esterified(USP)0.625MG/Methyltestosterone1.25MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|857224-Sevelamerhydrochloride800MGOralTablet|SPD 632|1001|N|N|N||Preferred Brand|1000491-Prempro0.3/1.528DayPack|SPD 632|1001|Y|N|N||Preferred Generic|857216-Sevelamerhydrochloride400MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|283077-prednisolone3MG/MLOralSolution|SPD 632|1001|N|N|N||Preferred Generic|979409-MetaproterenolSulfate10MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|855626-Twice-Dailydiclofenacepolamine0.013MG/MGMedicatedPatch|SPD 632|1001|Y|N|N||Preferred Generic|857700-DiclofenacSodium15MG/MLTopicalSolution|SPD 632|1001|N|N|Y||Preferred Generic|310149-Erythromycin0.005MG/MGOphthalmicOintment|SPD 632|1001|N|N|N||Preferred Generic|833008-DesmopressinAcetate0.2MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|979092-HydroxychloroquineSulfate200MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|1313885-Phenytoin50MGChewableTablet|SPD 632|1001|N|N|N||Preferred Generic|237776-vitaminB121MGExtendedReleaseOralTablet|SPD 632|1001|N|N|N||Preferred Generic|311353-Lisinopril2.5MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|850091-24HRlamotrigine50MGExtendedReleaseOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|1049225-Acetaminophen325MG/OxycodoneHydrochloride7.5MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|850087-24HRlamotrigine100MGExtendedReleaseOralTablet|SPD 632|1001|N|N|N||Preferred Generic|237723-Ergocalciferol0.2MG/MLOralSolution|SPD 632|1001|N|N|N||Preferred Generic|966920-POLYETHYLENEGLYCOL3350236000MG/PotassiumChloride2970MG/SodiumBicarbonate6740MG/SodiumChloride5860MG/sodiumsulfate22740|SPD 632|1001|Y|N|N||Preferred Generic|848151-Amlodipine10MG/Hydrochlorothiazide25MG/valsartan160MGOralTablet|SPD 632|1001|N|N|N||Preferred Brand|1099026-Loryna28DayPack|SPD 632|1001|N|N|Y||Preferred Generic|1000153-1MLmedroxyprogesteroneacetate150MG/MLPrefilledSyringe|SPD 632|1001|Y|N|N||Preferred Generic|848145-Amlodipine5MG/Hydrochlorothiazide25MG/valsartan160MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|728231-12HRranolazine1000MGExtendedReleaseOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|848140-Amlodipine5MG/Hydrochlorothiazide12.5MG/valsartan160MGOralTablet|SPD 632|1001|N|N|N||Preferred Brand|207273-Nitroglycerin0.02MG/MGTopicalOintment[Nitro-Bid]|SPD 632|1001|Y|N|N||Preferred Generic|848135-Amlodipine10MG/Hydrochlorothiazide25MG/valsartan320MGOralTablet|SPD 632|1001|N|N|N||Preferred Brand|1359032-Microgestin1.5/3021DayPack|SPD 632|1001|N|N|N||Preferred Generic|1313112-Phenytoin25MG/MLOralSuspension|SPD 632|1001|Y|N|N||Preferred Generic|848131-Amlodipine10MG/Hydrochlorothiazide12.5MG/valsartan160MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|860695-24HRgalantaminehydrobromide16MGExtendedReleaseOralCapsule|SPD 632|1001|Y|N|N||Preferred Generic|845515-everolimus5MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|966253-LevothyroxineSodium0.088MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|834241-febuxostat80MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|834235-febuxostat40MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|966249-LevothyroxineSodium0.175MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|226343-Dexamethasonephosphate1MG/MLOphthalmicSolution|SPD 632|1001|N|N|N||Preferred Generic|309112-Cephalexin250MGOralCapsule|SPD 632|1001|N|N|Y||Preferred Generic|477560-Fenofibrate145MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|824295-rufinamide200MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|810096-{7(EthinylEstradiol0.01MGOralTablet)/84(EthinylEstradiol0.02MG/Levonorgestrel0.1MGOralTablet)}Pack|SPD 632|1001|N|N|N||Preferred Generic|211365-chlorhexidinegluconate40MG/MLMedicatedLiquidSoap|SPD 632|1001|N|N|N||Preferred Generic|966225-LevothyroxineSodium0.15MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|803353-PhentermineHydrochloride37.5MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|966224-LevothyroxineSodium0.125MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|794639-lubiprostone0.008MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|1359117-{24(EthinylEstradiol0.02MG/norethindroneacetate1MGOralTablet)/4(Ferrousfumarate75MGOralTablet)}Pack|SPD 632|1001|Y|N|N||Preferred Generic|754508-{1(aprepitant125MGOralCapsule)/2(aprepitant80MGOralCapsule)}Pack|SPD 632|1001|N|N|N||Preferred Generic|2101899-Sodiumpolystyrenesulfonate15000MGPowderforOralSuspension|SPD 632|1001|N|N|N||Preferred Brand|751871-Nortrel1/3521DayPack|SPD 632|1001|Y|N|N||Preferred Brand|1012899-fingolimod0.5MGOralCapsule[Gilenya]|SPD 632|1001|N|N|N||Preferred Generic|966221-LevothyroxineSodium0.05MGOralTablet|SPD 632|1001|N|N|N||Preferred Brand|750839-erythromycinstearate250MGOralTablet[ErythrocinStearate]|SPD 632|1001|N|N|N||Preferred Generic|966220-LevothyroxineSodium0.025MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|209890-Acetaminophen500MGOralCapsule[Mapap]|SPD 632|1001|N|N|Y||Preferred Generic|1091145-8HRMethylphenidateHydrochloride10MGExtendedReleaseOralTablet|SPD 632|1001|N|N|N||Preferred Brand|1667916-5MLIsoproterenolHydrochloride0.2MG/MLInjection[Isuprel]|SPD 632|1001|N|N|Y||Preferred Generic|477562-Fenofibrate48MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|722122-ambrisentan5MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|206842-IsosorbideDinitrate20MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|905225-HydralazineHydrochloride25MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|722116-ambrisentan10MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|311354-Lisinopril5MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|197443-Carbidopa10MG/Levodopa100MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|905222-HydralazineHydrochloride100MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|700885-temozolomide180MGOralCapsule|SPD 632|1001|Y|N|N||Preferred Generic|700883-temozolomide140MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|1298066-Cyclopentolatehydrochloride10MG/MLOphthalmicSolution|SPD 632|1001|N|N|N||Preferred Generic|205326-Lisinopril30MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|656659-bosentan125MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|905158-Sirolimus0.5MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|1049221-Acetaminophen325MG/OxycodoneHydrochloride5MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|904932-ibandronicacid150MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|205305-telmisartan80MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|616578-lubiprostone0.024MGOralCapsule|SPD 632|1001|N|N|Y||Preferred Generic|1091150-MethylphenidateHydrochloride10MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|603208-erlotinib25MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|205304-telmisartan40MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|904475-PravastatinSodium40MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|603206-erlotinib150MGOralTablet|SPD 632|1001|N|N|N||Preferred Brand|207136-Methylprednisolone2MGOralTablet[Medrol]|SPD 632|1001|N|N|N||Preferred Generic|1806181-30/70Release24HRMethylphenidateHydrochloride10MGExtendedReleaseOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|904467-PravastatinSodium20MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|602635-lanthanumcarbonate1000MGChewableTablet|SPD 632|1001|N|N|N||Preferred Generic|205285-leflunomide20MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|597768-deferasirox125MGTabletforOralSuspension|SPD 632|1001|N|N|N||Preferred Generic|904431-Alendronicacid70MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|579148-Galantamine12MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|578330-candesartancilexetil32MG/Hydrochlorothiazide12.5MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|904396-Alendronicacid35MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|1099563-24HRDivalproexSodium250MGExtendedReleaseOralTablet|SPD 632|1001|N|N|N||Preferred Generic|205284-leflunomide10MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|856845-AmitriptylineHydrochloride50MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|578018-bromfenac0.9MG/MLOphthalmicSolution|SPD 632|1001|N|N|Y||Preferred Generic|485442-Eszopiclone2MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|1091225-8HRMethylphenidateHydrochloride20MGExtendedReleaseOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|577776-candesartancilexetil16MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|577348-ramelteon8MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|204844-Azithromycin600MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|309307-Ciprofloxacin3MG/MLOphthalmicSolution|SPD 632|1001|N|N|N||Preferred Generic|903891-FluvoxamineMaleate50MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|577208-Omega-3AcidEthylEsters(USP)1000MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|103456-Fluocinonide0.5MG/MLTopicalCream|SPD 632|1001|N|N|N||Preferred Generic|311372-Loratadine10MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|309113-Cephalexin50MG/MLOralSuspension|SPD 632|1001|N|N|N||Preferred Generic|903887-FluvoxamineMaleate25MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|545835-LeuprolideAcetate5MG/MLInjectableSolution|SPD 632|1001|Y|N|N||Preferred Generic|543218-1MLGranisetron0.1MG/MLInjection|SPD 632|1001|N|N|N||Preferred Generic|1245919-Marlissa28DayPack|SPD 632|1001|N|N|N||Preferred Generic|204423-Hydrocortisone10MG/ML/Neomycin3.5MG/ML/PolymyxinB10000UNT/MLOticSolution|SPD 632|1001|Y|N|N||Preferred Generic|485489-Temazepam22.5MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|903703-liothyroninesodium0.05MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|485423-24HRdarifenacin7.5MGExtendedReleaseOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|2557216-trikafta50MG/37.5MG/25MGand75MGPack|SPD 632|1001|N|N|N||Preferred Generic|903697-liothyroninesodium0.025MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|204135-Desonide0.0005MG/MGTopicalOintment|SPD 632|1001|Y|N|N||Preferred Brand|2559707-1.14MLdupilumab175MG/MLAuto-Injector[Dupixent]|SPD 632|1001|N|N|Y||Preferred Generic|1091392-MethylphenidateHydrochloride20MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|349405-Olmesartanmedoxomil40MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|485465-Eszopiclone3MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|477347-lanthanumcarbonate500MGChewableTablet|SPD 632|1001|N|N|N||Preferred Generic|200371-Citalopram20MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|898723-Benazeprilhydrochloride5MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|477130-Hydrochlorothiazide25MG/telmisartan80MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|309114-Cephalexin500MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|898690-Benazeprilhydrochloride20MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|403930-Isotretinoin30MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|200346-cefdinir300MGOralCapsule|SPD 632|1001|Y|N|N||Preferred Generic|403878-imatinib100MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|485440-Eszopiclone1MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|403818-moxifloxacin5MG/MLOphthalmicSolution|SPD 632|1001|Y|N|N||Preferred Brand|1100706-Linagliptin5MGOralTablet[Tradjenta]|SPD 632|1001|N|N|N||Preferred Generic|898378-Benazeprilhydrochloride5MG/Hydrochlorothiazide6.25MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|403811-aprepitant125MGOralCapsule|SPD 632|1001|N|N|N||Preferred Brand|750243-Ogestrel28DayPack|SPD 632|1001|Y|N|N||Preferred Generic|402506-12HRCarbamazepine400MGExtendedReleaseOralTablet|SPD 632|1001|N|N|N||Preferred Brand|1359030-Junel1.5/3021DayPack|SPD 632|1001|N|N|N||Preferred Generic|898372-Benazeprilhydrochloride20MG/Hydrochlorothiazide25MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|1245230-chlorhexidinegluconate20MG/MLMedicatedLiquidSoap|SPD 632|1001|N|N|N||Preferred Generic|200257-repaglinide0.5MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|884619-eltrombopag75MGOralTablet[Promacta]|SPD 632|1001|N|N|Y||Preferred Generic|485484-tizanidine6MGOralCapsule|SPD 632|1001|N|N|N||Preferred Brand|991233-bexarotene0.01MG/MGTopicalGel[Targretin]|SPD 632|1001|N|N|N||Preferred Generic|311376-Lorazepam2MG/MLOralSolution|SPD 632|1001|Y|N|N||Preferred Generic|349435-voriconazole50MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|1091497-MethylphenidateHydrochloride5MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|313413-tizanidine4MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|349434-voriconazole200MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|200256-repaglinide1MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|898359-Amlodipine5MG/Benazeprilhydrochloride40MGOralCapsule|SPD 632|1001|Y|N|N||Preferred Generic|349410-Treprostinil5MG/MLInjectableSolution|SPD 632|1001|Y|N|N||Preferred Generic|864761-MethadoneHydrochloride1MG/MLOralSolution|SPD 632|1001|N|N|N||Preferred Generic|898356-Amlodipine5MG/Benazeprilhydrochloride20MGOralCapsule|SPD 632|1001|Y|N|N||Preferred Generic|349408-Treprostinil10MG/MLInjectableSolution|SPD 632|1001|N|N|N||Preferred Generic|1243585-Flurbiprofensodium0.3MG/MLOphthalmicSolution|SPD 632|1001|N|N|N||Preferred Generic|200133-12HRCarbamazepine200MGExtendedReleaseOralCapsule|SPD 632|1001|N|N|Y||Preferred Generic|313566-valganciclovir450MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|348719-Tobramycin60MG/MLInhalationSolution|SPD 632|1001|N|N|N||Preferred Generic|898350-Amlodipine2.5MG/Benazeprilhydrochloride10MGOralCapsule|SPD 632|1001|Y|N|N||Preferred Generic|317160-temozolomide100MGOralCapsule|SPD 632|1001|Y|N|N||Preferred Generic|313472-Trientinehydrochloride250MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|898346-Amlodipine10MG/Benazeprilhydrochloride40MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|200132-Acarbose25MGOralTablet|SPD 632|1001|N|N|N||Preferred Brand|544597-PotassiumIodide1000MG/MLOralSolution[SSKIbrandofPotassiumIodide]|SPD 632|1001|N|N|N||Preferred Generic|309115-Cephalexin250MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|1115698-Oseltamivir6MG/MLOralSuspension|SPD 632|1001|Y|N|N||Preferred Generic|313209-temozolomide20MGOralCapsule|SPD 632|1001|Y|N|N||Preferred Generic|313165-0.5MLSumatriptan12MG/MLInjection|SPD 632|1001|N|N|N||Preferred Generic|200131-12HRCarbamazepine300MGExtendedReleaseOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|897722-Verapamilhydrochloride40MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|857183-FosinoprilSodium20MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|312835-rivastigmine3MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|238920-Betamethasone0.5MG/MLTopicalCream|SPD 632|1001|N|N|N||Preferred Generic|897683-Verapamilhydrochloride80MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|310599-Granisetron1MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|1085633-TriamcinoloneAcetonide0.00025MG/MGTopicalOintment|SPD 632|1001|Y|N|N||Preferred Generic|310437-Galantamine8MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|200064-letrozole2.5MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|283317-Hydrochlorothiazide12.5MG/telmisartan80MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|897649-Verapamilhydrochloride240MGExtendedReleaseOralTablet|SPD 632|1001|N|N|N||Preferred Generic|897624-24HRVerapamilhydrochloride240MGExtendedReleaseOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|200060-mycophenolatemofetil500MGOralTablet|SPD 632|1001|N|N|N||Preferred Brand|207478-Primidone50MGOralTablet[Mysoline]|SPD 632|1001|N|N|Y||Preferred Generic|1149632-84HREstradiol0.00313MG/HRTransdermalSystem|SPD 632|1001|N|N|Y||Preferred Generic|485486-tizanidine2MGOralCapsule|SPD 632|1001|Y|N|N||Preferred Generic|240912-Granisetron1MG/MLInjectableSolution|SPD 632|1001|N|N|N||Preferred Generic|200033-carvedilol25MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|897590-24HRVerapamilhydrochloride200MGExtendedReleaseOralCapsule|SPD 632|1001|Y|N|N||Preferred Generic|2198370-pretomanid200MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|311486-meloxicam7.5MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|897584-24HRVerapamilhydrochloride100MGExtendedReleaseOralCapsule|SPD 632|1001|Y|N|N||Preferred Generic|205324-modafinil200MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|349420-desloratadine5MGOralTablet|SPD 632|1001|N|N|N||Preferred Brand|206961-Nadolol20MGOralTablet[Corgard]|SPD 632|1001|Y|N|N||Preferred Generic|205316-topiramate15MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|1234571-PhenylephrineHydrochloride100MG/MLOphthalmicSolution|SPD 632|1001|N|N|N||Preferred Generic|200032-carvedilol12.5MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|205315-topiramate25MGOralCapsule|SPD 632|1001|Y|N|N||Preferred Generic|200328-capecitabine500MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|896762-Labetalolhydrochloride200MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|1359858-Fluticasonepropionate0.5MG/ACTUAT/salmeterol0.05MG/ACTUATDryPowderInhaler|SPD 632|1001|N|N|N||Preferred Generic|896758-Labetalolhydrochloride100MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|200031-carvedilol6.25MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|541363-Amphetamineaspartate7.5MG/AmphetamineSulfate7.5MG/Dextroamphetaminesaccharate7.5MG/DextroamphetamineSulfate7.5MGOralTa|SPD 632|1001|Y|N|N||Preferred Generic|1988980-24HRpregabalin82.5MGExtendedReleaseOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|1244214-Budesonide3MGDelayedReleaseOralCapsule|SPD 632|1001|Y|N|N||Preferred Generic|1988977-24HRpregabalin330MGExtendedReleaseOralTablet|SPD 632|1001|N|N|N||Preferred Generic|199903-Hydrochlorothiazide12.5MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|895987-Fluticasonepropionate0.5MG/MLTopicalCream|SPD 632|1001|N|N|N||Preferred Generic|309273-cholinesalicylate58.6MG/ML/MagnesiumSalicylate72.4MG/MLOralSolution|SPD 632|1001|Y|N|N||Preferred Generic|1988974-24HRpregabalin165MGExtendedReleaseOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|876529-Amlodipine5MG/telmisartan80MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|895487-Fluticasonepropionate0.00005MG/MGTopicalOintment|SPD 632|1001|Y|N|N||Preferred Generic|198200-Rifabutin150MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|199890-topiramate200MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|197845-Isotretinoin40MGOralCapsule|SPD 632|1001|N|N|N||Preferred Brand|207373-Mitotane500MGOralTablet[Lysodren]|SPD 632|1001|Y|N|N||Preferred Brand|1145932-1MLabatacept125MG/MLPrefilledSyringe[Orencia]|SPD 632|1001|N|N|N||Preferred Generic|857301-ClomipramineHydrochloride50MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|892251-LevothyroxineSodium0.2MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|876519-Amlodipine10MG/telmisartan80MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|197844-Isotretinoin20MGOralCapsule|SPD 632|1001|N|N|N||Preferred Brand|748859-Zovia1/35E28DayPack|SPD 632|1001|Y|N|N||Preferred Generic|197843-Isotretinoin10MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|892246-LevothyroxineSodium0.1MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|199889-topiramate100MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|197696-72HRFentanyl0.075MG/HRTransdermalSystem|SPD 632|1001|N|N|Y||Preferred Generic|541878-Amphetamineaspartate1.25MG/AmphetamineSulfate1.25MG/Dextroamphetaminesaccharate1.25MG/DextroamphetamineSulfate1.25MGOr|SPD 632|1001|Y|N|N||Preferred Generic|1923828-deferasirox180MGOralGranules|SPD 632|1001|Y|N|N||Preferred Generic|1923826-deferasirox360MGOralGranules|SPD 632|1001|N|N|N||Preferred Generic|199888-topiramate25MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|886666-FlecainideAcetate100MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|197445-Carbidopa25MG/Levodopa250MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1796091-24HRLinagliptin2.5MG/Metforminhydrochloride1000MGExtendedReleaseOralTablet[Jentadueto]|SPD 632|1001|N|N|N||Preferred Generic|311665-Metipranolol3MG/MLOphthalmicSolution|SPD 632|1001|N|N|N||Preferred Generic|886662-FlecainideAcetate50MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|1874559-24HRdesvenlafaxinesuccinate50MGExtendedReleaseOralTablet|SPD 632|1001|N|N|N||Preferred Generic|197319-Allopurinol100MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|1874553-24HRdesvenlafaxinesuccinate100MGExtendedReleaseOralTablet|SPD 632|1001|N|N|N||Preferred Generic|1193358-100MLLevetiracetam10MG/MLInjection|SPD 632|1001|Y|N|N||Preferred Generic|1860157-Abuse-Deterrent12HROxycodoneHydrochloride10MGExtendedReleaseOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|404450-Thalidomide200MGOralCapsule[Thalomid]|SPD 632|1001|N|N|N||Preferred Generic|884707-Estradiol0.01MGVaginalInsert|SPD 632|1001|Y|N|N||Preferred Generic|1860148-Abuse-Deterrent12HROxycodoneHydrochloride80MGExtendedReleaseOralTablet|SPD 632|1001|N|N|N||Preferred Generic|310797-Hydrochlorothiazide12.5MG/quinapril20MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|884308-Nystatin100UNT/MGTopicalOintment|SPD 632|1001|N|N|N||Preferred Generic|199884-Levofloxacin250MGOralTablet|SPD 632|1001|N|N|N||Preferred Brand|1098924-SodiumFluoride11MG/MLOralSolution[Flura-Drops]|SPD 632|1001|Y|N|N||Preferred Generic|1860129-Abuse-Deterrent12HROxycodoneHydrochloride20MGExtendedReleaseOralTablet|SPD 632|1001|N|N|N||Preferred Brand|102250-Hydrocortisone1.67MG/MLEnema[Cortenema]|SPD 632|1001|N|N|N||Preferred Brand|1359027-MicrogestinFe1.5/3028DayPack|SPD 632|1001|Y|N|N||Preferred Generic|1860127-Abuse-Deterrent12HROxycodoneHydrochloride60MGExtendedReleaseOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|1799212-sofosbuvir400MG/velpatasvir100MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|199703-cabergoline0.5MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|884185-ClonidineHydrochloride0.2MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|1796690-1MLhydroxyprogesteronecaproate(USP)250MG/MLInjection|SPD 632|1001|N|N|N||Preferred Brand|206314-Hydrocortisone0.01MG/MGTopicalOintment[Cortizone]|SPD 632|1001|N|N|N||Preferred Generic|309290-ciclopirox7.7MG/MLTopicalLotion|SPD 632|1001|Y|N|N||Preferred Generic|892349-24HRMorphineSulfate60MGExtendedReleaseOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|884173-ClonidineHydrochloride0.1MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|1745091-Lidocaine0.05MG/MGMedicatedPatch|SPD 632|1001|Y|N|N||Preferred Generic|1737461-PamidronateDisodium90MGInjection|SPD 632|1001|N|N|N||Preferred Generic|199425-Melatonin1MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|1737459-PamidronateDisodium30MGInjection|SPD 632|1001|Y|N|N||Preferred Generic|1734399-1MLGranisetron1MG/MLInjection|SPD 632|1001|N|N|N||Preferred Generic|866924-MetoprololTartrate25MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|1657173-0.5MLSumatriptan8MG/MLCartridge|SPD 632|1001|N|N|N||Preferred Generic|866514-MetoprololTartrate50MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|1191310-FluocinoloneAcetonide0.1MG/MLTopicalSolution|SPD 632|1001|N|N|N||Preferred Generic|199390-Etodolac500MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|311666-Metoclopramide10MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|1607796-deferasirox90MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|1543069-Lidocaine0.05MG/MGTopicalOintment|SPD 632|1001|Y|N|N||Preferred Generic|1607792-deferasirox360MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|199353-trandolapril1MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|866436-24HRmetoprololsuccinate50MGExtendedReleaseOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|1607784-deferasirox180MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|1806189-30/70Release24HRMethylphenidateHydrochloride30MGExtendedReleaseOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|866427-24HRmetoprololsuccinate25MGExtendedReleaseOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|1599949-60ACTUATTestosterone30MG/ACTUATTopicalSolution|SPD 632|1001|Y|N|N||Preferred Generic|898715-pregabalin20MG/MLOralSolution|SPD 632|1001|Y|N|N||Preferred Generic|1597129-5000MGTestosterone0.01MG/MGTopicalGel|SPD 632|1001|N|N|N||Preferred Generic|1191256-FluocinoloneAcetonide0.00025MG/MGTopicalOintment|SPD 632|1001|N|N|N||Preferred Generic|1043690-hydrocortisoneacetate10MG/MLTopicalCream|SPD 632|1001|Y|N|N||Preferred Generic|1597123-2500MGTestosterone0.01MG/MGTopicalGel|SPD 632|1001|N|N|N||Preferred Generic|309098-Cefuroxime500MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|1591943-ledipasvir90MG/sofosbuvir400MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|866412-24HRmetoprololsuccinate100MGExtendedReleaseOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|1547565-Isotretinoin35MGOralCapsule|SPD 632|1001|Y|N|N||Preferred Generic|1547561-Isotretinoin25MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|866144-Cyproheptadinehydrochloride4MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|199351-trandolapril2MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|387003-Levetiracetam1000MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|309291-ciclopirox80MG/MLTopicalSolution|SPD 632|1001|Y|N|N||Preferred Brand|603978-nepafenac1MG/MLOphthalmicSuspension[Nevanac]|SPD 632|1001|N|N|Y||Preferred Generic|577961-Amphetamineaspartate5MG/AmphetamineSulfate5MG/Dextroamphetaminesaccharate5MG/DextroamphetamineSulfate5MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|1490065-RaloxifeneHydrochloride60MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|1487361-1MLglatirameracetate40MG/MLPrefilledSyringe|SPD 632|1001|N|N|N||Preferred Generic|199246-glimepiride2MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|866094-buspironehydrochloride5MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|1435115-28ACTUATTeriparatide0.02MG/ACTUATPenInjector|SPD 632|1001|N|N|N||Preferred Generic|866090-buspironehydrochloride30MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|1373503-{7(EthinylEstradiol0.01MGOralTablet)/42(EthinylEstradiol0.02MG/Levonorgestrel0.15MGOralTablet)/21(EthinylEstradiol0.0|SPD 632|1001|Y|N|N||Preferred Generic|1373497-{14(dimethylfumarate120MGDelayedReleaseOralCapsule)/46(dimethylfumarate240MGDelayedReleaseOralCapsule)}Pack|SPD 632|1001|N|N|N||Preferred Generic|199245-glimepiride1MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|1298091-FlurazepamHydrochloride30MGOralCapsule|SPD 632|1001|Y|N|N||Preferred Generic|1373483-dimethylfumarate120MGDelayedReleaseOralCapsule|SPD 632|1001|Y|N|N||Preferred Generic|900164-24HRlamotrigine25MGExtendedReleaseOralTablet|SPD 632|1001|N|N|N||Preferred Generic|866018-buspironehydrochloride15MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|1366550-24HRBudesonide9MGExtendedReleaseOralTablet|SPD 632|1001|N|N|N||Preferred Brand|692694-thyroid(USP)65MGOralTablet[Westhroid]|SPD 632|1001|N|N|N||Preferred Generic|863669-Tamsulosinhydrochloride0.4MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|1992303-12HRTimolol5MG/MLOphthalmicSolution|SPD 632|1001|Y|N|N||Preferred Brand|861045-1.5MLpramlintideacetate1MG/MLPenInjector[Symlin]|SPD 632|1001|N|N|N||Preferred Brand|212373-Estrogens,Esterified(USP)1.25MGOralTablet[Menest]|SPD 632|1001|N|N|Y||Preferred Generic|1596780-60ACTUATTestosterone12.5MG/ACTUATTopicalGel|SPD 632|1001|N|N|Y||Preferred Generic|596926-duloxetine20MGDelayedReleaseOralCapsule|SPD 632|1001|Y|N|N||Preferred Generic|903843-PyridostigmineBromide12MG/MLOralSolution|SPD 632|1001|Y|N|N||Preferred Generic|1304979-icosapentethyl1000MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|863636-24HROxybutyninchloride5MGExtendedReleaseOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|1299917-Tiagabinehydrochloride4MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|311668-Metoclopramide5MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|197448-Levocarnitine330MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|863628-24HROxybutyninchloride15MGExtendedReleaseOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|1299909-Tiagabinehydrochloride16MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|1299903-Tiagabinehydrochloride12MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|1099625-DivalproexSodium125MGDelayedReleaseOralTablet|SPD 632|1001|N|N|N||Preferred Generic|1190572-AtropineSulfate0.025MG/DiphenoxylateHydrochloride2.5MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|199193-famciclovir250MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|903847-PyridostigmineBromide180MGExtendedReleaseOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|1119400-everolimus7.5MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|861753-Glyburide5MG/Metforminhydrochloride500MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|861748-Glyburide2.5MG/Metforminhydrochloride500MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|199192-famciclovir125MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|596930-duloxetine30MGDelayedReleaseOralCapsule|SPD 632|1001|Y|N|N||Preferred Generic|1092357-rufinamide40MG/MLOralSuspension|SPD 632|1001|N|N|Y||Preferred Generic|1649401-DoxycyclineMonohydrate50MGOralCapsule|SPD 632|1001|Y|N|N||Preferred Generic|1087964-hydroxyprogesteronecaproate(USP)250MG/MLInjectableSolution|SPD 632|1001|N|N|N||Preferred Generic|199168-Phenobarbital64.8MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|861657-24HRNitroglycerin0.1MG/HRTransdermalSystem|SPD 632|1001|Y|N|N||Preferred Generic|1050493-{21(drospirenone3MG/EthinylEstradiol0.03MG/levomefolatecalcium0.451MGOralTablet)/7(levomefolatecalcium0.451MGOralTabl|SPD 632|1001|N|N|N||Preferred Generic|857461-ClemastineFumarate2.68MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|1855086-thyroid(USP)15MGOralTablet[NPThyroid]|SPD 632|1001|N|N|N||Preferred Generic|861495-ClobetasolPropionate0.5MG/MLTopicalCream|SPD 632|1001|Y|N|N||Preferred Generic|1011739-aliskiren300MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|199167-Phenobarbital32.4MGOralTablet|SPD 632|1001|Y|N|N||Preferred Generic|904952-3MLibandronicacid1MG/MLPrefilledSyringe|SPD 632|1001|Y|N|N||Preferred Brand|995156-lacosamide10MG/MLOralSolution[Vimpat]|SPD 632|1001|N|N|N||Preferred Generic|861448-ClobetasolPropionate0.0005MG/MGTopicalOintment|SPD 632|1001|Y|N|N||Preferred Brand|616283-sunitinib12.5MGOralCapsule[Sutent]|SPD 632|1001|Y|N|N||Preferred Brand|993456-1MLdenosumab60MG/MLPrefilledSyringe[Prolia]|SPD 632|1001|Y|N|N||Preferred Brand|979115-0.6MLMethylnaltrexonebromide20MG/MLInjection[Relistor]|SPD 632|1001|N|N|N||Preferred Generic|861430-PropafenoneHydrochloride300MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|199164-Phenobarbital97.2MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|903855-2MLPyridostigmineBromide5MG/MLInjection[Regonol]|SPD 632|1001|N|N|Y||Preferred Generic|596934-duloxetine60MGDelayedReleaseOralCapsule|SPD 632|1001|Y|N|N||Preferred Brand|902626-dexlansoprazole60MGDelayedReleaseOralCapsule[Dexilant]|SPD 632|1001|Y|N|N||Preferred Brand|902624-dexlansoprazole30MGDelayedReleaseOralCapsule[Dexilant]|SPD 632|1001|N|N|N||Preferred Generic|199163-Melatonin3MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|861424-PropafenoneHydrochloride150MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|901614-Aztreonam75MG/MLInhalationSolution[Cayston]|SPD 632|1001|Y|N|N||Preferred Brand|897126-3MLliraglutide6MG/MLPenInjector[Victoza]|SPD 632|1001|Y|N|N||Preferred Brand|1243052-ivacaftor150MGOralTablet[Kalydeco]|SPD 632|1001|N|N|Y||Preferred Generic|541892-Amphetamineaspartate2.5MG/AmphetamineSulfate2.5MG/Dextroamphetaminesaccharate2.5MG/DextroamphetamineSulfate2.5MGOralTa|SPD 632|1001|N|N|N||Preferred Generic|861416-Azithromycin1000MGPowderforOralSuspension|SPD 632|1001|Y|N|N||Preferred Brand|896273-120ACTUATFluticasonepropionate0.23MG/ACTUAT/salmeterol0.021MG/ACTUATMeteredDoseInhaler[Advair]|SPD 632|1001|N|N|N||Preferred Brand|206208-aluminumchloride200MG/MLTopicalSolution[Drysol]|SPD 632|1001|Y|N|N||Preferred Brand|616287-sunitinib25MGOralCapsule[Sutent]|SPD 632|1001|Y|N|N||Preferred Brand|896245-120ACTUATFluticasonepropionate0.115MG/ACTUAT/salmeterol0.021MG/ACTUATMeteredDoseInhaler[Advair]|SPD 632|1001|N|N|Y||Preferred Generic|242891-84HREstradiol0.00208MG/HRTransdermalSystem|SPD 632|1001|N|N|N||Preferred Brand|1359025-JunelFe28DayPack|SPD 632|1001|N|N|N||Preferred Generic|1150836-LevobunololHydrochloride5MG/MLOphthalmicSolution|SPD 632|1001|N|N|N||Preferred Generic|199159-Tretinoin10MGOralCapsule|SPD 632|1001|Y|N|N||Preferred Brand|896237-120ACTUATFluticasonepropionate0.045MG/ACTUAT/salmeterol0.021MG/ACTUATMeteredDoseInhaler[Advair]|SPD 632|1001|N|N|N||Preferred Generic|992528-Terbinafinehydrochloride10MG/MLTopicalCream|SPD 632|1001|N|N|N||Preferred Generic|861171-12HRPropafenoneHydrochloride425MGExtendedReleaseOralCapsule|SPD 632|1001|Y|N|N||Preferred Brand|864820-Oxybutyninchloride0.1MG/MGTopicalGel[Gelnique]|SPD 632|1001|N|N|N||Preferred Brand|751884-Lutera28DayPack|SPD 632|1001|N|N|N||Preferred Generic|861164-12HRPropafenoneHydrochloride325MGExtendedReleaseOralCapsule|SPD 632|1001|Y|N|N||Preferred Brand|861043-2.7MLpramlintideacetate1MG/MLPenInjector[Symlin]|SPD 632|1001|N|N|N||Preferred Generic|199150-Acarbose100MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|1650142-DoxycyclineMonohydrate100MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|608139-atomoxetine100MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|403853-Hydrochlorothiazide12.5MG/Olmesartanmedoxomil20MGOralTablet|SPD 632|1001|N|N|N||Preferred Brand|896001-120ACTUATFluticasonepropionate0.11MG/ACTUATMeteredDoseInhaler[Flovent]|SPD 632|1001|Y|N|N||Preferred Brand|860898-Vigabatrin500MGPowderforOralSolution[Sabril]|SPD 632|1001|N|N|N||Preferred Generic|199149-Acarbose50MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|861132-24HRAlfuzosinhydrochloride10MGExtendedReleaseOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|860244-interferonbeta-1b0.3MGInjection[Extavia]|SPD 632|1001|N|N|N||Preferred Generic|309337-Clindamycin20MG/MLVaginalCream|SPD 632|1001|N|N|N||Preferred Generic|861064-Sertraline20MG/MLOralSolution|SPD 632|1001|Y|N|N||Preferred Brand|858044-saxagliptin2.5MGOralTablet[Onglyza]|SPD 632|1001|N|N|N||Preferred Brand|890786-Butoconazolenitrate20MG/MLVaginalCream[Gynazole-1]|SPD 632|1001|N|N|N||Preferred Generic|861156-12HRPropafenoneHydrochloride225MGExtendedReleaseOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|199143-Niacin250MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|857799-Treprostinil0.6MG/MLInhalationSolution[Tyvaso]|SPD 632|1001|Y|N|N||Preferred Brand|854852-lisdexamfetaminedimesylate50MGOralCapsule[Vyvanse]|SPD 632|1001|N|N|N||Preferred Generic|861007-Metforminhydrochloride500MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1244062-0.6MLMethylnaltrexonebromide20MG/MLPrefilledSyringe[Relistor]|SPD 632|1001|N|N|N||Preferred Brand|630475-SodiumFluoride5.56MG/MLOralSolution[FluoraDay]|SPD 632|1001|Y|N|N||Preferred Brand|854844-lisdexamfetaminedimesylate70MGOralCapsule[Vyvanse]|SPD 632|1001|N|N|N||Preferred Generic|861004-Metforminhydrochloride1000MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|1116150-bacitracinzinc0.4UNT/MG/hydrocortisoneacetate0.01MG/MG/NeomycinSulfate0.0035MG/MG/PolymyxinBSulfate10UNT/MGOphthalmic|SPD 632|1001|N|N|N||Preferred Generic|199058-mycophenolatemofetil250MGOralCapsule|SPD 632|1001|N|N|Y||Preferred Generic|608143-atomoxetine80MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|311679-Metronidazole0.0075MG/MGTopicalGel|SPD 632|1001|Y|N|N||Preferred Brand|854832-lisdexamfetaminedimesylate20MGOralCapsule[Vyvanse]|SPD 632|1001|N|N|Y||Preferred Generic|1806191-30/70Release24HRMethylphenidateHydrochloride40MGExtendedReleaseOralCapsule|SPD 632|1001|N|N|Y||Preferred Generic|313161-Sumatriptan50MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|853356-1MLustekinumab90MG/MLPrefilledSyringe[Stelara]|SPD 632|1001|N|N|N||Preferred Generic|199047-Famotidine10MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|858613-Nicardipinehydrochloride20MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|860975-24HRMetforminhydrochloride500MGExtendedReleaseOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|853354-0.5MLustekinumab90MG/MLPrefilledSyringe[Stelara]|SPD 632|1001|N|N|N||Preferred Generic|860805-Azelastinehydrochloride0.5MG/MLOphthalmicSolution|SPD 632|1001|Y|N|N||Preferred Brand|848164-0.5MLgolimumab100MG/MLPrefilledSyringe[Simponi]|SPD 632|1001|N|N|N||Preferred Generic|1115005-DocusateSodium100MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|198861-SodiumBicarbonate650MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|845512-everolimus10MGOralTablet[Afinitor]|SPD 632|1001|N|N|N||Preferred Generic|860221-MegestrolAcetate40MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|836649-Zolpidemtartrate5MGSublingualTablet[Edluar]|SPD 632|1001|Y|N|N||Preferred Brand|836645-Zolpidemtartrate10MGSublingualTablet[Edluar]|SPD 632|1001|N|N|N||Preferred Generic|860215-MegestrolAcetate20MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|198857-Simethicone66.7MG/MLOralSuspension|SPD 632|1001|Y|N|N||Preferred Brand|1593833-24HRdapagliflozin5MG/Metforminhydrochloride1000MGExtendedReleaseOralTablet[Xigduo]|SPD 632|1001|N|N|N||Preferred Generic|311678-Metronidazole7.5MG/MLTopicalCream|SPD 632|1001|N|N|Y||Preferred Generic|1806193-30/70Release24HRMethylphenidateHydrochloride50MGExtendedReleaseOralCapsule|SPD 632|1001|Y|N|N||Preferred Brand|828364-hydrocortisoneacetate10MG/ML/Pramoxinehydrochloride10MG/MLRectalFoam[Proctofoam-HC]|SPD 632|1001|N|N|N||Preferred Brand|854921-BisoprololFumarate5MG/Hydrochlorothiazide6.25MGOralTablet[Ziac]|SPD 632|1001|Y|N|N||Preferred Brand|825429-eltrombopag50MGOralTablet[Promacta]|SPD 632|1001|N|N|N||Preferred Generic|198760-Niacin50MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|859751-Rosuvastatincalcium20MGOralTablet|SPD 632|1001|N|N|N||Preferred Brand|205669-Dexamethasone1MG/MLOphthalmicSuspension[Maxidex]|SPD 632|1001|Y|N|N||Preferred Generic|999996-Amlodipine5MG/Hydrochlorothiazide12.5MG/Olmesartanmedoxomil40MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|859747-Rosuvastatincalcium10MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|810079-24HRFesoterodineFumarate8MGExtendedReleaseOralTablet[Toviaz]|SPD 632|1001|Y|N|N||Preferred Brand|810075-24HRFesoterodineFumarate4MGExtendedReleaseOralTablet[Toviaz]|SPD 632|1001|N|N|N||Preferred Generic|198759-Niacin100MGOralTablet|SPD 632|1001|N|N|N||Preferred Brand|205562-Estramustine140MGOralCapsule[Emcyt]|SPD 632|1001|N|N|Y||Preferred Generic|313160-Sumatriptan100MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|809998-lacosamide200MGOralTablet[Vimpat]|SPD 632|1001|N|N|N||Preferred Generic|859419-Rosuvastatincalcium40MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|403967-zonisamide50MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|859193-selegilinehydrochloride5MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|198741-MagnesiumOxide400MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|668606-Vorinostat100MGOralCapsule[Zolinza]|SPD 632|1001|N|N|Y||Preferred Generic|1806197-30/70Release24HRMethylphenidateHydrochloride60MGExtendedReleaseOralCapsule|SPD 632|1001|N|N|Y||Preferred Generic|636045-Hydrochlorothiazide25MG/valsartan320MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|795749-RebifTitrationPack|SPD 632|1001|N|N|N||Preferred Generic|198707-Hydrocortisone5MG/MLTopicalCream|SPD 632|1001|N|N|N||Preferred Generic|859052-Pramipexoledihydrochloride1MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|795085-certolizumabpegol200MGInjection[Cimzia]|SPD 632|1001|N|N|N||Preferred Generic|311681-Metronidazole500MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|1362720-MexiletineHydrochloride250MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|859048-Pramipexoledihydrochloride1.5MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|1047895-HyoscyamineSulfate0.125MG/MLOralSolution|SPD 632|1001|Y|N|N||Preferred Brand|758032-0.5MLInterferonbeta-1a0.044MG/MLPrefilledSyringe[Rebif]|SPD 632|1001|Y|N|N||Preferred Brand|758027-0.5MLInterferonbeta-1a0.088MG/MLPrefilledSyringe[Rebif]|SPD 632|1001|N|N|N||Preferred Generic|1099687-ValproicAcid50MG/MLOralSolution|SPD 632|1001|N|N|N||Preferred Generic|198630-ferrousgluconate324MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|753443-9HRMethylphenidate3.33MG/HRTransdermalSystem[Daytrana]|SPD 632|1001|Y|N|N||Preferred Brand|753442-9HRMethylphenidate2.22MG/HRTransdermalSystem[Daytrana]|SPD 632|1001|N|N|N||Preferred Generic|859040-Pramipexoledihydrochloride0.25MGOralTablet|SPD 632|1001|Y|N|Y||Preferred Brand|665040-sitagliptin25MGOralTablet[Januvia]|SPD 632|1001|N|N|N||Preferred Generic|858747-Ursodiol300MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|859033-Pramipexoledihydrochloride0.125MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|198555-Capsaicin0.25MG/MLTopicalCream|SPD 632|1001|N|N|N||Preferred Generic|639566-VitaminB650MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|686379-celecoxib50MGOralCapsule|SPD 632|1001|Y|N|N||Preferred Brand|731250-0.3MLdarbepoetinalfa0.2MG/MLPrefilledSyringe[Aranesp]|SPD 632|1001|N|N|Y||Preferred Generic|1812011-Osmotic24HRNifedipine30MGExtendedReleaseOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|731245-0.42MLdarbepoetinalfa0.06MG/MLPrefilledSyringe[Aranesp]|SPD 632|1001|N|N|N||Preferred Generic|198546-CalciumGluconate500MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|858824-EnalaprilMaleate5MG/Hydrochlorothiazide12.5MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|309367-Clotrimazole10MG/MLTopicalCream|SPD 632|1001|Y|N|N||Preferred Brand|731241-1MLdarbepoetinalfa0.5MG/MLPrefilledSyringe[Aranesp]|SPD 632|1001|Y|N|Y||Preferred Brand|665044-sitagliptin50MGOralTablet[Januvia]|SPD 632|1001|N|N|N||Preferred Generic|858817-EnalaprilMaleate10MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|731231-0.3MLdarbepoetinalfa0.5MG/MLPrefilledSyringe[Aranesp]|SPD 632|1001|N|N|N||Preferred Generic|198509-Bisacodyl10MGRectalSuppository|SPD 632|1001|Y|N|N||Preferred Brand|1310138-everolimus2MGTabletforOralSuspension[Afinitor]|SPD 632|1001|N|N|N||Preferred Generic|309362-clopidogrel75MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|730046-0.5MLdarbepoetinalfa0.2MG/MLPrefilledSyringe[Aranesp]|SPD 632|1001|Y|N|Y||Preferred Brand|665036-sitagliptin100MGOralTablet[Januvia]|SPD 632|1001|N|N|N||Preferred Generic|239238-Griseofulvin25MG/MLOralSuspension|SPD 632|1001|N|N|N||Preferred Generic|858810-EnalaprilMaleate20MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|727816-0.5MLInterferonbeta-1a0.06MG/MLPrefilledSyringe[Avonex]|SPD 632|1001|N|N|N||Preferred Brand|616449-MycophenolicAcid360MGDelayedReleaseOralTablet[Myfortic]|SPD 632|1001|Y|N|N||Preferred Brand|727714-0.67MLanakinra149MG/MLPrefilledSyringe[Kineret]|SPD 632|1001|N|N|N||Preferred Brand|1359020-Microgestin1/2021DayPack|SPD 632|1001|N|N|N||Preferred Generic|858804-EnalaprilMaleate2.5MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|198440-Acetaminophen500MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|242333-168HREstradiol0.00104MG/HRTransdermalSystem|SPD 632|1001|Y|N|N||Preferred Brand|723846-orlistat60MGOralCapsule[Alli]|SPD 632|1001|N|N|Y||Preferred Generic|687043-Amphetamineaspartate3.125MG/AmphetamineSulfate3.125MG/Dextroamphetaminesaccharate3.125MG/DextroamphetamineSulfate3.125|SPD 632|1001|N|N|Y||Preferred Generic|1812013-Osmotic24HRNifedipine60MGExtendedReleaseOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|706872-Azithromycin10MG/MLOphthalmicSolution[AzaSite]|SPD 632|1001|Y|N|N||Preferred Brand|700418-Thalidomide150MGOralCapsule[Thalomid]|SPD 632|1001|N|N|N||Preferred Generic|198429-lamotrigine200MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|858625-Pramipexoledihydrochloride0.75MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|197454-Cephalexin500MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|311725-Mirtazapine15MGOralTablet|SPD 632|1001|Y|N|Y||Preferred Brand|861771-Metforminhydrochloride1000MG/sitagliptin50MGOralTablet[Janumet]|SPD 632|1001|Y|N|N||Preferred Brand|643722-lenalidomide25MGOralCapsule[Revlimid]|SPD 632|1001|N|N|N||Preferred Generic|993541-24HRBupropionHydrochloride150MGExtendedReleaseOralTablet|SPD 632|1001|N|N|N||Preferred Generic|858616-Nicardipinehydrochloride30MGOralCapsule|SPD 632|1001|Y|N|N||Preferred Brand|643714-lenalidomide15MGOralCapsule[Revlimid]|SPD 632|1001|Y|N|N||Preferred Brand|643488-Isotretinoin30MGOralCapsule[Claravis]|SPD 632|1001|N|N|N||Preferred Generic|1099648-5MLValproicAcid100MG/MLInjection|SPD 632|1001|N|N|N||Preferred Generic|198428-lamotrigine150MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|643177-dasatinib70MGOralTablet[Sprycel]|SPD 632|1001|Y|N|N||Preferred Brand|643175-dasatinib50MGOralTablet[Sprycel]|SPD 632|1001|N|N|N||Preferred Generic|857683-TerbutalineSulfate5MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|643173-dasatinib20MGOralTablet[Sprycel]|SPD 632|1001|Y|N|N||Preferred Brand|616292-sunitinib50MGOralCapsule[Sutent]|SPD 632|1001|N|N|N||Preferred Generic|857677-TerbutalineSulfate2.5MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|198427-lamotrigine100MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|1812015-Osmotic24HRNifedipine90MGExtendedReleaseOralTablet|SPD 632|1001|N|N|N||Preferred Generic|311277-lansoprazole30MGDelayedReleaseOralCapsule|SPD 632|1001|N|N|Y||Preferred Generic|728109-Oseltamivir30MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|199352-trandolapril4MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|616116-lenalidomide5MGOralCapsule[Revlimid]|SPD 632|1001|N|N|N||Preferred Generic|244967-PolymyxinB10000UNT/ML/Trimethoprim1MG/MLOphthalmicSolution|SPD 632|1001|N|N|N||Preferred Brand|616444-mycophenolatemofetil200MG/MLOralSuspension[Cellcept]|SPD 632|1001|Y|N|N||Preferred Brand|616114-lenalidomide10MGOralCapsule[Revlimid]|SPD 632|1001|N|N|N||Preferred Generic|198382-famciclovir500MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|857340-BethanecholChloride50MGOralTablet|SPD 632|1001|Y|N|Y||Preferred Brand|861821-Metforminhydrochloride500MG/sitagliptin50MGOralTablet[Janumet]|SPD 632|1001|Y|N|N||Preferred Brand|616018-abatacept250MGInjection[Orencia]|SPD 632|1001|N|N|N||Preferred Generic|309370-Clotrimazole10MG/MLTopicalSolution|SPD 632|1001|Y|N|N||Preferred Brand|615979-sorafenib200MGOralTablet[Nexavar]|SPD 632|1001|N|N|N||Preferred Generic|857336-BethanecholChloride5MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|607579-entecavir0.05MG/MLOralSolution[Baraclude]|SPD 632|1001|N|N|N||Preferred Generic|198380-tioconazole0.065MG/MGVaginalOintment|SPD 632|1001|N|N|N||Preferred Generic|857328-BethanecholChloride25MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|602862-magnesiumaminoacidchelate133MGOralTablet[MGPlusProtein]|SPD 632|1001|N|N|N||Preferred Generic|996824-MethylergonovineMaleate0.2MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|582595-Iloprost0.01MG/MLInhalationSolution[Ventavis]|SPD 632|1001|N|N|N||Preferred Generic|858813-EnalaprilMaleate5MGOralTablet|SPD 632|1001|N|N|Y||Preferred Brand|830253-0.5MLHepatitisBSurfaceAntigenVaccine0.01MG/MLPrefilledSyringe[Recombivax]|SPD 632|1001|N|N|N||Preferred Generic|857321-BethanecholChloride10MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|580286-mesalamine500MGExtendedReleaseOralCapsule[Pentasa]|SPD 632|1001|Y|N|N||Preferred Brand|731227-0.4MLdarbepoetinalfa0.1MG/MLPrefilledSyringe[Aranesp]|SPD 632|1001|Y|N|N||Preferred Brand|540181-alosetron0.5MGOralTablet[Lotronex]|SPD 632|1001|Y|N|Y||Preferred Generic|106303-Tretinoin0.5MG/MLTopicalCream|SPD 632|1001|N|N|N||Preferred Generic|857305-ClomipramineHydrochloride75MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|1099596-DivalproexSodium125MGDelayedReleaseOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|198378-Tacrolimus5MGOralCapsule|SPD 632|1001|Y|N|N||Preferred Brand|731229-0.6MLdarbepoetinalfa0.5MG/MLPrefilledSyringe[Aranesp]|SPD 632|1001|Y|N|N||Preferred Brand|404449-Thalidomide100MGOralCapsule[Thalomid]|SPD 632|1001|N|N|N||Preferred Generic|311726-Mirtazapine45MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|404065-Isotretinoin40MGOralCapsule[Claravis]|SPD 632|1001|N|N|Y||Preferred Generic|1918194-60ACTUATfluticasonepropionate0.113MG/ACTUAT/salmeterol0.014MG/ACTUATDryPowderInhaler|SPD 632|1001|Y|N|N||Preferred Brand|404062-Isotretinoin20MGOralCapsule[Claravis]|SPD 632|1001|N|N|N||Preferred Generic|198377-Tacrolimus1MGOralCapsule|SPD 632|1001|Y|N|N||Preferred Brand|1364358-ponatinib15MGOralTablet[Iclusig]|SPD 632|1001|N|N|N||Preferred Generic|857297-ClomipramineHydrochloride25MGOralCapsule|SPD 632|1001|Y|N|N||Preferred Brand|404059-Isotretinoin10MGOralCapsule[Claravis]|SPD 632|1001|Y|N|Y||Preferred Generic|197634-dronabinol10MGOralCapsule|SPD 632|1001|Y|N|N||Preferred Brand|352262-1MLdarbepoetinalfa0.3MG/MLInjection[Aranesp]|SPD 632|1001|N|N|N||Preferred Generic|1870230-NDA0208000.3MLEpinephrine1MG/MLAuto-Injector|SPD 632|1001|N|N|N||Preferred Generic|857187-FosinoprilSodium40MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|352047-1MLdarbepoetinalfa0.1MG/MLInjection[Aranesp]|SPD 632|1001|Y|N|N||Preferred Brand|727705-0.8MLadalimumab50MG/MLPrefilledSyringe[Humira]|SPD 632|1001|N|N|N||Preferred Brand|1095362-Balziva28DayPack|SPD 632|1001|N|N|N||Preferred Brand|2045958-avatrombopag20MGOralTablet[Doptelet]|SPD 632|1001|Y|N|N||Preferred Brand|352046-1MLdarbepoetinalfa0.06MG/MLInjection[Aranesp]|SPD 632|1001|N|N|N||Preferred Generic|1099569-24HRDivalproexSodium500MGExtendedReleaseOralTablet|SPD 632|1001|N|N|N||Preferred Generic|198372-torsemide5MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|352045-1MLdarbepoetinalfa0.04MG/MLInjection[Aranesp]|SPD 632|1001|N|N|N||Preferred Brand|751890-Portia28DayPack|SPD 632|1001|Y|N|N||Preferred Brand|352044-1MLdarbepoetinalfa0.025MG/MLInjection[Aranesp]|SPD 632|1001|N|N|N||Preferred Generic|857169-FosinoprilSodium10MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|261362-alosetron1MGOralTablet[Lotronex]|SPD 632|1001|Y|N|N||Preferred Brand|261105-Etanercept25MG/MLInjectableSolution[Enbrel]|SPD 632|1001|N|N|N||Preferred Generic|856853-AmitriptylineHydrochloride75MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|198371-torsemide20MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|731235-0.4MLdarbepoetinalfa0.5MG/MLPrefilledSyringe[Aranesp]|SPD 632|1001|N|N|N||Preferred Generic|309371-Clotrimazole10MGOralLozenge|SPD 632|1001|N|N|Y||Preferred Generic|801957-0.5MLDiazepam5MG/MLRectalGel|SPD 632|1001|Y|N|N||Preferred Brand|2550713-0.5MLsecukinumab150MG/MLPrefilledSyringe[Cosentyx]|SPD 632|1001|Y|N|N||Preferred Generic|855642-DiclofenacSodium0.03MG/MGTopicalGel|SPD 632|1001|Y|N|N||Preferred Brand|2536758-24HRviloxazine200MGExtendedReleaseOralCapsule[Qelbree]|SPD 632|1001|N|N|N||Preferred Generic|198370-torsemide100MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|856840-AmitriptylineHydrochloride50MG/Perphenazine4MGOralTablet|SPD 632|1001|N|N|N||Preferred Brand|845305-Nonoxynol-90.04MG/MGVaginalGel[Conceptrol]|SPD 632|1001|Y|N|N||Preferred Brand|2536752-24HRviloxazine150MGExtendedReleaseOralCapsule[Qelbree]|SPD 632|1001|Y|N|N||Preferred Brand|2536554-24HRviloxazine100MGExtendedReleaseOralCapsule[Qelbree]|SPD 632|1001|N|N|N||Preferred Generic|856834-AmitriptylineHydrochloride25MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|2531134-HumiraPen80MG/0.8ML-StarterPackageforPediatricUlcerativeColitis(4count)|SPD 632|1001|N|N|N||Preferred Generic|993691-BupropionHydrochloride75MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|2475860-vericiguat5MGOralTablet[Verquvo]|SPD 632|1001|N|N|N||Preferred Generic|198369-torsemide10MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|856825-AmitriptylineHydrochloride25MG/Perphenazine4MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|2475856-vericiguat2.5MGOralTablet[Verquvo]|SPD 632|1001|Y|N|N||Preferred Brand|1373333-Isotretinoin10MGOralCapsule[Zenatane]|SPD 632|1001|Y|N|N||Preferred Brand|2475852-vericiguat10MGOralTablet[Verquvo]|SPD 632|1001|N|N|N||Preferred Generic|1099681-ValproicAcid250MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|856797-AmitriptylineHydrochloride25MG/Perphenazine2MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|2475406-voclosporin7.9MGOralCapsule[Lupkynis]|SPD 632|1001|N|N|N||Preferred Brand|542059-Didanosine10MG/MLOralSolution[Videx]|SPD 632|1001|Y|N|N||Preferred Brand|2473042-ponatinib10MGOralTablet[Iclusig]|SPD 632|1001|Y|N|Y||Preferred Generic|197636-dronabinol5MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|856783-AmitriptylineHydrochloride10MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|1099316-DesipramineHydrochloride75MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|198365-Prochlorperazine10MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|2463733-epoetinalfa-epbx10000UNT/MLInjectableSolution[Retacrit]|SPD 632|1001|N|N|Y||Preferred Generic|1918209-60ACTUATfluticasonepropionate0.055MG/ACTUAT/salmeterol0.014MG/ACTUATDryPowderInhaler|SPD 632|1001|N|N|Y||Preferred Generic|801961-2MLDiazepam5MG/MLRectalGel|SPD 632|1001|Y|N|N||Preferred Brand|2395775-30ACTUATfluticasonefuroate0.2MG/ACTUAT/umeclidinium0.0625MG/ACTUAT/vilanterol0.025MG/ACTUATDryPowderInhaler[Trelegy]|SPD 632|1001|Y|N|N||Preferred Brand|1592752-nintedanib150MGOralCapsule[Ofev]|SPD 632|1001|Y|N|Y||Preferred Generic|245723-Tretinoin0.0005MG/MGTopicalGel|SPD 632|1001|Y|N|N||Preferred Brand|2392142-0.5MLetanercept50MG/MLInjection[Enbrel]|SPD 632|1001|N|N|N||Preferred Generic|198352-Zidovudine100MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|856762-AmitriptylineHydrochloride100MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|2387331-120ACTUATbudesonide0.16MG/ACTUAT/formoterolfumarate0.0048MG/ACTUAT/glycopyrrolate0.009MG/ACTUATMeteredDoseInhaler[Bre|SPD 632|1001|N|N|N||Preferred Generic|311727-Misoprostol0.1MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|197499-Chlorthalidone25MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|2373941-bedaquiline20MGOralTablet[Sirturo]|SPD 632|1001|N|N|N||Preferred Generic|993943-Acetaminophen325MG/butalbital50MG/Caffeine40MG/CodeinePhosphate30MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|856733-PropranololHydrochloride8MG/MLOralSolution|SPD 632|1001|Y|N|N||Preferred Brand|2371768-Oriahnn28DayKit|SPD 632|1001|Y|N|N||Preferred Brand|2359358-24HRempagliflozin5MG/linagliptin2.5MG/metforminhydrochloride1000MGExtendedReleaseOralTablet[Trijardy]|SPD 632|1001|N|N|N||Preferred Generic|1099304-DesipramineHydrochloride50MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|198335-Sulfamethoxazole800MG/Trimethoprim160MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|2359353-24HRempagliflozin25MG/linagliptin5MG/metforminhydrochloride1000MGExtendedReleaseOralTablet[Trijardy]|SPD 632|1001|Y|N|N||Preferred Brand|2359290-24HRempagliflozin12.5MG/linagliptin2.5MG/metforminhydrochloride1000MGExtendedReleaseOralTablet[Trijardy]|SPD 632|1001|N|N|N||Preferred Generic|856720-AmitriptylineHydrochloride10MG/Perphenazine4MGOralTablet|SPD 632|1001|Y|N|Y||Preferred Generic|310140-eprosartan600MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|2287905-1.5MLfremanezumab-vfrm150MG/MLAuto-Injector[Ajovy]|SPD 632|1001|N|N|N||Preferred Generic|856706-AmitriptylineHydrochloride10MG/Perphenazine2MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|2283236-bempedoicacid180MG/ezetimibe10MGOralTablet[Nexlizet]|SPD 632|1001|N|N|N||Preferred Generic|198334-Sulfamethoxazole400MG/Trimethoprim80MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|1363309-ChlorpheniramineMaleate4MGOralTablet|SPD 632|1001|N|N|N||Preferred Brand|1358780-Junel1/2021DayPack|SPD 632|1001|N|N|N||Preferred Generic|856578-PropranololHydrochloride80MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|2282320-Rimegepant75MGDisintegratingOralTablet[Nurtec]|SPD 632|1001|N|N|Y||Preferred Generic|1926331-0.5UNTDoses3MLInsulinLispro100UNT/MLPenInjector|SPD 632|1001|N|N|N||Preferred Brand|404550-Estrogens,Conjugated(USP)0.45MGOralTablet[Premarin]|SPD 632|1001|Y|N|N||Preferred Brand|2273115-24HRtofacitinib22MGExtendedReleaseOralTablet[Xeljanz]|SPD 632|1001|N|N|N||Preferred Generic|198332-Trimethoprim100MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|858828-EnalaprilMaleate10MG/Hydrochlorothiazide25MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|746609-nilotinib200MGOralCapsule[Tasigna]|SPD 632|1001|N|N|N||Preferred Generic|856556-PropranololHydrochloride60MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|1099678-DivalproexSodium250MGDelayedReleaseOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|226917-orlistat120MGOralCapsule[Xenical]|SPD 632|1001|N|N|N||Preferred Brand|202301-Estrogens,Conjugated(USP)1.25MGOralTablet[Premarin]|SPD 632|1001|Y|N|N||Preferred Brand|2268231-ubrogepant50MGOralTablet[Ubrelvy]|SPD 632|1001|Y|N|N||Preferred Brand|748738-Topotecan0.25MGOralCapsule[Hycamtin]|SPD 632|1001|N|N|N||Preferred Generic|1923422-SotalolHydrochloride120MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|856519-PropranololHydrochloride40MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|2268227-ubrogepant100MGOralTablet[Ubrelvy]|SPD 632|1001|Y|N|N||Preferred Brand|2265689-Voxelotor500MGOralTablet[Oxbryta]|SPD 632|1001|N|N|N||Preferred Generic|1362706-MexiletineHydrochloride150MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|198316-Hydrochlorothiazide25MG/Triamterene37.5MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|856457-PropranololHydrochloride20MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|2262731-MicronizedIsotretinoin8MGOralCapsule[Absorica]|SPD 632|1001|Y|N|N||Preferred Brand|748740-Topotecan1MGOralCapsule[Hycamtin]|SPD 632|1001|Y|N|N||Preferred Brand|2262727-MicronizedIsotretinoin32MGOralCapsule[Absorica]|SPD 632|1001|N|N|N||Preferred Generic|856448-PropranololHydrochloride10MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|349594-atomoxetine40MGOralCapsule|SPD 632|1001|N|N|N||Preferred Brand|1440936-Hydrocortisone25MG/MLTopicalCream[ProctozoneHC]|SPD 632|1001|Y|N|N||Preferred Brand|2262719-MicronizedIsotretinoin24MGOralCapsule[Absorica]|SPD 632|1001|N|N|N||Preferred Brand|1113046-amylase15000UNT/lipase3000UNT/protease9500UNTDelayedReleaseOralCapsule[Creon]|SPD 632|1001|Y|N|N||Preferred Brand|2262713-MicronizedIsotretinoin16MGOralCapsule[Absorica]|SPD 632|1001|N|N|N||Preferred Generic|856429-Hydrochlorothiazide25MG/PropranololHydrochloride80MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|198293-Tolazamide500MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|2256947-lasmiditan50MGOralTablet[Reyvow]|SPD 632|1001|N|N|Y||Preferred Generic|807832-24HRLevetiracetam500MGExtendedReleaseOralTablet|SPD 632|1001|N|N|N||Preferred Brand|1046771-12HRHyoscyamineSulfate0.375MGExtendedReleaseOralTablet[Levbid]|SPD 632|1001|Y|N|N||Preferred Brand|2256943-lasmiditan100MGOralTablet[Reyvow]|SPD 632|1001|N|N|N||Preferred Generic|1049167-PseudoephedrineHydrochloride60MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|248420-mesalamine1000MGRectalSuppository|SPD 632|1001|N|N|N||Preferred Brand|208949-Estrogens,Conjugated(USP)0.9MGOralTablet[Premarin]|SPD 632|1001|Y|N|N||Preferred Brand|2205634-1MLbenralizumab30MG/MLAuto-Injector[Fasenra]|SPD 632|1001|N|N|N||Preferred Generic|198292-Tolazamide250MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|856377-TrazodoneHydrochloride50MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|2203897-ledipasvir45MG/sofosbuvir200MGOralTablet[Harvoni]|SPD 632|1001|N|N|N||Preferred Generic|311892-nabumetone500MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|2203893-sofosbuvir200MGOralTablet[Sovaldi]|SPD 632|1001|N|N|N||Preferred Generic|309594-vitaminB121MG/MLInjectableSolution|SPD 632|1001|N|N|N||Preferred Generic|856373-TrazodoneHydrochloride100MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|2201540-romiplostim0.125MGInjection[Nplate]|SPD 632|1001|Y|N|N||Preferred Brand|753437-9HRMethylphenidate1.11MG/HRTransdermalSystem[Daytrana]|SPD 632|1001|Y|N|N||Preferred Brand|2196592-120ACTUATformoterolfumarate0.005MG/ACTUAT/mometasonefuroate0.05MG/ACTUATMeteredDoseInhaler[Dulera]|SPD 632|1001|N|N|N||Preferred Generic|1099292-DesipramineHydrochloride100MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|198240-Tamoxifen10MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|2182340-1MLEtanercept50MG/MLCartridge[Enbrel]|SPD 632|1001|Y|N|N||Preferred Brand|2174390-symdeko50MG/75MGand75MGPack|SPD 632|1001|Y|N|Y||Preferred Generic|577033-sildenafil20MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|855926-DiclofenacSodium75MGDelayedReleaseOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|2173822-1MLmepolizumab100MG/MLPrefilledSyringe[Nucala]|SPD 632|1001|Y|N|N||Preferred Brand|2170993-1MLmepolizumab100MG/MLAuto-Injector[Nucala]|SPD 632|1001|N|N|N||Preferred Generic|855911-2MLPhenytoinsodium50MG/MLCartridge|SPD 632|1001|Y|N|N||Preferred Brand|2170613-1MLgalcanezumab-gnlm100MG/MLPrefilledSyringe[Emgality]|SPD 632|1001|N|N|N||Preferred Generic|198239-Sulindac200MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|197512-Ciprofloxacin750MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|830801-24HRDiltiazemHydrochloride300MGExtendedReleaseOralCapsule|SPD 632|1001|Y|N|N||Preferred Brand|213475-1MLEpoetinAlfa40000UNT/MLInjection[Procrit]|SPD 632|1001|N|N|N||Preferred Brand|2564038-influenzaAvirusA/Cambodia/e0826360/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.03MG/|SPD 632|1001|Y|N|N||Preferred Brand|213360-Thalidomide50MGOralCapsule[Thalomid]|SPD 632|1001|N|N|N||Preferred Generic|198238-Sulindac150MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|855873-Phenytoinsodium300MGExtendedReleaseOralCapsule|SPD 632|1001|Y|N|N||Preferred Brand|2123314-Mayzent0.25MGStarterPack|SPD 632|1001|N|N|N||Preferred Generic|309679-Dexamethasone0.001MG/MG/Neomycin0.0035MG/MG/PolymyxinB10UNT/MGOphthalmicOintment|SPD 632|1001|Y|N|N||Preferred Brand|212219-EpoetinAlfa20000UNT/MLInjectableSolution[Procrit]|SPD 632|1001|N|N|N||Preferred Generic|855861-Phenytoinsodium200MGExtendedReleaseOralCapsule|SPD 632|1001|Y|N|N||Preferred Brand|212218-EpoetinAlfa20000UNT/MLInjectableSolution[Epogen]|SPD 632|1001|N|N|N||Preferred Generic|995241-HydroxyzineHydrochloride2MG/MLOralSolution|SPD 632|1001|N|N|N||Preferred Generic|198232-Sulfasalazine500MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|1439899-riociguat1.5MGOralTablet[Adempas]|SPD 632|1001|N|N|N||Preferred Generic|855818-prasugrel5MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|2121096-siponimod0.25MGOralTablet[Mayzent]|SPD 632|1001|N|N|Y||Preferred Generic|801966-4MLDiazepam5MG/MLRectalGel|SPD 632|1001|N|N|Y||Preferred Generic|1009145-Amphetamineaspartate1.875MG/AmphetamineSulfate1.875MG/Dextroamphetaminesaccharate1.875MG/DextroamphetamineSulfate1.87|SPD 632|1001|N|N|N||Preferred Generic|562510-SodiumFluoride2MG/MLMouthwash|SPD 632|1001|Y|N|N||Preferred Brand|2120195-1MLerenumab-aooe140MG/MLAuto-Injector[Aimovig]|SPD 632|1001|N|N|N||Preferred Generic|855812-prasugrel10MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|2119391-Spravato56MGDoseKit|SPD 632|1001|Y|N|N||Preferred Brand|1439901-riociguat2MGOralTablet[Adempas]|SPD 632|1001|N|N|N||Preferred Brand|404492-5MLLaronidase0.58MG/MLInjection[Aldurazyme]|SPD 632|1001|Y|N|N||Preferred Brand|2119389-Spravato84MGDoseKit|SPD 632|1001|N|N|N||Preferred Generic|855671-Phenytoinsodium100MGExtendedReleaseOralCapsule|SPD 632|1001|Y|N|N||Preferred Brand|2107355-prucalopride2MGOralTablet[Motegrity]|SPD 632|1001|N|N|N||Preferred Generic|1098134-24HRNiacin1000MGExtendedReleaseOralTablet|SPD 632|1001|N|N|N||Preferred Generic|198224-Hydrochlorothiazide25MG/Spironolactone25MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|830837-24HRDiltiazemHydrochloride240MGExtendedReleaseOralCapsule|SPD 632|1001|Y|N|Y||Preferred Generic|891874-MorphineSulfate100MGExtendedReleaseOralTablet|SPD 632|1001|N|N|N||Preferred Brand|993804-Gianvi28-DayPack|SPD 632|1001|N|N|N||Preferred Generic|311893-nabumetone750MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|2106362-rifamycinSV194MGDelayedReleaseOralTablet[Aemcolo]|SPD 632|1001|N|N|Y||Preferred Generic|197527-Clonazepam0.5MGOralTablet|SPD 632|1001|N|N|Y||Preferred Generic|312087-Ondansetron8MGDisintegratingOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|2106075-0.9MLtocilizumab180MG/MLAuto-Injector[Actemra]|SPD 632|1001|N|N|N||Preferred Generic|198223-Spironolactone50MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|855480-alclometasonedipropionate0.0005MG/MGTopicalOintment|SPD 632|1001|Y|N|N||Preferred Brand|2102705-0.6MLpegfilgrastim-cbqv10MG/MLPrefilledSyringe[Udenyca]|SPD 632|1001|N|N|N||Preferred Generic|251156-ferroussulfate75MG/MLOralSolution|SPD 632|1001|Y|N|N||Preferred Brand|208083-sargramostim0.25MG/MLInjectableSolution[Leukine]|SPD 632|1001|N|N|N||Preferred Generic|855474-alclometasonedipropionate0.5MG/MLTopicalCream|SPD 632|1001|Y|N|N||Preferred Brand|207059-interferonbeta-1b0.3MGInjection[Betaseron]|SPD 632|1001|Y|N|N||Preferred Brand|206791-mesalamine250MGExtendedReleaseOralCapsule[Pentasa]|SPD 632|1001|N|N|N||Preferred Generic|1095725-ClemastineFumarate1.34MGOralTablet[Dayhist-1]|SPD 632|1001|N|N|N||Preferred Generic|198222-Spironolactone100MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|855344-WarfarinSodium7.5MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|205924-1MLEpoetinAlfa4000UNT/MLInjection[Procrit]|SPD 632|1001|N|N|Y||Preferred Generic|1000126-1MLmedroxyprogesteroneacetate150MG/MLInjection|SPD 632|1001|Y|N|N||Preferred Brand|205923-1MLEpoetinAlfa4000UNT/MLInjection[Epogen]|SPD 632|1001|N|N|N||Preferred Generic|855338-WarfarinSodium6MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|205922-1MLEpoetinAlfa3000UNT/MLInjection[Procrit]|SPD 632|1001|N|N|N||Preferred Brand|213282-hydroxyurea200MGOralCapsule[Droxia]|SPD 632|1001|Y|N|N||Preferred Brand|205921-1MLEpoetinAlfa3000UNT/MLInjection[Epogen]|SPD 632|1001|N|N|N||Preferred Generic|855332-WarfarinSodium5MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|198211-Simvastatin40MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|562704-ropinirole4MGOralTablet|SPD 632|1001|Y|N|Y||Preferred Brand|1292435-0.65MLVaricella-ZosterVirusVaccineLive(Oka-Merck)strain29800UNT/MLInjection[Zostavax]|SPD 632|1001|N|N|N||Preferred Generic|309680-Dexamethasone1MG/ML/Neomycin3.5MG/ML/PolymyxinB10000UNT/MLOphthalmicSuspension|SPD 632|1001|N|N|Y||Preferred Generic|197528-Clonazepam1MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|205917-1MLEpoetinAlfa2000UNT/MLInjection[Epogen]|SPD 632|1001|Y|N|N||Preferred Brand|763565-0.4MLadalimumab50MG/MLPrefilledSyringe[Humira]|SPD 632|1001|N|N|N||Preferred Brand|404476-Azathioprine100MGOralTablet[Azasan]|SPD 632|1001|Y|N|N||Preferred Brand|205913-EpoetinAlfa10000UNT/MLInjectableSolution[Procrit]|SPD 632|1001|N|N|N||Preferred Generic|198202-Rifampin300MGOralCapsule|SPD 632|1001|N|N|N||Preferred Generic|855318-WarfarinSodium3MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|205912-EpoetinAlfa10000UNT/MLInjectableSolution[Epogen]|SPD 632|1001|Y|N|N||Preferred Brand|2058950-0.5MLomalizumab150MG/MLPrefilledSyringe[Xolair]|SPD 632|1001|N|N|N||Preferred Generic|855312-WarfarinSodium2.5MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|2058946-1MLomalizumab150MG/MLPrefilledSyringe[Xolair]|SPD 632|1001|Y|N|Y||Preferred Generic|891893-MorphineSulfate60MGExtendedReleaseOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|2058906-cannabidiol100MG/MLOralSolution[Epidiolex]|SPD 632|1001|N|N|N||Preferred Generic|198201-Rifampin150MGOralCapsule|SPD 632|1001|Y|N|N||Preferred Brand|2058887-1MLgalcanezumab-gnlm120MG/MLPrefilledSyringe[Emgality]|SPD 632|1001|N|N|N||Preferred Generic|577040-CalciumCarbonate648MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|2058877-1MLgalcanezumab-gnlm120MG/MLAuto-Injector[Emgality]|SPD 632|1001|N|N|N||Preferred Generic|855296-WarfarinSodium10MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|2057216-0.8MLfilgrastim-aafi0.6MG/MLPrefilledSyringe[Nivestym]|SPD 632|1001|N|N|N||Preferred Generic|855288-WarfarinSodium1MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|1094107-Phenazopyridinehydrochloride100MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|198181-Pyrazinamide500MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|859186-selegilinehydrochloride5MGOralCapsule|SPD 632|1001|Y|N|N||Preferred Brand|799830-dasatinib100MGOralTablet[Sprycel]|SPD 632|1001|Y|N|N||Preferred Brand|2056670-AimovigAutoinjector2-Pack(140MGDose)|SPD 632|1001|Y|N|Y||Preferred Generic|892646-MorphineSulfate200MGExtendedReleaseOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|205532-DornaseAlfa1MG/MLInhalationSolution[Pulmozyme]|SPD 632|1001|N|N|N||Preferred Generic|992432-PromethazineHydrochloride1.25MG/MLOralSolution|SPD 632|1001|N|N|N||Preferred Generic|311955-Niacin250MGExtendedReleaseOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|2054995-lusutrombopag3MGOralTablet[Mulpleta]|SPD 632|1001|N|N|N||Preferred Generic|198175-Propylthiouracil50MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|855168-levocetirizinedihydrochloride0.5MG/MLOralSolution|SPD 632|1001|N|N|N||Preferred Generic|1367410-Ergocalciferol1.25MGOralCapsule|SPD 632|1001|N|N|N||Preferred Brand|1000158-0.65MLmedroxyprogesteroneacetate160MG/MLPrefilledSyringe[depo-subQprovera]|SPD 632|1001|N|N|N||Preferred Brand|1087012-thyroid(USP)32.5MGOralTablet[Westhroid]|SPD 632|1001|N|N|N||Preferred Generic|359601-Guaifenesin400MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|2053512-ivacaftor125MG/lumacaftor100MGOralGranules[ORKAMBI]|SPD 632|1001|N|N|N||Preferred Brand|1000497-Prempro0.45/1.528DayPack|SPD 632|1001|N|N|N||Preferred Brand|209360-Acetaminophen325MGRectalSuppository[Acephen]|SPD 632|1001|N|N|N||Preferred Generic|854905-BisoprololFumarate5MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|2048568-tofacitinib10MGOralTablet[Xeljanz]|SPD 632|1001|N|N|N||Preferred Brand|201338-Nadolol80MGOralTablet[Corgard]|SPD 632|1001|Y|N|N||Preferred Brand|2048025-0.6MLpegfilgrastim-jmdb10MG/MLPrefilledSyringe[Fulphila]|SPD 632|1001|N|N|N||Preferred Brand|1000487-Premphase28DayPack|SPD 632|1001|N|N|N||Preferred Brand|1358775-MicrogestinFe1/2028DayPack|SPD 632|1001|N|N|N||Preferred Brand|404475-Azathioprine75MGOralTablet[Azasan]|SPD 632|1001|N|N|N||Preferred Generic|1094104-Phenazopyridinehydrochloride200MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|198165-Propantheline15MGOralTablet|SPD 632|1001|N|N|N||Preferred Generic|854901-BisoprololFumarate10MGOralTablet|SPD 632|1001|Y|N|N||Preferred Brand|2047623-1MLepoetinalfa-epbx40000UNT/MLInjection[Retacrit]|SPD 632|2002|N|N|N||Preferred Generic|856556-PropranololHydrochloride60MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2182340-1MLEtanercept50MG/MLCartridge[Enbrel]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|856519-PropranololHydrochloride40MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197318-Albuterol4MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|856457-PropranololHydrochloride20MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|856448-PropranololHydrochloride10MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|856429-Hydrochlorothiazide25MG/PropranololHydrochloride80MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|856422-Hydrochlorothiazide25MG/PropranololHydrochloride40MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|856377-TrazodoneHydrochloride50MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|1860127-Abuse-Deterrent12HROxycodoneHydrochloride60MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|856373-TrazodoneHydrochloride100MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1796096-24HRLinagliptin5MG/Metforminhydrochloride1000MGExtendedReleaseOralTablet[Jentadueto]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|856364-TrazodoneHydrochloride150MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|855926-DiclofenacSodium75MGDelayedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|855911-2MLPhenytoinsodium50MG/MLCartridge|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|855906-DiclofenacSodium50MGDelayedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Generic|1368403-alogliptin12.5MG/pioglitazone15MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|855873-Phenytoinsodium300MGExtendedReleaseOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|855861-Phenytoinsodium200MGExtendedReleaseOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2201540-romiplostim0.125MGInjection[Nplate]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|855818-prasugrel5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|855812-prasugrel10MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Generic|1368410-alogliptin12.5MG/pioglitazone30MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|855671-Phenytoinsodium100MGExtendedReleaseOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|855664-DiclofenacSodium25MGDelayedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|855480-alclometasonedipropionate0.0005MG/MGTopicalOintment|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|855474-alclometasonedipropionate0.5MG/MLTopicalCream|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|855344-WarfarinSodium7.5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|855338-WarfarinSodium6MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|700885-temozolomide180MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|855332-WarfarinSodium5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|855324-WarfarinSodium4MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1801278-HumiraPsoriasisStarterPack40MG/0.8MLPen(4count)|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|855318-WarfarinSodium3MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|855312-WarfarinSodium2.5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|855302-WarfarinSodium2MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|855296-WarfarinSodium10MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1799230-1MLabatacept125MG/MLAuto-Injector[Orencia]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|855288-WarfarinSodium1MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|855172-levocetirizinedihydrochloride5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2203897-ledipasvir45MG/sofosbuvir200MGOralTablet[Harvoni]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|855168-levocetirizinedihydrochloride0.5MG/MLOralSolution|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2203893-sofosbuvir200MGOralTablet[Sovaldi]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|854905-BisoprololFumarate5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|854901-BisoprololFumarate10MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|854801-DiclofenacSodium1MG/MLOphthalmicSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|852913-QuinidineSulfate300MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|852877-QuinidineSulfate200MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|849515-DesmopressinAcetate0.1MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|849506-DesmopressinAcetate0.01MG/ACTUATNasalSpray|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2256943-lasmiditan100MGOralTablet[Reyvow]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|848943-CholestyramineResin4000MGPowderforOralSuspension|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|848176-AugmentedBetamethasone0.5MG/MLTopicalCream|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|847121-CalciumCitrate1500MG/Cholecalciferol250UNTOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|836358-IpratropiumBromide0.2MG/MLInhalationSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|835925-cyclosporine,modified50MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|835913-MefloquineHydrochloride250MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|835894-cyclosporine,modified25MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|835886-cyclosporine,modified100MG/MLOralSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|835593-ImipramineHydrochloride10MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|835568-ImipramineHydrochloride50MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|835564-ImipramineHydrochloride25MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2257013-trikafta100MG/50MG/75MGand150MGPack|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|834127-chlorhexidinegluconate1.2MG/MLMouthwash|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|834102-PenicillinVPotassium500MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Generic|1368438-alogliptin25MG/pioglitazone45MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|834061-PenicillinVPotassium250MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|700883-temozolomide140MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|834046-PenicillinVPotassium25MG/MLOralSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|834040-PenicillinVPotassium50MG/MLOralSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|833528-Amiodaronehydrochloride200MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|1745091-Lidocaine0.05MG/MGMedicatedPatch|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|1796690-1MLhydroxyprogesteronecaproate(USP)250MG/MLInjection|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|833217-DiltiazemHydrochloride30MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Generic|1797863-flunisolide0.025MG/ACTUATMeteredDoseNasalSpray|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|833008-DesmopressinAcetate0.2MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|832909-CalciumCarbonate1250MG/Cholecalciferol100UNTChewableTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|831261-CromolynSodium20MG/MLOralSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|831109-CromolynSodium40MG/MLOphthalmicSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Generic|1855389-Levalbuterol2.5MG/MLInhalationSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|831103-DiltiazemHydrochloride60MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|831102-DiltiazemHydrochloride90MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|831054-DiltiazemHydrochloride120MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|830882-24HRDiltiazemHydrochloride300MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|828348-Cyclobenzaprinehydrochloride10MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|828320-Cyclobenzaprinehydrochloride5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|801054-POLYETHYLENEGLYCOL3350420000MG/PotassiumChloride1480MG/SodiumBicarbonate5720MG/SodiumChloride11200MGPowderforOralSolut|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2262727-MicronizedIsotretinoin32MGOralCapsule[Absorica]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|763185-{21(Prednisone10MGOralTablet)}Pack|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|763181-{21(Prednisone5MGOralTablet)}Pack|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|762675-{21(Methylprednisolone4MGOralTablet)}Pack|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|672149-lapatinib250MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|756209-Zidovudine10MG/MLOralSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|755497-Albuterol0.4MG/MLOralSolution|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|644088-aprepitant40MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|751901-{84(EthinylEstradiol0.03MG/Levonorgestrel0.15MGOralTablet)/7(InertIngredients1MGOralTablet)}Pack|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|749860-{21(EthinylEstradiol0.035MG/norgestimate0.25MGOralTablet)/7(InertIngredients1MGOralTablet)}Pack|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|749784-{7(EthinylEstradiol0.035MG/norgestimate0.18MGOralTablet)/7(EthinylEstradiol0.035MG/norgestimate0.215MGOralTablet)/7(Et|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|749783-{6(Azithromycin250MGOralTablet)}Pack|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Generic|197419-Bumetanide2MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|749780-{3(Azithromycin500MGOralTablet)}Pack|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|749157-{7(EthinylEstradiol0.025MG/norgestimate0.18MGOralTablet)/7(EthinylEstradiol0.025MG/norgestimate0.215MGOralTablet)/7(Et|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2262731-MicronizedIsotretinoin8MGOralCapsule[Absorica]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|748961-{28(Norethindrone0.35MGOralTablet)}Pack|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|748868-{21(EthinylEstradiol0.02MG/Levonorgestrel0.1MGOralTablet)/7(InertIngredients1MGOralTablet)}Pack|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2174390-symdeko50MG/75MGand75MGPack|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|748800-{21(drospirenone3MG/EthinylEstradiol0.03MGOralTablet)/7(InertIngredients1MGOralTablet)}Pack|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|727316-NDA0194300.3MLEpinephrine0.5MG/MLAuto-Injector|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|722137-Amlodipine5MG/valsartan320MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|722134-Amlodipine5MG/valsartan160MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2262719-MicronizedIsotretinoin24MGOralCapsule[Absorica]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|1793916-0.5MLSumatriptan8MG/MLAuto-Injector|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|722131-Amlodipine10MG/valsartan320MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|722126-Amlodipine10MG/valsartan160MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|702519-Phenobarbital4MG/MLOralSolution|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2268227-ubrogepant100MGOralTablet[Ubrelvy]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|702249-ferroussulfate44MG/MLOralSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Generic|197506-Cimetidine300MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|692783-Loratadine1MG/MLOralSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|686924-carvedilol3.125MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|686418-ErythromycinEthylsuccinate80MG/MLOralSuspension|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2268231-ubrogepant50MGOralTablet[Ubrelvy]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|686405-ErythromycinEthylsuccinate400MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|686400-ErythromycinEthylsuccinate40MG/MLOralSuspension|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|647121-5MLLevetiracetam100MG/MLInjection|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|646456-Nystatin100UNT/MGTopicalPowder|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|646333-Capsaicin1MG/MLTopicalCream|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|643102-Ibuprofen200MGOralTablet[Wal-Profen]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|226917-orlistat120MGOralCapsule[Xenical]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|639566-VitaminB650MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|628953-PotassiumChloride10MEQExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|617993-Amoxicillin120MG/ML/Clavulanate8.58MG/MLOralSuspension|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|656659-bosentan125MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|617430-Amoxicillin80MG/ML/Clavulanate11.4MG/MLOralSuspension|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|617423-Amoxicillin40MG/ML/Clavulanate5.7MG/MLOralSuspension|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|617322-Amoxicillin50MG/ML/Clavulanate12.5MG/MLOralSuspension|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|617316-Amoxicillin400MG/Clavulanate57MGChewableTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Generic|197508-Cimetidine800MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|617312-atorvastatin10MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|617311-atorvastatin40MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|617310-atorvastatin20MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|617309-Amoxicillin200MG/Clavulanate28.5MGChewableTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Generic|197551-Cycloserine250MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|617296-Amoxicillin500MG/Clavulanate125MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|598025-Amoxicillin250MGChewableTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2282320-Rimegepant75MGDisintegratingOralTablet[Nurtec]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|598006-Erythromycin250MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|597852-anagrelide1MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|596843-lansoprazole15MGDelayedReleaseOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1367410-Ergocalciferol1.25MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|583170-Salsalate750MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|582926-podofilox5MG/MLTopicalSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|577040-CalciumCarbonate648MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|562704-ropinirole4MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|562524-12HRAcetazolamide500MGExtendedReleaseOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|562510-SodiumFluoride2MG/MLMouthwash|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|562508-Amoxicillin875MG/Clavulanate125MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1790546-infliximab-dyyb100MGInjection[Inflectra]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|562251-Amoxicillin250MG/Clavulanate125MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|544455-Lactulose667MG/MLOralSolution[Generlac]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|543546-Nystatin100000UNT/MLTopicalCream|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|486152-24HRNitroglycerin0.4MG/HRTransdermalSystem|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|486148-24HRNitroglycerin0.2MG/HRTransdermalSystem|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|486146-24HRNitroglycerin0.6MG/HRTransdermalSystem|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2283236-bempedoicacid180MG/ezetimibe10MGOralTablet[Nexlizet]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|486131-BenzoylPeroxide0.1MG/MGTopicalGel|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|476809-Mirtazapine7.5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|476576-cefdinir50MG/MLOralSuspension|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|432402-cinacalcet30MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|432401-cinacalcet60MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|432400-cinacalcet90MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|1737461-PamidronateDisodium90MGInjection|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|429503-Hydrochlorothiazide12.5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|403967-zonisamide50MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|403966-zonisamide25MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2359285-24HRempagliflozin10MG/linagliptin5MG/metforminhydrochloride1000MGExtendedReleaseOralTablet[Trijardy]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|403855-Hydrochlorothiazide25MG/Olmesartanmedoxomil40MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|403854-Hydrochlorothiazide12.5MG/Olmesartanmedoxomil40MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|403853-Hydrochlorothiazide12.5MG/Olmesartanmedoxomil20MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|402698-24HRFelodipine2.5MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2359290-24HRempagliflozin12.5MG/linagliptin2.5MG/metforminhydrochloride1000MGExtendedReleaseOralTablet[Trijardy]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|402696-24HRFelodipine5MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|402695-24HRFelodipine10MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|393245-Digoxin0.05MG/MLOralSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|391937-Lactulose667MG/MLOralSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|387003-Levetiracetam1000MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1724437-thyroid(USP)90MGOralTablet[NPThyroid]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|381056-IsosorbideDinitrate10MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2359353-24HRempagliflozin25MG/linagliptin5MG/metforminhydrochloride1000MGExtendedReleaseOralTablet[Trijardy]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|360110-Sirolimus2MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|359601-Guaifenesin400MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Generic|242754-Levalbuterol0.417MG/MLInhalationSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|359296-calciumacetate667MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|597768-deferasirox125MGTabletforOralSuspension|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|642452-lanthanumcarbonate750MGChewableTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|353538-24HRIsosorbideMononitrate60MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|351250-Escitalopram20MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|351249-Escitalopram5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|1737459-PamidronateDisodium30MGInjection|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|351172-Dutasteride0.5MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Generic|284008-travoprost0.04MG/MLOphthalmicSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|351137-Albuterol0.21MG/MLInhalationSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|351136-Albuterol0.417MG/MLInhalationSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|349420-desloratadine5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|349405-Olmesartanmedoxomil40MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Generic|308865-calcipotriene0.05MG/MLTopicalSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|349401-Olmesartanmedoxomil20MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|349373-Olmesartanmedoxomil5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2371768-Oriahnn28DayKit|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|349332-Escitalopram10MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|349208-Sirolimus1MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|348472-Theophylline600MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|343033-Dexamethasone0.75MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|328161-Methylprednisolone16MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2373941-bedaquiline20MGOralTablet[Sirturo]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|328160-Cyclosporine100MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|318272-Aspirin81MGChewableTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|317769-Theophylline300MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|317573-pioglitazone15MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|317173-Captopril25MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|317136-Nortriptyline25MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|317128-Misoprostol0.2MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|317110-24HRIsosorbideMononitrate30MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|315187-Prednisone1MG/MLOralSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Generic|311345-linezolid20MG/MLOralSuspension|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|315183-PotassiumChloride8MEQExtendedReleaseOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|315134-Levocarnitine100MG/MLOralSolution|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2387331-120ACTUATbudesonide0.16MG/ACTUAT/formoterolfumarate0.0048MG/ACTUAT/glycopyrrolate0.009MG/ACTUATMeteredDoseInhaler[Bre|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|315107-24HRGlipizide10MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|315102-SodiumFluoride1.1MG/MLOralSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|315090-Erythromycin333MGDelayedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|314277-venlafaxine50MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1362712-MexiletineHydrochloride200MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|314241-Theophylline450MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|314238-Tropicamide10MG/MLOphthalmicSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|314234-Sucralfate1000MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|314231-Simvastatin10MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|314208-ropinirole1MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2395775-30ACTUATfluticasonefuroate0.2MG/ACTUAT/umeclidinium0.0625MG/ACTUAT/vilanterol0.025MG/ACTUATDryPowderInhaler[Trelegy]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|314203-quinapril40MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Generic|311787-moxifloxacin400MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|314182-PotassiumChloride2.67MEQ/MLOralSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|314165-prednisolone10MG/MLOphthalmicSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|314131-Niacin250MGExtendedReleaseOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2463733-epoetinalfa-epbx10000UNT/MLInjectableSolution[Retacrit]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|314111-Mirtazapine30MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|314106-Metronidazole250MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|314077-Lisinopril20MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|314076-Lisinopril10MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|314072-latanoprost0.05MG/MLOphthalmicSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|314055-IsosorbideDinitrate5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2463737-epoetinalfa-epbx20000UNT/MLInjectableSolution[Retacrit]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|314006-24HRGlipizide5MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|314000-Glyburide1.5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|313989-Fluoxetine40MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|616749-12HRranolazine500MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|313988-Furosemide40MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|313979-fludrocortisoneacetate0.1MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|313919-salmoncalcitonin200UNT/ACTUATNasalSpray|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|1728055-5MLpalonosetron0.05MG/MLInjection|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|313888-Cefaclor50MG/MLOralSuspension|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Generic|317094-entacapone200MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|313850-Amoxicillin40MG/MLOralSuspension|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|313797-Amoxicillin25MG/MLOralSuspension|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|313786-AceticAcid20MG/ML/Hydrocortisone10MG/MLOticSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|313586-venlafaxine75MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Generic|349556-ezetimibe10MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|313585-24HRvenlafaxine75MGExtendedReleaseOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|313584-venlafaxine37.5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2475406-voclosporin7.9MGOralCapsule[Lupkynis]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|313583-24HRvenlafaxine37.5MGExtendedReleaseOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|313582-venlafaxine25MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|639537-candesartancilexetil32MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|313581-24HRvenlafaxine150MGExtendedReleaseOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|313580-venlafaxine100MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|313565-valacyclovir500MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|313564-valacyclovir1000MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|313521-Tropicamide5MG/MLOphthalmicSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|313477-Trifluridine10MG/MLOphthalmicSolution|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|616578-lubiprostone0.024MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|313428-Toremifene60MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|313423-Tolnaftate10MG/MLTopicalSolution|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1746898-10MLreslizumab10MG/MLInjection[Cinqair]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|313306-Theophylline5.33MG/MLOralSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|313291-Theophylline400MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|313227-terconazole8MG/MLVaginalCream|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|313226-terconazole4MG/MLVaginalCream|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1745114-1MLixekizumab80MG/MLPrefilledSyringe[Taltz]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|313219-Terazosin5MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|313217-Terazosin2MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2475856-vericiguat2.5MGOralTablet[Verquvo]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|313215-Terazosin1MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2475852-vericiguat10MGOralTablet[Verquvo]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|313195-Tamoxifen20MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|313190-Tacrolimus0.5MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|313142-Sulfasalazine500MGDelayedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|313134-Sulfamethoxazole40MG/ML/Trimethoprim8MG/MLOralSuspension|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|313123-Sucralfate100MG/MLOralSuspension|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|1657173-0.5MLSumatriptan8MG/MLCartridge|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|313096-Spironolactone25MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|313092-Sorbitol700MG/MLOralSolution|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2531134-HumiraPen80MG/0.8ML-StarterPackageforPediatricUlcerativeColitis(4count)|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|312997-SodiumChloride9MG/MLInhalationSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|312962-Simvastatin5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|312961-Simvastatin20MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|312941-Sertraline50MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|312940-Sertraline25MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2536554-24HRviloxazine100MGExtendedReleaseOralCapsule[Qelbree]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|312938-Sertraline100MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|312899-Salsalate500MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|312849-ropinirole5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|312847-ropinirole2MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|312846-ropinirole0.5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|312845-ropinirole0.25MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2536752-24HRviloxazine150MGExtendedReleaseOralCapsule[Qelbree]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|312750-quinapril5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|312749-quinapril20MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|312748-quinapril10MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|312641-Progesterone200MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|312635-Prochlorperazine5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|312617-Prednisone5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|1607796-deferasirox90MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|1657160-0.5MLSumatriptan12MG/MLCartridge|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|312615-Prednisone20MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Generic|686429-mesalamine1200MGDelayedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|312594-Prazosin2MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|312593-Prazosin1MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|312529-PotassiumChloride8MEQExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|312515-PotassiumChloride1.33MEQ/MLOralSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|312504-PotassiumChloride10MEQExtendedReleaseOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|312441-pioglitazone45MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|312440-pioglitazone30MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|312362-Phenobarbital30MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Generic|745791-200ACTUATLevalbuterol0.045MG/ACTUATMeteredDoseInhaler|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|312357-Phenobarbital15MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|312301-Pentoxifylline400MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|312289-Naloxone0.5MG/Pentazocine50MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2557216-trikafta50MG/37.5MG/25MGand75MGPack|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|312138-oxcarbazepine600MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|312137-oxcarbazepine300MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|312136-oxcarbazepine150MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|603206-erlotinib150MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|312059-Nystatin500000UNTOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|312055-Nystatin100000UNT/MLOralSuspension|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|602635-lanthanumcarbonate1000MGChewableTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|312036-Nortriptyline2MG/MLOralSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|312013-Nitroglycerin2.5MGExtendedReleaseOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|311995-NITROFURANTOIN,MACROCRYSTALS50MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|311994-NITROFURANTOIN,MACROCRYSTALS25MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Generic|810083-Carbidopa31.25MG/entacapone200MG/Levodopa125MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|311989-Nitrofurantoin5MG/MLOralSuspension|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|311963-Niacin750MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2559707-1.14MLdupilumab175MG/MLAuto-Injector[Dupixent]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|311960-Niacin500MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|311955-Niacin250MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|311893-nabumetone750MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|311892-nabumetone500MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|311727-Misoprostol0.1MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|311726-Mirtazapine45MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2550713-0.5MLsecukinumab150MG/MLPrefilledSyringe[Cosentyx]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|311725-Mirtazapine15MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|311681-Metronidazole500MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|311679-Metronidazole0.0075MG/MGTopicalGel|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|261362-alosetron1MGOralTablet[Lotronex]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|311678-Metronidazole7.5MG/MLTopicalCream|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Generic|825130-24HRmesalamine375MGExtendedReleaseOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|311668-Metoclopramide5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|311666-Metoclopramide10MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|311665-Metipranolol3MG/MLOphthalmicSolution|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|352044-1MLdarbepoetinalfa0.025MG/MLInjection[Aranesp]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|311486-meloxicam7.5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|311376-Lorazepam2MG/MLOralSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|311372-Loratadine10MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|311354-Lisinopril5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|311353-Lisinopril2.5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|311296-Levofloxacin750MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|352045-1MLdarbepoetinalfa0.04MG/MLInjection[Aranesp]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|311290-Levetiracetam750MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|311289-Levetiracetam500MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|311288-Levetiracetam250MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|603203-erlotinib100MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|311277-lansoprazole30MGDelayedReleaseOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|311264-lamotrigine25MGChewableTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|311197-IsosorbideMononitrate20MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|311196-24HRIsosorbideMononitrate120MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Generic|855182-24HRtolterodinetartrate2MGExtendedReleaseOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|311194-IsosorbideDinitrate40MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|311192-IsosorbideMononitrate10MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|311166-isoniazid100MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|310982-imiquimod50MG/MLTopicalCream|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Generic|855189-24HRtolterodinetartrate4MGExtendedReleaseOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|310965-Ibuprofen200MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|310964-Ibuprofen200MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|352047-1MLdarbepoetinalfa0.1MG/MLInjection[Aranesp]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|310891-Hydrocortisone25MG/MLTopicalCream|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|310818-Hydrochlorothiazide50MG/Triamterene75MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|310812-Hydrochlorothiazide25MG/Triamterene37.5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|310809-Hydrochlorothiazide25MG/quinapril20MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|310798-Hydrochlorothiazide25MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|310797-Hydrochlorothiazide12.5MG/quinapril20MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|310796-Hydrochlorothiazide12.5MG/quinapril10MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|310687-Hydrocortisone10MG/ML/Neomycin3.5MG/ML/PolymyxinB10000UNT/MLOticSuspension|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|310594-Gramicidin0.025MG/ML/Neomycin1.75MG/ML/PolymyxinB10000UNT/MLOphthalmicSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|310539-Glyburide6MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1734642-elbasvir50MG/grazoprevir100MGOralTablet[Zepatier]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|310537-Glyburide5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|310536-Glyburide3MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|310534-Glyburide2.5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|310490-Glipizide5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|310489-24HRGlipizide2.5MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|310488-Glipizide10MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|404059-Isotretinoin10MGOralCapsule[Claravis]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|310459-Gemfibrozil600MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|310442-Ganciclovir500MGInjection|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197310-Acyclovir200MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|310434-gabapentin800MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|310433-gabapentin600MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|200327-capecitabine150MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|310432-gabapentin400MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|310431-gabapentin300MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|1607792-deferasirox360MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|310430-gabapentin100MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|310429-Furosemide20MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|310410-FolicAcid1MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|404065-Isotretinoin40MGOralCapsule[Claravis]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|310386-Fluoxetine4MG/MLOralSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|310385-Fluoxetine20MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|310384-Fluoxetine10MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|310380-Fluorouracil50MG/MLTopicalSolution|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|404449-Thalidomide100MGOralCapsule[Thalomid]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|310379-Fluorouracil20MG/MLTopicalSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|310377-Fluorometholone1MG/MLOphthalmicSuspension|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|310364-Fluocinonide0.5MG/MLTopicalSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|310362-Fluocinonide0.0005MG/MGTopicalGel|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|310353-Fluconazole40MG/MLOralSuspension|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|310352-Fluconazole10MG/MLOralSuspension|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1747187-0.4MLMethotrexate43.8MG/MLAuto-Injector[Otrexup]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|310346-Finasteride5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|310325-ferroussulfate325MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Generic|996603-24HRMemantinehydrochloride21MGExtendedReleaseOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Generic|1368034-alogliptin12.5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|310324-ferroussulfate325MGDelayedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1732165-incobotulinumtoxinA200UNTInjection[Xeomin]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|310273-Famotidine20MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|310261-exemestane25MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|310169-Estradiol0.1MG/MLVaginalCream|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|1607784-deferasirox180MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|310157-Erythromycin500MGDelayedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Generic|996615-24HRMemantinehydrochloride7MGExtendedReleaseOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|310155-Erythromycin250MGDelayedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|310154-Erythromycin250MGDelayedReleaseOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|310015-dorzolamide20MG/MLOphthalmicSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|309955-Dipyridamole75MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Generic|997406-12HRFexofenadinehydrochloride60MG/PseudoephedrineHydrochloride120MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|309952-Dipyridamole25MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|309686-Dexamethasone0.1MG/MLOralSolution|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|580286-mesalamine500MGExtendedReleaseOralCapsule[Pentasa]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|309680-Dexamethasone1MG/ML/Neomycin3.5MG/ML/PolymyxinB10000UNT/MLOphthalmicSuspension|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|309679-Dexamethasone0.001MG/MG/Neomycin0.0035MG/MG/PolymyxinB10UNT/MGOphthalmicOintment|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|309594-vitaminB121MG/MLInjectableSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|309371-Clotrimazole10MGOralLozenge|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|309370-Clotrimazole10MG/MLTopicalSolution|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|582595-Iloprost0.01MG/MLInhalationSolution[Ventavis]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|309367-Clotrimazole10MG/MLTopicalCream|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|309362-clopidogrel75MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|309337-Clindamycin20MG/MLVaginalCream|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|597770-deferasirox250MGTabletforOralSuspension|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|309313-Citalopram2MG/MLOralSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|309291-ciclopirox80MG/MLTopicalSolution|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1732161-incobotulinumtoxinA100UNTInjection[Xeomin]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|309290-ciclopirox7.7MG/MLTopicalLotion|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|309273-cholinesalicylate58.6MG/ML/MagnesiumSalicylate72.4MG/MLOralSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|309115-Cephalexin250MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|309114-Cephalexin500MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|Y||Preferred Brand|1716223-patiromer25200MGPowderforOralSuspension[Veltassa]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|309113-Cephalexin50MG/MLOralSuspension|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|309112-Cephalexin250MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|602862-magnesiumaminoacidchelate133MGOralTablet[MGPlusProtein]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|309110-Cephalexin25MG/MLOralSuspension|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|309098-Cefuroxime500MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|309054-cefdinir25MG/MLOralSuspension|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|309045-Cefaclor250MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|309044-Cefaclor25MG/MLOralSuspension|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|308989-Carbidopa50MG/Levodopa200MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|1607617-24HRdesvenlafaxinesuccinate25MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|308988-Carbidopa25MG/Levodopa100MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|308979-Carbamazepine200MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|308976-Carbamazepine20MG/MLOralSuspension|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|607579-entecavir0.05MG/MLOralSolution[Baraclude]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|308973-Carbamazepine100MGChewableTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|Y||Preferred Brand|2200654-semaglutide3MGOralTablet[Rybelsus]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|308964-Captopril50MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|308963-Captopril12.5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|308962-Captopril100MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|404450-Thalidomide200MGOralCapsule[Thalomid]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|615979-sorafenib200MGOralTablet[Nexavar]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|308891-CalciumCarbonate250MG/MLOralSuspension|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|308868-Calcitriol0.0005MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|308867-Calcitriol0.00025MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|308725-bexarotene75MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|308714-Betamethasone0.5MG/ML/Clotrimazole10MG/MLTopicalCream|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|308696-BenzoylPeroxide50MG/MLMedicatedLiquidSoap|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|616018-abatacept250MGInjection[Orencia]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|308694-BenzoylPeroxide0.05MG/MGTopicalGel|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1946772-Methotrexate25MG/MLInjectableSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|308689-BenzoylPeroxide0.025MG/MGTopicalGel|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|308512-Bacitracin0.5UNT/MG/PolymyxinB10UNT/MGTopicalOintment|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|308508-Bacitracin0.5UNT/MGOphthalmicOintment|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|308493-Bacitracin0.4UNT/MG/Neomycin0.0035MG/MG/PolymyxinB10UNT/MGOphthalmicOintment|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|308459-Azithromycin20MG/MLOralSuspension|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|1599949-60ACTUATTestosterone30MG/ACTUATTopicalSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|308416-Aspirin81MGDelayedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1729061-selexipag0.6MGOralTablet[Uptravi]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|308345-apraclonidine5MG/MLOphthalmicSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|308212-Ampicillin500MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|308194-Amoxicillin875MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|308191-Amoxicillin500MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|308189-Amoxicillin80MG/MLOralSuspension|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|308182-Amoxicillin250MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|616116-lenalidomide5MGOralCapsule[Revlimid]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|308177-Amoxicillin125MGChewableTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|308136-Amlodipine2.5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|Y||Preferred Generic|1797865-mometasonefuroate0.05MG/ACTUATMeteredDoseNasalSpray|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|308135-Amlodipine10MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|308078-AluminumHydroxide64MG/MLOralSuspension|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|307730-Acyclovir40MG/MLOralSuspension|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|307719-Acetylcysteine200MG/MLInhalationSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|307718-Acetylcysteine100MG/MLInhalationSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|307675-Acetaminophen32MG/MLOralSolution|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|579148-Galantamine12MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|284988-Didanosine400MGDelayedReleaseOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|284245-Famotidine40MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|284215-Clindamycin300MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|284185-Didanosine200MGDelayedReleaseOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|284184-Didanosine250MGDelayedReleaseOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|283858-ropinirole3MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|283672-Citalopram10MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|283523-gabapentin50MG/MLOralSolution|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|616287-sunitinib25MGOralCapsule[Sutent]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|283485-Mirtazapine45MGDisintegratingOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|616283-sunitinib12.5MGOralCapsule[Sutent]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|283433-Melatonin10MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|283406-Mirtazapine15MGDisintegratingOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|283077-prednisolone3MG/MLOralSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|282755-telmisartan20MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|282401-lamotrigine25MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|1597129-5000MGTestosterone0.01MG/MGTopicalGel|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|260376-Terazosin10MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|260243-Progesterone100MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|259966-Methylprednisolone4MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|259255-atorvastatin80MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|2532159-PMDDfluoxetine10MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|253059-Levocarnitine500MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|253039-Melatonin1MG/MLOralSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|252732-Melatonin5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|251322-Ethosuximide50MG/MLOralSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|251156-ferroussulfate75MG/MLOralSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|248420-mesalamine1000MGRectalSuppository|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|248109-Ribavirin200MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|245314-Albuterol5MG/MLInhalationSolution|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|643177-dasatinib70MGOralTablet[Sprycel]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|244967-PolymyxinB10000UNT/ML/Trimethoprim1MG/MLOphthalmicSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|242590-ferrousgluconate240MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|Y||Preferred Generic|197978-Metolazone10MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|242446-Ofloxacin3MG/MLOticSolution|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|578330-candesartancilexetil32MG/Hydrochlorothiazide12.5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|241834-cyclosporine,modified100MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|240209-Betamethasone0.5MG/MLTopicalLotion|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|1547565-Isotretinoin35MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|240029-Cholecalciferol0.125MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|239238-Griseofulvin25MG/MLOralSuspension|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|Y||Preferred Generic|2001564-BXRating24HRMethylphenidateHydrochloride18MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|239191-Amoxicillin50MG/MLOralSuspension|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|238920-Betamethasone0.5MG/MLTopicalCream|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|238600-seleniumsulfide25MG/MLMedicatedShampoo|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|238154-Acetaminophen325MG/butalbital50MG/Caffeine40MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|Y||Preferred Generic|2001565-BXRating24HRMethylphenidateHydrochloride27MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|238151-mesalamine66.7MG/MLEnema|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|238006-Estrogens,Esterified(USP)0.625MG/Methyltestosterone1.25MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|237776-vitaminB121MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|237723-Ergocalciferol0.2MG/MLOralSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|237420-CalciumCarbonate1500MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|226343-Dexamethasonephosphate1MG/MLOphthalmicSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|211365-chlorhexidinegluconate40MG/MLMedicatedLiquidSoap|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|643722-lenalidomide25MGOralCapsule[Revlimid]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|2101899-Sodiumpolystyrenesulfonate15000MGPowderforOralSuspension|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|209890-Acetaminophen500MGOralCapsule[Mapap]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|206842-IsosorbideDinitrate20MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|578325-candesartancilexetil16MG/Hydrochlorothiazide12.5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|205326-Lisinopril30MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|205305-telmisartan80MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|577776-candesartancilexetil16MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|205304-telmisartan40MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|205285-leflunomide20MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|205284-leflunomide10MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|204844-Azithromycin600MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|Y||Preferred Generic|200193-zolmitriptan2.5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|204423-Hydrocortisone10MG/ML/Neomycin3.5MG/ML/PolymyxinB10000UNT/MLOticSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|204135-Desonide0.0005MG/MGTopicalOintment|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|668606-Vorinostat100MGOralCapsule[Zolinza]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|200371-Citalopram20MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|200346-cefdinir300MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|200257-repaglinide0.5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|200256-repaglinide1MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|200133-12HRCarbamazepine200MGExtendedReleaseOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|200132-Acarbose25MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|643714-lenalidomide15MGOralCapsule[Revlimid]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|1591943-ledipasvir90MG/sofosbuvir400MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|200131-12HRCarbamazepine300MGExtendedReleaseOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|200064-letrozole2.5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|200060-mycophenolatemofetil500MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|706872-Azithromycin10MG/MLOphthalmicSolution[AzaSite]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|200033-carvedilol25MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|Y||Preferred Generic|244374-BenzoylPeroxide0.05MG/MG/Erythromycin0.03MG/MGTopicalGel|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|200032-carvedilol12.5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|200031-carvedilol6.25MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|199903-Hydrochlorothiazide12.5MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|723846-orlistat60MGOralCapsule[Alli]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|199890-topiramate200MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|199889-topiramate100MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|199888-topiramate25MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|199885-Levofloxacin500MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|199884-Levofloxacin250MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|199703-cabergoline0.5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|727705-0.8MLadalimumab50MG/MLPrefilledSyringe[Humira]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|199425-Melatonin1MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|199390-Etodolac500MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|199353-trandolapril1MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|578018-bromfenac0.9MG/MLOphthalmicSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|199352-trandolapril4MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|199351-trandolapril2MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|199246-glimepiride2MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|199245-glimepiride1MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|Y||Preferred Generic|309332-Clindamycin0.01MG/MGTopicalGel|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1992303-12HRTimolol5MG/MLOphthalmicSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|199224-anastrozole1MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|199193-famciclovir250MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|199192-famciclovir125MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|Y||Preferred Generic|309333-Clindamycin10MG/MLTopicalSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|199168-Phenobarbital64.8MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|199167-Phenobarbital32.4MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|727816-0.5MLInterferonbeta-1a0.06MG/MLPrefilledSyringe[Avonex]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|199164-Phenobarbital97.2MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|199163-Melatonin3MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|199159-Tretinoin10MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|199150-Acarbose100MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|199149-Acarbose50MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|199143-Niacin250MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|199058-mycophenolatemofetil250MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|199047-Famotidine10MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|198861-SodiumBicarbonate650MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|198857-Simethicone66.7MG/MLOralSuspension|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1729053-selexipag0.2MGOralTablet[Uptravi]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|198760-Niacin50MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|198759-Niacin100MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|198741-MagnesiumOxide400MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|198707-Hydrocortisone5MG/MLTopicalCream|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|643173-dasatinib20MGOralTablet[Sprycel]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|198630-ferrousgluconate324MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|198555-Capsaicin0.25MG/MLTopicalCream|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|731227-0.4MLdarbepoetinalfa0.1MG/MLPrefilledSyringe[Aranesp]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|198546-CalciumGluconate500MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|198509-Bisacodyl10MGRectalSuppository|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|198440-Acetaminophen500MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|198429-lamotrigine200MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|198428-lamotrigine150MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|198427-lamotrigine100MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|1547561-Isotretinoin25MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|198382-famciclovir500MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|198380-tioconazole0.065MG/MGVaginalOintment|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|198378-Tacrolimus5MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|731231-0.3MLdarbepoetinalfa0.5MG/MLPrefilledSyringe[Aranesp]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|198377-Tacrolimus1MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|198372-torsemide5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|198371-torsemide20MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|198370-torsemide100MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|731235-0.4MLdarbepoetinalfa0.5MG/MLPrefilledSyringe[Aranesp]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|198369-torsemide10MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|198365-Prochlorperazine10MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|198352-Zidovudine100MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|198335-Sulfamethoxazole800MG/Trimethoprim160MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|198334-Sulfamethoxazole400MG/Trimethoprim80MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|198332-Trimethoprim100MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|731241-1MLdarbepoetinalfa0.5MG/MLPrefilledSyringe[Aranesp]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|198316-Hydrochlorothiazide25MG/Triamterene37.5MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|198293-Tolazamide500MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|Y||Preferred Generic|314266-Tacrolimus0.001MG/MGTopicalOintment|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|198292-Tolazamide250MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1729047-selexipag1.6MGOralTablet[Uptravi]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|577348-ramelteon8MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|198240-Tamoxifen10MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|198239-Sulindac200MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|198238-Sulindac150MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|153823-candesartancilexetil8MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|198232-Sulfasalazine500MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|Y||Preferred Generic|483438-pregabalin100MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|198224-Hydrochlorothiazide25MG/Spironolactone25MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|198223-Spironolactone50MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|198222-Spironolactone100MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|198211-Simvastatin40MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|Y||Preferred Generic|483440-pregabalin150MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|198202-Rifampin300MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|198201-Rifampin150MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|731250-0.3MLdarbepoetinalfa0.2MG/MLPrefilledSyringe[Aranesp]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|198181-Pyrazinamide500MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|198175-Propylthiouracil50MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|198165-Propantheline15MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|198153-Colchicine0.5MG/Probenecid500MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|198152-Probenecid500MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|746609-nilotinib200MGOralCapsule[Tasigna]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|198148-Prednisone50MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|198146-Prednisone2.5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|198145-Prednisone10MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|198144-Prednisone1MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|198141-Prazosin5MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1729033-selexipag1.4MGOralTablet[Uptravi]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|198116-PotassiumChloride20MEQExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|198108-Piroxicam20MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|198107-Piroxicam10MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|198105-Pindolol5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|Y||Preferred Generic|483446-pregabalin200MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|198104-Pindolol10MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|198102-vitaminK15MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|748738-Topotecan0.25MGOralCapsule[Hycamtin]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|198089-Phenobarbital60MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|198086-Phenobarbital16.2MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|198083-Phenobarbital100MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|198049-Ofloxacin300MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1298070-Cyclopentolatehydrochloride20MG/MLOphthalmicSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|198047-Nortriptyline75MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|198046-Nortriptyline50MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|153822-candesartancilexetil4MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|198045-Nortriptyline10MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|198040-Nitroglycerin0.6MGSublingualTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|198039-Nitroglycerin0.4MGSublingualTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|753437-9HRMethylphenidate1.11MG/HRTransdermalSystem[Daytrana]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|198038-Nitroglycerin0.3MGSublingualTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|Y||Preferred Generic|483450-pregabalin75MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|198033-Nifedipine20MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|198032-Nifedipine10MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|198024-Niacin500MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|753442-9HRMethylphenidate2.22MG/HRTransdermalSystem[Daytrana]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|198014-Naproxen500MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|198013-Naproxen250MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|198012-Naproxen375MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197987-Minoxidil2.5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197986-Minoxidil10MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197973-Methylprednisolone8MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|753443-9HRMethylphenidate3.33MG/HRTransdermalSystem[Daytrana]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197971-Methylprednisolone32MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197963-Hydrochlorothiazide15MG/Methyldopa250MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197960-Hydrochlorothiazide25MG/Methyldopa250MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|577057-72HRFentanyl0.012MG/HRTransdermalSystem|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197958-Methyldopa500MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197956-Methyldopa250MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197944-Methocarbamol750MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|1490065-RaloxifeneHydrochloride60MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197943-Methocarbamol500MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|Y||Preferred Generic|606726-Esomeprazole20MGDelayedReleaseOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197942-Methimazole5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197941-Methimazole10MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197940-Methazolamide50MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197939-Methazolamide25MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|Y||Preferred Generic|797274-Clindamycin10MG/MLMedicatedPad|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197931-mercaptopurine50MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197919-Melphalan2MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|758032-0.5MLInterferonbeta-1a0.044MG/MLPrefilledSyringe[Rebif]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197905-Lovastatin40MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197904-Lovastatin20MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|577208-Omega-3AcidEthylEsters(USP)1000MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197903-Lovastatin10MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197887-Hydrochlorothiazide25MG/Lisinopril20MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197886-Hydrochlorothiazide12.5MG/Lisinopril20MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197885-Hydrochlorothiazide12.5MG/Lisinopril10MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197884-Lisinopril40MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197863-Leucovorin5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|545835-LeuprolideAcetate5MG/MLInjectableSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197862-Leucovorin25MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197861-Leucovorin15MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1729013-selexipag1MGOralTablet[Uptravi]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197860-Leucovorin10MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197856-Ketoprofen75MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197855-Ketoprofen50MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197854-Ketoprofen25MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1728099-romiplostim0.5MGInjection[Nplate]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197853-Ketoconazole200MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197839-IsosorbideDinitrate30MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|795085-certolizumabpegol200MGInjection[Cimzia]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197832-isoniazid300MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|763565-0.4MLadalimumab50MG/MLPrefilledSyringe[Humira]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197818-Indomethacin50MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197817-Indomethacin25MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197816-Indapamide2.5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197815-Indapamide1.25MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197807-Ibuprofen800MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|1487361-1MLglatirameracetate40MG/MLPrefilledSyringe|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197806-Ibuprofen600MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197805-Ibuprofen400MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|799830-dasatinib100MGOralTablet[Sprycel]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197803-Ibuprofen20MG/MLOralSuspension|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197797-hydroxyurea500MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197787-Hydrocortisone5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197785-Hydrocortisone25MG/MLTopicalLotion|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197783-Hydrocortisone20MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|802652-1MLEtanercept50MG/MLPrefilledSyringe[Enbrel]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197782-Hydrocortisone10MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197770-Hydrochlorothiazide50MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197746-Guanfacine2MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197745-Guanfacine1MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197741-Guaifenesin200MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197737-Glyburide1.25MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|809159-0.5MLEtanercept50MG/MLPrefilledSyringe[Enbrel]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197732-Furosemide80MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197726-Flutamide125MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197701-Fluconazole50MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|543218-1MLGranisetron0.1MG/MLInjection|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197700-Fluconazole200MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197699-Fluconazole150MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197698-Fluconazole100MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|1373503-{7(EthinylEstradiol0.01MGOralTablet)/42(EthinylEstradiol0.02MG/Levonorgestrel0.15MGOralTablet)/21(EthinylEstradiol0.0|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|1435115-28ACTUATTeriparatide0.02MG/ACTUATPenInjector|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197686-Etodolac400MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|Y||Preferred Generic|860654-epinastinehydrochloride0.5MG/MLOphthalmicSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197685-Etodolac300MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197684-Etodolac200MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197682-Ethosuximide250MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197670-Estrogens,Esterified(USP)1.25MG/Methyltestosterone2.5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197659-Estradiol2MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|809994-lacosamide150MGOralTablet[Vimpat]|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|Y||Preferred Generic|998675-168HRClonidine0.00833MG/HRTransdermalSystem|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197658-Estradiol1MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197657-Estradiol0.5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|Y||Preferred Generic|891881-MorphineSulfate15MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197650-Erythromycin500MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197628-Doxazosin8MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|485489-Temazepam22.5MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|810002-lacosamide50MGOralTablet[Vimpat]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|2123194-PulmonaryHypertensiontadalafil20MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197627-Doxazosin4MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|1426600-{24(EthinylEstradiol0.02MG/norethindroneacetate1MGChewableTablet)/4(Ferrousfumarate75MGOralTablet)}Pack|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197625-Doxazosin1MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197624-Disulfiram500MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|Y||Preferred Generic|197635-dronabinol2.5MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1011712-aliskiren150MG/Hydrochlorothiazide12.5MGOralTablet[TekturnaHCT]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197623-Disulfiram250MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|825170-HumiraPen40MG/0.8ML-Crohn'sDiseaseStarterPack|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197606-Digoxin0.25MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197604-Digoxin0.125MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|485436-entecavir1MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|825425-eltrombopag25MGOralTablet[Promacta]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|810079-24HRFesoterodineFumarate8MGExtendedReleaseOralTablet[Toviaz]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197596-Dicloxacillin500MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|Y||Preferred Brand|1292435-0.65MLVaricella-ZosterVirusVaccineLive(Oka-Merck)strain29800UNT/MLInjection[Zostavax]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197583-Dexamethasone6MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1011755-aliskiren300MG/Hydrochlorothiazide25MGOralTablet[TekturnaHCT]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197582-Dexamethasone4MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|1299911-Tiagabinehydrochloride2MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197581-Dexamethasone2MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197580-Dexamethasone1.5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1011752-aliskiren300MG/Hydrochlorothiazide12.5MGOralTablet[TekturnaHCT]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197579-Dexamethasone1MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197577-Dexamethasone0.5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|828703-1.2MLPlerixafor20MG/MLInjection[Mozobil]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1721690-1MLEpoetinAlfa10000UNT/MLInjection[Procrit]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197575-Desoximetasone0.0025MG/MGTopicalOintment|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|1373497-{14(dimethylfumarate120MGDelayedReleaseOralCapsule)/46(dimethylfumarate240MGDelayedReleaseOralCapsule)}Pack|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197557-Dapsone100MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1726639-ponatinib30MGOralTablet[Iclusig]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|809998-lacosamide200MGOralTablet[Vimpat]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197553-Cyclosporine25MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|876529-Amlodipine5MG/telmisartan80MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197518-Clindamycin150MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|845512-everolimus10MGOralTablet[Afinitor]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197516-Clarithromycin250MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197500-Chlorthalidone50MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|847913-60ACTUATexenatide0.01MG/ACTUATPenInjector[Byetta]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|836649-Zolpidemtartrate5MGSublingualTablet[Edluar]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197499-Chlorthalidone25MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|1373491-dimethylfumarate240MGDelayedReleaseOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197449-Cefaclor500MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1045408-dasatinib80MGOralTablet[Sprycel]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197448-Levocarnitine330MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|848164-0.5MLgolimumab100MG/MLPrefilledSyringe[Simponi]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197445-Carbidopa25MG/Levodopa250MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1045404-dasatinib140MGOralTablet[Sprycel]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197444-Carbidopa25MG/Levodopa100MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|849599-1MLcertolizumabpegol200MG/MLPrefilledSyringe[Cimzia]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197443-Carbidopa10MG/Levodopa100MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197433-calciumacetate667MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|485421-24HRdarifenacin15MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|853354-0.5MLustekinumab90MG/MLPrefilledSyringe[Stelara]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1091654-azilsartanmedoxomil80MGOralTablet[Edarbi]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197411-Bromocriptine2.5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|1373483-dimethylfumarate120MGDelayedReleaseOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197408-Betamethasone1MG/MLTopicalLotion|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1721685-1MLEpoetinAlfa10000UNT/MLInjection[Epogen]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197407-Betamethasone1MG/MLTopicalCream|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|848135-Amlodipine10MG/Hydrochlorothiazide25MG/valsartan320MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1100706-Linagliptin5MGOralTablet[Tradjenta]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197405-Betamethasone0.0005MG/MGTopicalOintment|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197392-Baclofen20MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|854836-lisdexamfetaminedimesylate30MGOralCapsule[Vyvanse]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197391-Baclofen10MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|Y||Preferred Generic|798133-Erythromycin20MG/MLMedicatedPad[Ery]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197388-Azathioprine50MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|597772-deferasirox500MGTabletforOralSuspension|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|810096-{7(EthinylEstradiol0.01MGOralTablet)/84(EthinylEstradiol0.02MG/Levonorgestrel0.1MGOralTablet)}Pack|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|854832-lisdexamfetaminedimesylate20MGOralCapsule[Vyvanse]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197383-Atenolol50MG/Chlorthalidone25MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|802749-candesartancilexetil32MG/Hydrochlorothiazide25MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|1366550-24HRBudesonide9MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197381-Atenolol50MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1114096-Vandetanib300MGOralTablet[Caprelsa]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197380-Atenolol25MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|854848-lisdexamfetaminedimesylate60MGOralCapsule[Vyvanse]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1115259-1.5MLLeuprolideAcetate30MG/MLPrefilledSyringe[Lupron]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197379-Atenolol100MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197362-ammoniumlactate120MG/MLTopicalLotion|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1665900-1MLevolocumab140MG/MLAuto-Injector[Repatha]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|854852-lisdexamfetaminedimesylate50MGOralCapsule[Vyvanse]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197361-Amlodipine5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197320-Allopurinol300MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|477367-solifenacinsuccinate5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|857799-Treprostinil0.6MG/MLInhalationSolution[Tyvaso]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1665906-1MLevolocumab140MG/MLPrefilledSyringe[Repatha]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197319-Allopurinol100MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197316-Albuterol2MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1666334-Ticagrelor60MGOralTablet[Brilinta]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197313-Acyclovir800MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|603208-erlotinib25MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1115464-1MLLeuprolideAcetate7.5MG/MLPrefilledSyringe[Lupron]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197311-Acyclovir400MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197305-AceticAcid20MG/MLOticSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197304-Acetazolamide250MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|477347-lanthanumcarbonate500MGChewableTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|860244-interferonbeta-1b0.3MGInjection[Extavia]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|858044-saxagliptin2.5MGOralTablet[Onglyza]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197303-Acetazolamide125MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|1359861-Budesonide0.16MG/ACTUAT/formoterolfumarate0.0045MG/ACTUATMeteredDoseInhaler|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1923809-thyroid(USP)120MGOralTablet[NPThyroid]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1116639-Ticagrelor90MGOralTablet[Brilinta]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1923432-dorzolamide20MG/ML/Timolol5MG/MLOphthalmicSolution|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|1307427-sildenafil10MG/MLOralSuspension|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|861043-2.7MLpramlintideacetate1MG/MLPenInjector[Symlin]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1923428-Timolol2.5MG/MLOphthalmicSolution|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1115473-1.5MLLeuprolideAcetate7.5MG/MLPrefilledSyringe[Lupron]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1923426-SotalolHydrochloride80MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|485423-24HRdarifenacin7.5MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1923424-SotalolHydrochloride160MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1923422-SotalolHydrochloride120MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|477130-Hydrochlorothiazide25MG/telmisartan80MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|861966-Iloprost0.02MG/MLInhalationSolution[Ventavis]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1148506-crizotinib250MGOralCapsule[Xalkori]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1870230-NDA0208000.3MLEpinephrine1MG/MLAuto-Injector|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|1308569-24HRrivastigmine0.554MG/HRTransdermalSystem|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1855086-thyroid(USP)15MGOralTablet[NPThyroid]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|403930-Isotretinoin30MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1806189-30/70Release24HRMethylphenidateHydrochloride30MGExtendedReleaseOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|402506-12HRCarbamazepine400MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1149667-Camrese91DayPack|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1806187-30/70Release24HRMethylphenidateHydrochloride20MGExtendedReleaseOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|884619-eltrombopag75MGOralTablet[Promacta]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1801298-MicroencapsulatedPotassiumChloride10MEQExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1801294-MicroencapsulatedPotassiumChloride20MEQExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|465355-voriconazole40MG/MLOralSuspension|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|896237-120ACTUATFluticasonepropionate0.045MG/ACTUAT/salmeterol0.021MG/ACTUATMeteredDoseInhaler[Advair]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|867506-pazopanib200MGOralTablet[Votrient]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1801289-SmokingCessation12HRBupropionHydrochloride150MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|348719-Tobramycin60MG/MLInhalationSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1797907-Fluticasonepropionate0.05MG/ACTUATMeteredDoseNasalSpray|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1232200-Zolpidemtartrate1.75MGSublingualTablet[Intermezzo]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1797867-Azelastinehydrochloride0.137MG/ACTUATMeteredDoseNasalSpray|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|896273-120ACTUATFluticasonepropionate0.23MG/ACTUAT/salmeterol0.021MG/ACTUATMeteredDoseInhaler[Advair]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1797851-CromolynSodium5.2MG/ACTUATMeteredDoseNasalSpray|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1245919-Marlissa28DayPack|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1738511-ParoxetineHydrochloride40MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1232190-asparaginaseErwiniachrysanthemi10000UNTInjection[Erwinaze]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1738503-ParoxetineHydrochloride30MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1738495-ParoxetineHydrochloride20MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|901614-Aztreonam75MG/MLInhalationSolution[Cayston]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|349409-Treprostinil2.5MG/MLInjectableSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1738483-ParoxetineHydrochloride10MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|1304979-icosapentethyl1000MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|854840-lisdexamfetaminedimesylate40MGOralCapsule[Vyvanse]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1731345-deferoxaminemesylate2000MGInjection|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1661567-TOBIPodhalerDailyKit,8|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|861045-1.5MLpramlintideacetate1MG/MLPenInjector[Symlin]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1724481-thyroid(USP)60MGOralTablet[NPThyroid]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|205316-topiramate15MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|312835-rivastigmine3MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1724439-thyroid(USP)30MGOralTablet[NPThyroid]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|903855-2MLPyridostigmineBromide5MG/MLInjection[Regonol]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1665188-1MLLorazepam2MG/MLInjection|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1665050-Cefazolin1000MGInjection|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|403879-imatinib400MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|978950-Natazia28DayPack|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|902626-dexlansoprazole60MGDelayedReleaseOralCapsule[Dexilant]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1659263-1MLheparinsodium,porcine5000UNT/MLInjection|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|1299917-Tiagabinehydrochloride4MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1648759-NITROFURANTOIN,MACROCRYSTALS100MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1242615-Isotretinoin40MGOralCapsule[Myorisan]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1648755-NITROFURANTOIN,MACROCRYSTALS25MG/Nitrofurantoin,Monohydrate75MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|993456-1MLdenosumab60MG/MLPrefilledSyringe[Prolia]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1547771-Tetracainehydrochloride5MG/MLOphthalmicSolution|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1242613-Isotretinoin20MGOralCapsule[Myorisan]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|152695-meloxicam15MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|995156-lacosamide10MG/MLOralSolution[Vimpat]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|151226-topiramate50MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1440184-hydrocortisoneacetate0.01MG/MGTopicalOintment|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|403878-imatinib100MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|1000001-Amlodipine5MG/Hydrochlorothiazide25MG/Olmesartanmedoxomil40MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1243033-Linagliptin2.5MG/Metforminhydrochloride500MGOralTablet[Jentadueto]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1437702-Albuterol0.833MG/ML/IpratropiumBromide0.167MG/MLInhalationSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|141963-Azithromycin40MG/MLOralSuspension|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|199378-12HRCarbamazepine100MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1376336-prednisoloneacetate10MG/MLOphthalmicSuspension|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|1799212-sofosbuvir400MG/velpatasvir100MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1243052-ivacaftor150MGOralTablet[Kalydeco]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1367436-21DAYEthinylEstradiol0.000625MG/HR/Etonogestrel0.005MG/HRVaginalSystem|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|1013629-{24(drospirenone3MG/EthinylEstradiol0.02MG/levomefolatecalcium0.451MGOralTablet)/4(levomefolatecalcium0.451MGOralTabl|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1366116-bacitracinzinc0.5UNT/MGTopicalOintment|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|403818-moxifloxacin5MG/MLOphthalmicSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1363309-ChlorpheniramineMaleate4MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|1050493-{21(drospirenone3MG/EthinylEstradiol0.03MG/levomefolatecalcium0.451MGOralTablet)/7(levomefolatecalcium0.451MGOralTabl|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|1011739-aliskiren300MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1362720-MexiletineHydrochloride250MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|1607990-{24(EthinylEstradiol0.025MG/Norethindrone0.8MGChewableTablet)/4(Ferrousfumarate75MGChewableTablet)}Pack|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|1299909-Tiagabinehydrochloride16MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1362706-MexiletineHydrochloride150MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1243848-24HRMetforminhydrochloride500MG/sitagliptin50MGExtendedReleaseOralTablet[Janumet]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1359858-Fluticasonepropionate0.5MG/ACTUAT/salmeterol0.05MG/ACTUATDryPowderInhaler|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|1092357-rufinamide40MG/MLOralSuspension|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1244062-0.6MLMethylnaltrexonebromide20MG/MLPrefilledSyringe[Relistor]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1359779-Fluticasonepropionate0.1MG/ACTUAT/salmeterol0.05MG/ACTUATDryPowderInhaler|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1359117-{24(EthinylEstradiol0.02MG/norethindroneacetate1MGOralTablet)/4(Ferrousfumarate75MGOralTablet)}Pack|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1243843-24HRMetforminhydrochloride1000MG/sitagliptin50MGExtendedReleaseOralTablet[Janumet]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|1095229-FlavoxateHydrochloride100MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1313885-Phenytoin50MGChewableTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1313112-Phenytoin25MG/MLOralSuspension|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|403811-aprepitant125MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|1098608-24HRlamotrigine300MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1657976-4MLtocilizumab20MG/MLInjection[Actemra]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1298072-Cyclopentolatehydrochloride5MG/MLOphthalmicSolution|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|1299903-Tiagabinehydrochloride12MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1298066-Cyclopentolatehydrochloride10MG/MLOphthalmicSolution|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1657980-10MLtocilizumab20MG/MLInjection[Actemra]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1291082-hydrocortisoneacetate25MGRectalSuppository|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|1360304-Budesonide0.08MG/ACTUAT/formoterolfumarate0.0045MG/ACTUATMeteredDoseInhaler|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1250490-hydrocortisoneacetate5MG/MLTopicalCream|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|1119400-everolimus7.5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1245468-DocusateSodium250MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1245230-chlorhexidinegluconate20MG/MLMedicatedLiquidSoap|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|1146690-24HRlamotrigine250MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|1111641-1MLglatirameracetate20MG/MLPrefilledSyringe|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1243585-Flurbiprofensodium0.3MG/MLOphthalmicSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1242787-Alyacen7/7/7Kit|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|1100075-abirateroneacetate250MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1242786-Alyacen1/3528-DayKit|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1234571-PhenylephrineHydrochloride100MG/MLOphthalmicSolution|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|1087964-hydroxyprogesteronecaproate(USP)250MG/MLInjectableSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1193362-100MLLevetiracetam5MG/MLInjection|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1300803-24HRmirabegron50MGExtendedReleaseOralTablet[Myrbetriq]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1193360-100MLLevetiracetam15MG/MLInjection|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|1011736-aliskiren150MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1193358-100MLLevetiracetam10MG/MLInjection|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1191315-FluocinoloneAcetonide0.25MG/MLTopicalCream|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|402505-12HRCarbamazepine200MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|979115-0.6MLMethylnaltrexonebromide20MG/MLInjection[Relistor]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1307630-bosutinib100MGOralTablet[Bosulif]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1191310-FluocinoloneAcetonide0.1MG/MLTopicalSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1191256-FluocinoloneAcetonide0.00025MG/MGTopicalOintment|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|902624-dexlansoprazole30MGDelayedReleaseOralCapsule[Dexilant]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1191013-Proparacainehydrochloride5MG/MLOphthalmicSolution|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|349435-voriconazole50MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|897126-3MLliraglutide6MG/MLPenInjector[Victoza]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1190655-AtropineSulfate10MG/MLOphthalmicSolution|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|896245-120ACTUATFluticasonepropionate0.115MG/ACTUAT/salmeterol0.021MG/ACTUATMeteredDoseInhaler[Advair]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1310138-everolimus2MGTabletforOralSuspension[Afinitor]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1190572-AtropineSulfate0.025MG/DiphenoxylateHydrochloride2.5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1190570-AtropineSulfate0.01MG/MGOphthalmicOintment|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|864820-Oxybutyninchloride0.1MG/MGTopicalGel[Gelnique]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1190568-AtropineSulfate0.005MG/ML/DiphenoxylateHydrochloride0.5MG/MLOralSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1150836-LevobunololHydrochloride5MG/MLOphthalmicSolution|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|351114-5MLzoledronicacid0.8MG/MLInjection|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|860898-Vigabatrin500MGPowderforOralSolution[Sabril]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1116758-chloroquinephosphate500MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|858366-KetorolacTromethamine4.5MG/MLOphthalmicSolution[Acuvail]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1116150-bacitracinzinc0.4UNT/MG/hydrocortisoneacetate0.01MG/MG/NeomycinSulfate0.0035MG/MG/PolymyxinBSulfate10UNT/MGOphthalmic|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|858040-saxagliptin5MGOralTablet[Onglyza]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1115005-DocusateSodium100MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1310531-teriflunomide14MGOralTablet[Aubagio]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1100457-PyridoxineHydrochloride25MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|854844-lisdexamfetaminedimesylate70MGOralCapsule[Vyvanse]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1099870-DivalproexSodium500MGDelayedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1099687-ValproicAcid50MG/MLOralSolution|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1310147-everolimus5MGTabletforOralSuspension[Afinitor]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|853356-1MLustekinumab90MG/MLPrefilledSyringe[Stelara]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1099681-ValproicAcid250MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1099678-DivalproexSodium250MGDelayedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|847917-60ACTUATexenatide0.005MG/ACTUATPenInjector[Byetta]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1654630-1MLglatirameracetate20MG/MLPrefilledSyringe[Glatopa]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1099648-5MLValproicAcid100MG/MLInjection|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1806181-30/70Release24HRMethylphenidateHydrochloride10MGExtendedReleaseOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|836645-Zolpidemtartrate10MGSublingualTablet[Edluar]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1099596-DivalproexSodium125MGDelayedReleaseOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1654955-1MLdarbepoetinalfa0.2MG/MLInjection[Aranesp]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|828696-Zolpidemtartrate5MG/ACTUATOralSpray[Zolpimist]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|828364-hydrocortisoneacetate10MG/ML/Pramoxinehydrochloride10MG/MLRectalFoam[Proctofoam-HC]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1099569-24HRDivalproexSodium500MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|825429-eltrombopag50MGOralTablet[Promacta]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1364362-ponatinib45MGOralTablet[Iclusig]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1099563-24HRDivalproexSodium250MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1099316-DesipramineHydrochloride75MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|810075-24HRFesoterodineFumarate4MGExtendedReleaseOralTablet[Toviaz]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1099304-DesipramineHydrochloride50MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1099300-DesipramineHydrochloride25MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|349434-voriconazole200MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|809990-lacosamide100MGOralTablet[Vimpat]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1099296-DesipramineHydrochloride150MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1099292-DesipramineHydrochloride100MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|795749-RebifTitrationPack|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1099288-DesipramineHydrochloride10MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1365866-nepafenac3MG/MLOphthalmicSuspension[Ilevro]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1098134-24HRNiacin1000MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|758027-0.5MLInterferonbeta-1a0.088MG/MLPrefilledSyringe[Rebif]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1095725-ClemastineFumarate1.34MGOralTablet[Dayhist-1]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1364515-Bedaquiline100MGOralTablet[Sirturo]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1094543-Briellyn28DayPack|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|245134-72HRFentanyl0.025MG/HRTransdermalSystem|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|748740-Topotecan1MGOralCapsule[Hycamtin]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1094107-Phenazopyridinehydrochloride100MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1094104-Phenazopyridinehydrochloride200MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|349410-Treprostinil5MG/MLInjectableSolution|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|731245-0.42MLdarbepoetinalfa0.06MG/MLPrefilledSyringe[Aranesp]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1373337-Isotretinoin40MGOralCapsule[Zenatane]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1085745-TriamcinoloneAcetonide1MG/MLTopicalLotion|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1085741-TriamcinoloneAcetonide0.25MG/MLTopicalLotion|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|731229-0.6MLdarbepoetinalfa0.5MG/MLPrefilledSyringe[Aranesp]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1085686-TriamcinoloneAcetonide5MG/MLTopicalCream|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1654079-0.5MLustekinumab90MG/MLInjection[Stelara]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|730046-0.5MLdarbepoetinalfa0.2MG/MLPrefilledSyringe[Aranesp]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1085644-TriamcinoloneAcetonide0.25MG/MLTopicalCream|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|727714-0.67MLanakinra149MG/MLPrefilledSyringe[Kineret]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1375922-bromfenac0.7MG/MLOphthalmicSolution[Prolensa]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1085640-TriamcinoloneAcetonide0.005MG/MGTopicalOintment|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1085636-TriamcinoloneAcetonide0.001MG/MGTopicalOintment|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|700418-Thalidomide150MGOralCapsule[Thalomid]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1085633-TriamcinoloneAcetonide0.00025MG/MGTopicalOintment|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1797913-TriamcinoloneAcetonide0.055MG/ACTUATMeteredDoseNasalSpray|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|106387-Permethrin50MG/MLTopicalCream|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|643488-Isotretinoin30MGOralCapsule[Claravis]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|106351-SilverSulfadiazine10MG/MLTopicalCream|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|643175-dasatinib50MGOralTablet[Sprycel]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|106336-Ketoconazole20MG/MLMedicatedShampoo|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|616292-sunitinib50MGOralCapsule[Sutent]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|106258-Hydrocortisone10MG/MLTopicalCream|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1429367-lenalidomide20MGOralCapsule[Revlimid]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|105585-Methotrexate2.5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|616114-lenalidomide10MGOralCapsule[Revlimid]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1431647-4MLgolimumab12.5MG/MLInjection[Simponi]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|105583-Fluorouracil50MG/MLTopicalCream|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1053753-Nystatin100000UNT/ML/TriamcinoloneAcetonide1MG/MLTopicalCream|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1653144-0.5MLgolimumab100MG/MLAuto-Injector[Simponi]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|603978-nepafenac1MG/MLOphthalmicSuspension[Nevanac]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1053697-Nystatin100UNT/MG/TriamcinoloneAcetonide0.001MG/MGTopicalOintment|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|105292-isoniazid10MG/MLOralSolution|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|349408-Treprostinil10MG/MLInjectableSolution|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|540181-alosetron0.5MGOralTablet[Lotronex]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1653166-1MLgolimumab100MG/MLAuto-Injector[Simponi]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1052760-magnesiumcitrate58.2MG/MLOralSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1050077-DiphenhydramineHydrochloride20MG/MLTopicalCream|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|404062-Isotretinoin20MGOralCapsule[Claravis]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1049909-DiphenhydramineHydrochloride25MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1653225-1MLEtanercept50MG/MLAuto-Injector[Enbrel]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|352262-1MLdarbepoetinalfa0.3MG/MLInjection[Aranesp]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1049906-DiphenhydramineHydrochloride2.5MG/MLOralSolution|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|352046-1MLdarbepoetinalfa0.06MG/MLInjection[Aranesp]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1439901-riociguat2MGOralTablet[Adempas]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1049630-DiphenhydramineHydrochloride25MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1049167-PseudoephedrineHydrochloride60MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|261105-Etanercept25MG/MLInjectableSolution[Enbrel]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|104884-Metoclopramide1MG/MLOralSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1047905-HyoscyamineSulfate0.125MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|349407-Treprostinil1MG/MLInjectableSolution|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2536758-24HRviloxazine200MGExtendedReleaseOralCapsule[Qelbree]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1047895-HyoscyamineSulfate0.125MG/MLOralSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1047881-HyoscyamineSulfate0.025MG/MLOralSolution|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2475860-vericiguat5MGOralTablet[Verquvo]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1046985-HyoscyamineSulfate0.125MGDisintegratingOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1441413-0.4MLMethotrexate37.5MG/MLAuto-Injector[Otrexup]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1043690-hydrocortisoneacetate10MG/MLTopicalCream|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2473042-ponatinib10MGOralTablet[Iclusig]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|103951-Tolnaftate10MG/MLTopicalCream|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1441407-0.4MLMethotrexate25MG/MLAuto-Injector[Otrexup]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|103457-Fluocinonide0.0005MG/MGTopicalOintment|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2392142-0.5MLetanercept50MG/MLInjection[Enbrel]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|103456-Fluocinonide0.5MG/MLTopicalCream|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|103403-Hydrocortisone10MG/MLTopicalLotion|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|349253-bosentan62.5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2359358-24HRempagliflozin5MG/linagliptin2.5MG/metforminhydrochloride1000MGExtendedReleaseOralTablet[Trijardy]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1441530-0.9MLtocilizumab180MG/MLPrefilledSyringe[Actemra]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|103401-Hydrocortisone0.025MG/MGTopicalOintment|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1020477-DiphenhydramineHydrochloride50MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2287905-1.5MLfremanezumab-vfrm150MG/MLAuto-Injector[Ajovy]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1014678-cetirizinehydrochloride10MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|317160-temozolomide100MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2282414-bempedoicacid180MGOralTablet[Nexletol]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1014676-cetirizinehydrochloride5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2273115-24HRtofacitinib22MGExtendedReleaseOralTablet[Xeljanz]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1482513-eslicarbazepineacetate200MGOralTablet[Aptiom]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1014673-cetirizinehydrochloride1MG/MLOralSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1014571-12HRcetirizinehydrochloride5MG/PseudoephedrineHydrochloride120MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2265689-Voxelotor500MGOralTablet[Oxbryta]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1014314-TriamcinoloneAcetonide1MG/MLTopicalCream|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1012021-Prednisolonesodiumphosphate2.5MG/ML/SulfacetamideSodium100MG/MLOphthalmicSolution|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2262713-MicronizedIsotretinoin16MGOralCapsule[Absorica]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1011852-LidocaineHydrochloride0.02MG/MGTopicalGel|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2256947-lasmiditan50MGOralTablet[Reyvow]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1010878-LidocaineHydrochloride40MG/MLMucousMembraneTopicalSolution|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2205634-1MLbenralizumab30MG/MLAuto-Injector[Fasenra]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1006688-SulfacetamideSodium100MG/MLTopicalLotion|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1486977-dapagliflozin10MGOralTablet[Farxiga]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1006120-SulfacetamideSodium100MG/MLOphthalmicSolution|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2196592-120ACTUATformoterolfumarate0.005MG/ACTUAT/mometasonefuroate0.05MG/ACTUATMeteredDoseInhaler[Dulera]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1005856-SulfacetamideSodium100MG/ML/Sulfur50MG/MLTopicalLotion|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1000897-PilocarpineHydrochloride40MG/MLOphthalmicSolution|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1484296-sucroferricoxyhydroxide500MGChewableTablet[Velphoro]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2170993-1MLmepolizumab100MG/MLAuto-Injector[Nucala]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1000862-PilocarpineHydrochloride20MG/MLOphthalmicSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1000673-SulfacetamideSodium0.1MG/MGOphthalmicOintment|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|213360-Thalidomide50MGOralCapsule[Thalomid]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1650004-0.5MLInterferonbeta-1a0.088MG/MLAuto-Injector[Rebif]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1000647-PilocarpineHydrochloride10MG/MLOphthalmicSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1000141-medroxyprogesteroneacetate5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1302845-24HRPhentermine3.75MG/topiramate23MGExtendedReleaseOralCapsule[Qsymia]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1860100-ferroussulfate324MGDelayedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2121100-siponimod2MGOralTablet[Mayzent]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2121096-siponimod0.25MGOralTablet[Mayzent]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1000135-medroxyprogesteroneacetate2.5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1650282-RebifRebidoseTitrationPack|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2120195-1MLerenumab-aooe140MG/MLAuto-Injector[Aimovig]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2119391-Spravato56MGDoseKit|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1000114-medroxyprogesteroneacetate10MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2119389-Spravato84MGDoseKit|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1488675-12HRTreprostinil1MGExtendedReleaseOralTablet[Orenitram]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1000097-DoxepinHydrochloride75MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1000076-DoxepinHydrochloride50MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2106075-0.9MLtocilizumab180MG/MLAuto-Injector[Actemra]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1000070-DoxepinHydrochloride25MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1000064-DoxepinHydrochloride150MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|313472-Trientinehydrochloride250MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|206791-mesalamine250MGExtendedReleaseOralCapsule[Pentasa]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1000058-DoxepinHydrochloride100MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1000054-DoxepinHydrochloride10MG/MLOralSolution|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|205921-1MLEpoetinAlfa3000UNT/MLInjection[Epogen]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1000048-DoxepinHydrochloride10MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|153324-Interferonbeta-1a0.03MGInjection[Avonex]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|993804-Gianvi28-DayPack|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|205913-EpoetinAlfa10000UNT/MLInjectableSolution[Procrit]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|992759-Homatropinehydrobromide50MG/MLOphthalmicSolution[Homatropaire]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1492746-apremilast30MGOralTablet[Otezla]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|992481-PromethazineHydrochloride50MGRectalSuppository[Promethegan]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2058906-cannabidiol100MG/MLOralSolution[Epidiolex]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|991233-bexarotene0.01MG/MGTopicalGel[Targretin]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|967012-POLYETHYLENEGLYCOL3350236000MG/PotassiumChloride2970MG/SodiumBicarbonate6740MG/SodiumChloride5860MG/sodiumsulfate22740|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|313211-temozolomide5MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2057205-0.5MLfilgrastim-aafi0.6MG/MLPrefilledSyringe[Nivestym]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1544383-0.2MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|905379-HydralazineHydrochloride37.5MG/IsosorbideDinitrate20MGOralTablet[Bidil]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|896031-28ACTUATFluticasonepropionate0.1MG/ACTUATDryPowderInhaler[Flovent]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2054995-lusutrombopag3MGOralTablet[Mulpleta]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|896019-60ACTUATFluticasonepropionate0.05MG/ACTUATDryPowderInhaler[Flovent]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1649996-0.5MLInterferonbeta-1a0.044MG/MLAuto-Injector[Rebif]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2053512-ivacaftor125MG/lumacaftor100MGOralGranules[ORKAMBI]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|896006-120ACTUATFluticasonepropionate0.22MG/ACTUATMeteredDoseInhaler[Flovent]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2048025-0.6MLpegfilgrastim-jmdb10MG/MLPrefilledSyringe[Fulphila]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1544388-0.3MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|896001-120ACTUATFluticasonepropionate0.11MG/ACTUATMeteredDoseInhaler[Flovent]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|895996-120ACTUATFluticasonepropionate0.044MG/ACTUATMeteredDoseInhaler[Flovent]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2047602-1MLepoetinalfa-epbx2000UNT/MLInjection[Retacrit]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|890786-Butoconazolenitrate20MG/MLVaginalCream[Gynazole-1]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|313210-temozolomide250MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|866049-60ACTUATsalmeterol0.05MG/ACTUATDryPowderInhaler[Serevent]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2045638-1MLerenumab-aooe70MG/MLAuto-Injector[Aimovig]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|864010-ammoniumlactate120MG/MLTopicalLotion[Geri-Hydrolac]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2003757-1.14MLsarilumab132MG/MLAuto-Injector[Kevzara]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|863841-amylase60000UNT/lipase12000UNT/protease38000UNTDelayedReleaseOralCapsule[Creon]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2000013-1.1MLhydroxyprogesteronecaproate(USP)250MG/MLAuto-Injector[Makena]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|863836-amylase30000UNT/lipase6000UNT/protease19000UNTDelayedReleaseOralCapsule[Creon]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1544396-0.45MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|863829-amylase120000UNT/lipase24000UNT/protease76000UNTDelayedReleaseOralCapsule[Creon]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1989085-bosentan32MGTabletforOralSuspension[Tracleer]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1544398-0.5MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|861834-amylase82000UNT/lipase15000UNT/protease51000UNTDelayedReleaseOralCapsule[Zenpep]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|856467-Tri-Lo-Sprintec28DayPack|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1544394-0.4MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1927290-infliximab-abda100MGInjection[Renflexis]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|855871-Phenytoinsodium30MGExtendedReleaseOralCapsule[Dilantin]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|855205-docosanol100MG/MLTopicalCream[Abreva]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|313209-temozolomide20MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1923338-1.14MLsarilumab132MG/MLPrefilledSyringe[Kevzara]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1649495-ivabradine7.5MGOralTablet[Corlanor]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|854921-BisoprololFumarate5MG/Hydrochlorothiazide6.25MGOralTablet[Ziac]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|854918-BisoprololFumarate2.5MG/Hydrochlorothiazide6.25MGOralTablet[Ziac]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1921081-1.56MLabaloparatide2MG/MLPenInjector[Tymlos]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|854910-BisoprololFumarate10MG/Hydrochlorothiazide6.25MGOralTablet[Ziac]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1649593-0.5MLpeginterferonbeta-1a0.25MG/MLAuto-Injector[Plegridy]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1921010-0.1MLadalimumab100MG/MLPrefilledSyringe[Humira]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|845305-Nonoxynol-90.04MG/MGVaginalGel[Conceptrol]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1873765-plecanatide3MGOralTablet[Trulance]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|836368-200ACTUATIpratropiumBromide0.017MG/ACTUATMeteredDoseInhaler[Atrovent]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|830470-1MLrabiesvirusvaccinewistarstrainPM-1503-3M(Human),Inactivated2.5UNT/MLInjection[Imovax]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1871469-lisdexamfetaminedimesylate50MGChewableTablet[Vyvanse]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|830463-1MLrabiesvirusvaccineflury-lepstrain2.5UNT/MLInjection[RabAvert]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|827713-MineralOil0.03MG/MG/Petrolatum0.94MG/MGOphthalmicOintment[SystaneNighttime]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|313165-0.5MLSumatriptan12MG/MLInjection|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1871461-lisdexamfetaminedimesylate30MGChewableTablet[Vyvanse]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|808118-prednisolone5MGOralTablet[MILLIPRED]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|797023-DexPakTaperPak13DayPack|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1870956-deflazacort18MGOralTablet[Emflaza]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|762663-Jolessa91DayPack|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|762334-Velivet28DayPack|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1868016-pirfenidone267MGOralTablet[Esbriet]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1551888-0.2MLadalimumab50MG/MLPrefilledSyringe[Humira]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|762007-Nortrel7/7/728DayPack|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1546198-PlegridyStarterPack|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|762001-Kariva28DayPack|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1812470-ivacaftor125MG/lumacaftor100MGOralTablet[ORKAMBI]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|759473-20ACTUATZanamivir5MG/ACTUATDryPowderInhaler[Relenza]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|759469-Quasense91DayPack|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1801322-3.5MLevolocumab120MG/MLCartridge[Repatha]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|283317-Hydrochlorothiazide12.5MG/telmisartan80MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|754766-Metronidazole0.0075MG/MGVaginalGel[MetroGel]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|753543-Reclipsen28DayPack|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1796091-24HRLinagliptin2.5MG/Metforminhydrochloride1000MGExtendedReleaseOralTablet[Jentadueto]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|753482-Apri28DayPack|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1747194-0.4MLMethotrexate56.3MG/MLAuto-Injector[Otrexup]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|751890-Portia28DayPack|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1731350-deferoxaminemesylate500MGInjection|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1747181-0.4MLMethotrexate31.3MG/MLAuto-Injector[Otrexup]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1592752-nintedanib150MGOralCapsule[Ofev]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|751884-Lutera28DayPack|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|751875-Necon0.5/3528DayPack|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1741049-24HRtofacitinib11MGExtendedReleaseOralTablet[Xeljanz]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|751871-Nortrel1/3521DayPack|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|751870-Nortrel1/3528DayPack|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|311204-Itraconazole100MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1732157-incobotulinumtoxinA50UNTInjection[Xeomin]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|750839-erythromycinstearate250MGOralTablet[ErythrocinStearate]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1729065-selexipag0.8MGOralTablet[Uptravi]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|750264-Necon7/7/728DayPack|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1729057-selexipag0.4MGOralTablet[Uptravi]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|750244-Low-Ogestrel28DayPack|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1593833-24HRdapagliflozin5MG/Metforminhydrochloride1000MGExtendedReleaseOralTablet[Xigduo]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|750243-Ogestrel28DayPack|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1729029-selexipag1.2MGOralTablet[Uptravi]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|749151-Tri-Norinyl28DayPack|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|748865-Trivora28DayPack|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1593831-24HRdapagliflozin5MG/Metforminhydrochloride500MGExtendedReleaseOralTablet[Xigduo]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1726846-0.4MLadalimumab100MG/MLPrefilledSyringe[Humira]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|748859-Zovia1/35E28DayPack|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|707333-SodiumChloride0.111MEQ/MLNasalSolution[AyrSalineNasal]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1720606-mepolizumab100MGInjection[Nucala]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1606866-ivacaftor50MGOralGranules[Kalydeco]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|705008-Cefixime40MG/MLOralSuspension[Suprax]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|692694-thyroid(USP)65MGOralTablet[Westhroid]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1663728-Isotretinoin30MGOralCapsule[Myorisan]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|688242-Estrogens,Conjugated(USP)0.625MG/MLVaginalCream[Premarin]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1606870-ivacaftor75MGOralGranules[Kalydeco]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1660938-60ACTUATformoterolfumarate0.005MG/ACTUAT/mometasonefuroate0.2MG/ACTUATMeteredDoseInhaler[Dulera]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1660934-60ACTUATformoterolfumarate0.005MG/ACTUAT/mometasonefuroate0.1MG/ACTUATMeteredDoseInhaler[Dulera]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|644304-Tamoxifen2MG/MLOralSolution[Soltamox]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1657982-20MLtocilizumab20MG/MLInjection[Actemra]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1596778-14ACTUATBudesonide2MG/ACTUATRectalFoam[Uceris]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|630475-SodiumFluoride5.56MG/MLOralSolution[FluoraDay]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|617333-Amoxicillin25MG/ML/Clavulanate6.25MG/MLOralSuspension[Augmentin]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1655934-ivacaftor125MG/lumacaftor200MGOralTablet[ORKAMBI]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|616450-MycophenolicAcid180MGDelayedReleaseOralTablet[Myfortic]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|616449-MycophenolicAcid360MGDelayedReleaseOralTablet[Myfortic]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|310437-Galantamine8MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1653243-1MLsecukinumab150MG/MLAuto-Injector[Cosentyx]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|616444-mycophenolatemofetil200MG/MLOralSuspension[Cellcept]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|544597-PotassiumIodide1000MG/MLOralSolution[SSKIbrandofPotassiumIodide]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1650901-0.5MLInterferonbeta-1a0.06MG/MLAuto-Injector[Avonex]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|542059-Didanosine10MG/MLOralSolution[Videx]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1605071-0.5MLFILGRASTIM-SNDZ0.6MG/MLPrefilledSyringe[Zarxio]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|404550-Estrogens,Conjugated(USP)0.45MGOralTablet[Premarin]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1649605-PlegridyPenStarterPack|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|404509-CalciumCarbonate1000MG/Simethicone60MGChewableTablet[MaaloxMaxQuickDissolve]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1601373-naloxegol25MGOralTablet[Movantik]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|404492-5MLLaronidase0.58MG/MLInjection[Aldurazyme]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1605455-Otezla28-DayStarterPack|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1648789-30ACTUATfluticasonefuroate0.2MG/ACTUAT/vilanterol0.025MG/ACTUATDryPowderInhaler[Breo]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|404476-Azathioprine100MGOralTablet[Azasan]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|404475-Azathioprine75MGOralTablet[Azasan]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|310436-Galantamine4MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1605172-0.4MLdarbepoetinalfa0.025MG/MLPrefilledSyringe[Aranesp]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1605075-0.8MLFILGRASTIM-SNDZ0.6MG/MLPrefilledSyringe[Zarxio]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|352210-Mesna400MGOralTablet[Mesnex]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|351901-Sirolimus1MG/MLOralSolution[Rapamune]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1599797-1MLsecukinumab150MG/MLPrefilledSyringe[Cosentyx]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|351750-podofilox0.005MG/MGTopicalGel[Condylox]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1596023-ferriccitrate1000MGOralTablet[Auryxia]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1594358-HumiraPediatricCrohn'sDiseaseStarterPackage(3count)|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|351487-thyroid(USP)130MGOralTablet[Westhroid]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1593858-lisdexamfetaminedimesylate10MGOralCapsule[Vyvanse]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1593835-24HRdapagliflozin10MG/Metforminhydrochloride500MGExtendedReleaseOralTablet[Xigduo]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|312020-Nitroglycerin9MGExtendedReleaseOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|312018-Nitroglycerin6.5MGExtendedReleaseOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1593775-24HRdapagliflozin10MG/Metforminhydrochloride1000MGExtendedReleaseOralTablet[Xigduo]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|284551-nilutamide150MGOralTablet[Nilandron]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1592748-nintedanib100MGOralCapsule[Ofev]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1592285-pirfenidone267MGOralCapsule[Esbriet]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|261353-Trimethoprim10MG/MLOralSolution[Primsol]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1551923-naloxegol12.5MGOralTablet[Movantik]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|310599-Granisetron1MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|260409-prednisolone1MG/MLOralSolution[Pediapred]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1551886-lanthanumcarbonate750MGOralPowder[Fosrenol]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|2564406-influenzaAvirusA/Tasmania/503/2020(H3N2)antigen158000000UNT/ML/influenzaAvirusA/Victoria/1/2020(H1N1)antigen158000000|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1546189-0.5MLpeginterferonbeta-1a0.25MG/MLPrefilledSyringe[Plegridy]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1545174-hydrocortisoneacetate100MG/MLRectalFoam[Cortifoam]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|2564038-influenzaAvirusA/Cambodia/e0826360/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.03MG/|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1544918-0.65MLexenatide3.08MG/MLPenInjector[Bydureon]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1544404-0.15MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|2564021-0.5MLinfluenzaAvirusA/Cambodia/e0826360/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1544402-0.6MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|2563039-0.5MLinfluenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.03MG/|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|2563032-0.5MLinfluenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.03MG/|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1649491-ivabradine5MGOralTablet[Corlanor]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1544390-0.35MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|2563031-influenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.03MG/ML/in|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1544386-0.25MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|2563020-influenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Washington/19/2020(H1N1)antigen0.03MG/ML/in|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|283316-Hydrochlorothiazide12.5MG/telmisartan40MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1541928-sunitinib37.5MGOralCapsule[Sutent]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1539893-30ACTUATfluticasonefuroate0.1MG/ACTUAT/vilanterol0.025MG/ACTUATDryPowderInhaler[Breo]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|2563004-0.7MLinfluenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.0857MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.085|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|2563002-0.5MLinfluenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.09MG/ML/influenzaAvirusA/Wisconsin/588/2019(H1N1)antigen0.09MG/|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1488679-12HRTreprostinil2.5MGExtendedReleaseOralTablet[Orenitram]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|2562996-0.5MLinfluenzaAvirusA/Cambodia/e0826360/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1488671-12HRTreprostinil0.25MGExtendedReleaseOralTablet[Orenitram]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1488667-12HRTreprostinil0.125MGExtendedReleaseOralTablet[Orenitram]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|2562995-0.5MLinfluenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Washington/19/2020(H1N1)antigen0.03MG/|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1487076-DiclofenacSodium20MG/MLTopicalSolution[Pennsaid]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1486981-dapagliflozin5MGOralTablet[Farxiga]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|2561275-0.5MLinfluenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.03MG/|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|2561270-0.5MLinfluenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.03MG/|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1482814-1MLgolimumab100MG/MLPrefilledSyringe[Simponi]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|2178792-0.3MLEpinephrine0.5MG/MLPrefilledSyringe[Symjepi]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1442143-Macitentan10MGOralTablet[Opsumit]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|2173508-Nonoxynol-91000MGVaginalSponge[TodaySponge]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|260218-modafinil100MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1441424-0.4MLMethotrexate62.5MG/MLAuto-Injector[Otrexup]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1441418-0.4MLMethotrexate50MG/MLAuto-Injector[Otrexup]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|213621-Bacitracin0.5UNT/MG/PolymyxinB10UNT/MGOphthalmicOintment[Polycin]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|213510-Auranofin3MGOralCapsule[Ridaura]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1439903-riociguat2.5MGOralTablet[Adempas]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|213291-ParoxetineHydrochloride2MG/MLOralSuspension[Paxil]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1439899-riociguat1.5MGOralTablet[Adempas]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1439896-riociguat1MGOralTablet[Adempas]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|213284-hydroxyurea400MGOralCapsule[Droxia]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1439894-riociguat0.5MGOralTablet[Adempas]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|213283-hydroxyurea300MGOralCapsule[Droxia]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1429284-NeostigmineMethylsulfate1MG/MLInjectableSolution[Bloxiverz]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|213282-hydroxyurea200MGOralCapsule[Droxia]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1429282-NeostigmineMethylsulfate0.5MG/MLInjectableSolution[Bloxiverz]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|212373-Estrogens,Esterified(USP)1.25MGOralTablet[Menest]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1374574-TOBIPodhalerKit,224|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|212232-Estrogens,Esterified(USP)0.625MGOralTablet[Menest]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|245136-72HRFentanyl0.1MG/HRTransdermalSystem|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1373335-Isotretinoin20MGOralCapsule[Zenatane]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1373333-Isotretinoin10MGOralCapsule[Zenatane]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|212039-Estrogens,Esterified(USP)0.3MGOralTablet[Menest]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|211633-AluminumHydroxide200MG/MagnesiumHydroxide200MG/Simethicone25MGChewableTablet[Gelusil]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1364477-teduglutide5MGInjection[Gattex]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|2110516-60ACTUATFluticasonepropionate0.5MG/ACTUAT/salmeterol0.05MG/ACTUATDryPowderInhaler[Wixela]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1364358-ponatinib15MGOralTablet[Iclusig]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1357547-tofacitinib5MGOralTablet[Xeljanz]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|2110513-60ACTUATFluticasonepropionate0.25MG/ACTUAT/salmeterol0.05MG/ACTUATDryPowderInhaler[Wixela]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1313061-24HRPhentermine11.25MG/topiramate69MGExtendedReleaseOralCapsule[Qsymia]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1310535-teriflunomide7MGOralTablet[Aubagio]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|2110510-60ACTUATFluticasonepropionate0.1MG/ACTUAT/salmeterol0.05MG/ACTUATDryPowderInhaler[Wixela]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|210000-AluminumHydroxide80MG/ML/MagnesiumHydroxide80MG/ML/Simethicone8MG/MLOralSuspension[Almacone]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1310144-everolimus3MGTabletforOralSuspension[Afinitor]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|209531-Acetaminophen80MGRectalSuppository[Feverall]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1307635-bosutinib500MGOralTablet[Bosulif]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|209360-Acetaminophen325MGRectalSuppository[Acephen]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|245135-72HRFentanyl0.05MG/HRTransdermalSystem|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1302856-24HRPhentermine15MG/topiramate92MGExtendedReleaseOralCapsule[Qsymia]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|209002-prednisolone1.2MG/MLOphthalmicSuspension[PredMild]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1302833-24HRPhentermine7.5MG/topiramate46MGExtendedReleaseOralCapsule[Qsymia]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|208949-Estrogens,Conjugated(USP)0.9MGOralTablet[Premarin]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1300797-24HRmirabegron25MGExtendedReleaseOralTablet[Myrbetriq]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1291092-hydrocortisoneacetate30MGRectalSuppository[Proctocort]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|208551-thyroid(USP)300MGOralTablet[ArmourThyroid]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1245003-eltrombopag12.5MGOralTablet[Promacta]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1244632-AmethiaLo91DayPack|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|208549-thyroid(USP)240MGOralTablet[ArmourThyroid]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1244064-0.4MLMethylnaltrexonebromide20MG/MLPrefilledSyringe[Relistor]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|208547-thyroid(USP)180MGOralTablet[ArmourThyroid]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|208513-Estrogens,Conjugated(USP)0.3MGOralTablet[Premarin]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1657212-omalizumab150MGInjection[Xolair]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1243833-24HRMetforminhydrochloride1000MG/sitagliptin100MGExtendedReleaseOralTablet[Janumet]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|207949-Succimer100MGOralCapsule[Chemet]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1243040-Linagliptin2.5MG/Metforminhydrochloride850MGOralTablet[Jentadueto]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|207864-crotamiton100MG/MLTopicalCream[Eurax]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1243026-Linagliptin2.5MG/Metforminhydrochloride1000MGOralTablet[Jentadueto]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1242968-exenatide2MGInjection[Bydureon]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|207588-Procarbazine50MGOralCapsule[Matulane]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|207478-Primidone50MGOralTablet[Mysoline]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1242611-Isotretinoin10MGOralCapsule[Myorisan]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1242233-lenalidomide2.5MGOralCapsule[Revlimid]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|207373-Mitotane500MGOralTablet[Lysodren]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1235267-CamreseLo91DayPack|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1235157-azilsartanmedoxomil40MG/Chlorthalidone25MGOralTablet[Edarbyclor]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|207273-Nitroglycerin0.02MG/MGTopicalOintment[Nitro-Bid]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1235150-azilsartanmedoxomil40MG/Chlorthalidone12.5MGOralTablet[Edarbyclor]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1232204-Zolpidemtartrate3.5MGSublingualTablet[Intermezzo]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|207136-Methylprednisolone2MGOralTablet[Medrol]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|206978-Ketoconazole20MG/MLMedicatedShampoo[Nizoral]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1191128-EdrophoniumChloride10MG/MLInjectableSolution[Enlon]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|206961-Nadolol20MGOralTablet[Corgard]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1149617-COLLAGENASE0.25UNT/MGTopicalOintment[Santyl]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|206314-Hydrocortisone0.01MG/MGTopicalOintment[Cortizone]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|240912-Granisetron1MG/MLInjectableSolution|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1148502-crizotinib200MGOralCapsule[Xalkori]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1145932-1MLabatacept125MG/MLPrefilledSyringe[Orencia]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|206216-2MLIron-DextranComplex50MG/MLInjection[InFed]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|206208-aluminumchloride200MG/MLTopicalSolution[Drysol]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1115468-1.5MLLeuprolideAcetate15MG/MLPrefilledSyringe[Lupron]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|205669-Dexamethasone1MG/MLOphthalmicSuspension[Maxidex]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1115459-1MLLeuprolideAcetate3.75MG/MLPrefilledSyringe[Lupron]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1115456-1MLLeuprolideAcetate15MG/MLPrefilledSyringe[Lupron]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|205562-Estramustine140MGOralCapsule[Emcyt]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1115449-1MLLeuprolideAcetate11.25MG/MLPrefilledSyringe[Lupron]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|2045958-avatrombopag20MGOralTablet[Doptelet]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1114074-Vandetanib100MGOralTablet[Caprelsa]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|202301-Estrogens,Conjugated(USP)1.25MGOralTablet[Premarin]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1112687-Amethia91DayPack|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|201747-Primidone250MGOralTablet[Mysoline]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1091843-Roflumilast0.5MGOralTablet[Daliresp]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|201338-Nadolol80MGOralTablet[Corgard]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|2198370-pretomanid200MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1091650-azilsartanmedoxomil40MGOralTablet[Edarbi]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1046402-1.7MLdenosumab70MG/MLInjection[Xgeva]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|201337-Nadolol40MGOralTablet[Corgard]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|1998774-Breath-Actuated120ACTUATBeclomethasoneDipropionate0.04MG/ACTUATMeteredDoseInhaler[Qvar]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1043582-24HRMetforminhydrochloride500MG/saxagliptin5MGExtendedReleaseOralTablet[Kombiglyze]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1043574-24HRMetforminhydrochloride1000MG/saxagliptin5MGExtendedReleaseOralTablet[Kombiglyze]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|1998772-Breath-Actuated120ACTUATBeclomethasoneDipropionate0.08MG/ACTUATMeteredDoseInhaler[Qvar]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1043567-24HRMetforminhydrochloride1000MG/saxagliptin2.5MGExtendedReleaseOralTablet[Kombiglyze]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1040058-DextromethorphanHydrobromide20MG/QuinidineSulfate10MGOralCapsule[Nuedexta]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|1995479-amylase168000UNT/lipase40000UNT/protease126000UNTDelayedReleaseOralCapsule[Zenpep]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1037185-LoLoestrinFe28DayPack|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1012899-fingolimod0.5MGOralCapsule[Gilenya]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|1989117-0.3MLEpinephrine1MG/MLPrefilledSyringe[Symjepi]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|198467-Aspirin325MGDelayedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1011715-aliskiren150MG/Hydrochlorothiazide25MGOralTablet[TekturnaHCT]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|1797880-Nafarelin0.2MG/ACTUATMeteredDoseNasalSpray[Synarel]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1002300-nilotinib150MGOralCapsule[Tasigna]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1000089-alcaftadine2.5MG/MLOphthalmicSolution[Lastacaft]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|1667916-5MLIsoproterenolHydrochloride0.2MG/MLInjection[Isuprel]|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|Y||Preferred Generic|998679-168HRClonidine0.0125MG/HRTransdermalSystem|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|485434-entecavir0.5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|1595478-amylase84000UNT/lipase20000UNT/protease63000UNTDelayedReleaseOralCapsule[Zenpep]|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|Y||Preferred Generic|998671-168HRClonidine0.00417MG/HRTransdermalSystem|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|1595473-amylase63000UNT/lipase15000UNT/protease47000UNTDelayedReleaseOralCapsule[Zenpep]|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|Y||Preferred Generic|856569-24HRPropranololHydrochloride80MGExtendedReleaseOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|Y||Preferred Generic|856535-24HRPropranololHydrochloride60MGExtendedReleaseOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|1595462-amylase42000UNT/lipase10000UNT/protease32000UNTDelayedReleaseOralCapsule[Zenpep]|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|Y||Preferred Generic|856481-24HRPropranololHydrochloride160MGExtendedReleaseOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|Y||Preferred Generic|856460-24HRPropranololHydrochloride120MGExtendedReleaseOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|1595457-amylase24000UNT/lipase5000UNT/protease17000UNTDelayedReleaseOralCapsule[Zenpep]|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|Y||Preferred Generic|854868-Rabeprazolesodium20MGDelayedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|1595292-amylase14000UNT/lipase3000UNT/protease10000UNTDelayedReleaseOralCapsule[Zenpep]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|1594673-amylase105000UNT/lipase25000UNT/protease79000UNTDelayedReleaseOralCapsule[Zenpep]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1728095-romiplostim0.25MGInjection[Nplate]|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|Y||Preferred Generic|577127-pregabalin225MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|1536586-168HREthinylEstradiol0.00146MG/HR/norelgestromin0.00625MG/HRTransdermalSystem[Xulane]|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|Y||Preferred Generic|483448-pregabalin50MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|153473-Altretamine50MGOralCapsule[Hexalen]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|205324-modafinil200MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|Y||Preferred Generic|483444-pregabalin300MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|Y||Preferred Generic|483442-pregabalin25MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|153183-adapalene0.001MG/MGTopicalGel[Differin]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|152854-Itraconazole10MG/MLOralSolution[Sporanox]|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|Y||Preferred Generic|351134-zolmitriptan5MGDisintegratingOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|150840-Estrogens,Conjugated(USP)0.625MGOralTablet[Premarin]|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|Y||Preferred Generic|314227-Sumatriptan20MG/ACTUATNasalSpray|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|Y||Preferred Generic|313189-Tacrolimus0.0003MG/MGTopicalOintment|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|1440936-Hydrocortisone25MG/MLTopicalCream[ProctozoneHC]|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|Y||Preferred Generic|313159-Sumatriptan5MG/ACTUATNasalSpray|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|Y||Preferred Generic|311671-Metolazone5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|1426881-Levonorgestrel1.5MGOralTablet[MyWay]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|1422081-Enskyce28DayPack|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|Y||Preferred Generic|284201-zolmitriptan2.5MGDisintegratingOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|1373327-amylase180000UNT/lipase36000UNT/protease114000UNTDelayedReleaseOralCapsule[Creon]|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|Y||Preferred Generic|200194-zolmitriptan5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|1359135-Tri-LegestFe28DayPack|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|Y||Preferred Generic|2001568-BXRating24HRMethylphenidateHydrochloride54MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|Y||Preferred Generic|2001566-BXRating24HRMethylphenidateHydrochloride36MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|1359134-TiliaFe28DayPack|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1099625-DivalproexSodium125MGDelayedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|1359032-Microgestin1.5/3021DayPack|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|Y||Preferred Generic|197979-Metolazone2.5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|1359030-Junel1.5/3021DayPack|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|Y||Preferred Generic|197519-Clindamycin10MG/MLTopicalLotion|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|Y||Preferred Generic|1806195-50/50Release24HRMethylphenidateHydrochloride10MGExtendedReleaseOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|1359027-MicrogestinFe1.5/3028DayPack|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|Y||Preferred Generic|1806185-50/50Release24HRMethylphenidateHydrochloride60MGExtendedReleaseOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|477372-solifenacinsuccinate10MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|1359025-JunelFe28DayPack|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|Y||Preferred Generic|1111343-olopatadine2MG/MLOphthalmicSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|Y||Preferred Generic|1111339-olopatadine1MG/MLOphthalmicSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|1359020-Microgestin1/2021DayPack|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|Y||Preferred Brand|2200658-semaglutide7MGOralTablet[Rybelsus]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|1358780-Junel1/2021DayPack|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|Y||Preferred Brand|2200650-semaglutide14MGOralTablet[Rybelsus]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|1358775-MicrogestinFe1/2028DayPack|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|205315-topiramate25MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|Y||Preferred Brand|1716219-patiromer16800MGPowderforOralSuspension[Veltassa]|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|Y||Preferred Brand|1716215-patiromer8400MGPowderforOralSuspension[Veltassa]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|1358765-JunelFe1/2028DayPack|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|1293864-ErgotamineTartrate2MGSublingualTablet[Ergomar]|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Generic|996609-24HRMemantinehydrochloride28MGExtendedReleaseOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|1293639-Caffeine100MG/ErgotamineTartrate2MGRectalSuppository[Migergot]|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Generic|996594-24HRMemantinehydrochloride14MGExtendedReleaseOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Generic|857564-24HRtrospiumchloride60MGExtendedReleaseOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|1250090-Nonoxynol-90.03MG/MGVaginalGel[GynolII]|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Generic|857560-trospiumchloride20MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Generic|855194-tolterodinetartrate2MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|1233850-Vestura28DayPack|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|1190225-120ACTUATAlbuterol0.1MG/ACTUAT/IpratropiumBromide0.02MG/ACTUATInhalationSpray[Combivent]|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Generic|855178-tolterodinetartrate1MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|1148646-28ACTUATFluticasonepropionate0.25MG/ACTUATDryPowderInhaler[Flovent]|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Generic|810090-Carbidopa18.75MG/entacapone200MG/Levodopa75MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|1114135-amylase16000UNT/lipase3000UNT/protease10000UNTDelayedReleaseOralCapsule[Zenpep]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|200328-capecitabine500MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Generic|749206-sevelamercarbonate800MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|1114041-DextromethorphanHydrobromide1MG/MLOralSolution[DayQuilCough]|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Generic|730988-Carbidopa50MG/entacapone200MG/Levodopa200MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|1113046-amylase15000UNT/lipase3000UNT/protease9500UNTDelayedReleaseOralCapsule[Creon]|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Generic|606730-Esomeprazole40MGDelayedReleaseOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Generic|562806-Pimecrolimus10MG/MLTopicalCream|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|1112715-Amethyst28DayPack|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Generic|403852-Carbidopa37.5MG/entacapone200MG/Levodopa150MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Generic|403851-Carbidopa25MG/entacapone200MG/Levodopa100MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|1101778-Monobasicpotassiumphosphate0.0408MEQ/MLOralSolution[K-Phos]|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Generic|403850-Carbidopa12.5MG/entacapone200MG/Levodopa50MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Generic|349590-Levalbuterol0.103MG/MLInhalationSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|1099026-Loryna28DayPack|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|1098924-SodiumFluoride11MG/MLOralSolution[Flura-Drops]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1745108-1MLixekizumab80MG/MLAuto-Injector[Taltz]|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Generic|313921-calcipotriene0.05MG/MLTopicalCream|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|1095362-Balziva28DayPack|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Generic|311347-linezolid600MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|1087012-thyroid(USP)32.5MGOralTablet[Westhroid]|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Generic|311286-Levalbuterol0.21MG/MLInhalationSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Generic|310600-Griseofulvin500MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|105590-Thioguanine40MGOralTablet[Tabloid]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|105553-Chlorambucil2MGOralTablet[Leukeran]|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Generic|242831-Griseofulvin125MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|105551-Busulfan2MGOralTablet[Myleran]|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Generic|239239-Griseofulvin250MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Generic|204119-Malathion5MG/MLTopicalLotion|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|1048452-ColestipolHydrochloride5000MGGranulesforOralSuspension[Colestid]|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Generic|198373-calcipotriene0.00005MG/MGTopicalOintment|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Generic|197984-Minocycline100MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|1046771-12HRHyoscyamineSulfate0.375MGExtendedReleaseOralTablet[Levbid]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|1039273-Hydrocortisone10MG/MLTopicalSolution[ScalpicinItchRelief]|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Generic|197507-Cimetidine400MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|102250-Hydrocortisone1.67MG/MLEnema[Cortenema]|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Generic|197505-Cimetidine200MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|1020155-Introvale91DayPack|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|200220-tolcapone100MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Generic|197418-Bumetanide1MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Generic|197417-Bumetanide0.5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|1005928-ulipristalacetate30MGOralTablet[Ella]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|1000500-Prempro0.625/528DayPack|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Generic|1368954-mesalamine400MGDelayedReleaseOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|1000499-Prempro0.625/2.528DayPack|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Generic|1368431-alogliptin25MG/pioglitazone30MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Generic|1368424-alogliptin25MG/pioglitazone15MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|1000497-Prempro0.45/1.528DayPack|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Generic|1368417-alogliptin12.5MG/pioglitazone45MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|1000491-Prempro0.3/1.528DayPack|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Generic|1368392-alogliptin12.5MG/Metforminhydrochloride500MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|1000487-Premphase28DayPack|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Generic|1368385-alogliptin12.5MG/Metforminhydrochloride1000MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Brand|1000158-0.65MLmedroxyprogesteroneacetate160MG/MLPrefilledSyringe[depo-subQprovera]|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Generic|1368018-alogliptin6.25MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Generic|1368006-alogliptin25MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|199521-Vigabatrin500MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Generic|1246673-Ivermectin5MG/MLTopicalLotion|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Generic|1085816-spinosad9MG/MLMedicatedShampoo|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Brand|996633-NamendaXR28DayTitrationPack|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|722116-ambrisentan10MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Brand|856666-rifaximin550MGOralTablet[XIFAXAN]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1801519-Methylnaltrexonebromide150MGOralTablet[Relistor]|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Brand|835721-Ethionamide250MGOralTablet[Trecator]|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Brand|833151-Savella4-WeekTitrationPack|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Brand|833149-Milnacipranhydrochloride25MGOralTablet[Savella]|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Brand|833146-Milnacipranhydrochloride50MGOralTablet[Savella]|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Brand|833143-Milnacipranhydrochloride12.5MGOralTablet[Savella]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1806942-carfilzomib60MGInjection[Kyprolis]|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Brand|833139-Milnacipranhydrochloride100MGOralTablet[Savella]|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Brand|539789-rifaximin200MGOralTablet[XIFAXAN]|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Brand|402092-Cyclosporine0.5MG/MLOphthalmicSuspension[Restasis]|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Brand|2398842-3MLsemaglutide1.34MG/MLPenInjector[Ozempic]|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Brand|2395785-0.5MLdulaglutide9MG/MLAuto-Injector[Trulicity]|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Brand|2395779-0.5MLdulaglutide6MG/MLAuto-Injector[Trulicity]|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Brand|213307-Ciprofloxacin0.003MG/MGOphthalmicOintment[Ciloxan]|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Brand|212381-aminosalicylicacid4000MGOralGranules[PaserD/R]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|724859-armodafinil150MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|722122-ambrisentan5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Brand|1992821-ertugliflozin15MGOralTablet[Steglatro]|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Brand|1992816-ertugliflozin5MGOralTablet[Steglatro]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|705824-100MLzoledronicacid0.05MG/MLInjection|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Brand|1992703-ertugliflozin7.5MG/Metforminhydrochloride500MGOralTablet[Segluromet]|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Brand|1992700-ertugliflozin7.5MG/Metforminhydrochloride1000MGOralTablet[Segluromet]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|724861-armodafinil250MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Brand|1992695-ertugliflozin2.5MG/Metforminhydrochloride500MGOralTablet[Segluromet]|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Brand|1992691-ertugliflozin2.5MG/Metforminhydrochloride1000MGOralTablet[Segluromet]|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Brand|1991317-1MGDose1.5MLsemaglutide1.34MG/MLPenInjector[Ozempic]|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Brand|1991311-0.25MG,0.5MGDose1.5MLsemaglutide1.34MG/MLPenInjector[Ozempic]|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Brand|1801840-lifitegrast50MG/MLOphthalmicSolution[Xiidra]|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Brand|1551306-0.5MLdulaglutide3MG/MLAuto-Injector[Trulicity]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|724863-armodafinil50MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Brand|1551300-0.5MLdulaglutide1.5MG/MLAuto-Injector[Trulicity]|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Brand|1356673-BenzylAlcohol0.05ML/MLTopicalLotion[Ulesfia]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|1655968-8MLMethotrexate25MG/MLInjection|ADULT FULL DUALS/PARTIAL 632|2002|N|Y|N||Preferred Brand|1190334-24HRFexofenadinehydrochloride180MG/PseudoephedrineHydrochloride240MGExtendedReleaseOralTablet[Wal-FexD]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|996757-CodeinePhosphate2MG/ML/PhenylephrineHydrochloride1MG/ML/PromethazineHydrochloride1.25MG/MLOralSolution|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|725021-24HRrivastigmine0.192MG/HRTransdermalSystem|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|995868-CodeinePhosphate2MG/ML/Guaifenesin20MG/MLOralSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|993890-Acetaminophen300MG/CodeinePhosphate60MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|993781-Acetaminophen300MG/CodeinePhosphate30MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|993770-Acetaminophen300MG/CodeinePhosphate15MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|993755-Acetaminophen24MG/ML/CodeinePhosphate2.4MG/MLOralSolution|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|725023-24HRrivastigmine0.396MG/HRTransdermalSystem|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|993470-midodrinehydrochloride5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|993466-midodrinehydrochloride2.5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|993462-midodrinehydrochloride10MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1855527-HumiraPediatricCrohn'sDiseaseStarterPackage(2count)|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|992668-homatropinemethylbromide0.3MG/ML/HydrocodoneBitartrate1MG/MLOralSolution|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1813112-Rajani28DayPack|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|991528-DextromethorphanHydrobromide3MG/ML/PromethazineHydrochloride1.25MG/MLOralSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|991486-CodeinePhosphate2MG/ML/PromethazineHydrochloride1.25MG/MLOralSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|977880-AmilorideHydrochloride5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|905516-ChlordiazepoxideHydrochloride5MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|905495-ChlordiazepoxideHydrochloride25MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|727339-0.5MLSumatriptan12MG/MLPrefilledSyringe|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|905369-ChlordiazepoxideHydrochloride10MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|904589-SotalolHydrochloride240MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|904447-Alendronicacid0.933MG/MLOralSolution|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|1988980-24HRpregabalin82.5MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|904419-Alendronicacid10MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|904405-Alendronicacid40MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|899557-dexmethylphenidatehydrochloride2.5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|899548-dexmethylphenidatehydrochloride10MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1868020-pirfenidone801MGOralTablet[Esbriet]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|899518-dexmethylphenidatehydrochloride5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|897749-HydromorphoneHydrochloride3MGRectalSuppository|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|897710-HydromorphoneHydrochloride8MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|754508-{1(aprepitant125MGOralCapsule)/2(aprepitant80MGOralCapsule)}Pack|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|897702-HydromorphoneHydrochloride4MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|897696-HydromorphoneHydrochloride2MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|897659-Verapamilhydrochloride120MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|897640-Verapamilhydrochloride180MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|728231-12HRranolazine1000MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|897630-24HRVerapamilhydrochloride360MGExtendedReleaseOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|897618-24HRVerapamilhydrochloride180MGExtendedReleaseOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|897612-24HRVerapamilhydrochloride120MGExtendedReleaseOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|894780-MorphineSulfate4MG/MLOralSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|892672-MorphineSulfate30MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|892625-MorphineSulfate20MG/MLOralSolution|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|794639-lubiprostone0.008MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|892589-MorphineSulfate2MG/MLOralSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|892582-MorphineSulfate15MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1870952-deflazacort30MGOralTablet[Emflaza]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|884386-DextroamphetamineSulfate5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|884385-DextroamphetamineSulfate10MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|866042-NeomycinSulfate500MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|863559-valganciclovir50MG/MLOralSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|862025-24HRGuanfacine4MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197382-Atenolol100MG/Chlorthalidone25MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|862019-24HRGuanfacine3MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|862013-24HRGuanfacine2MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|862006-24HRGuanfacine1MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|803353-PhentermineHydrochloride37.5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1870960-deflazacort36MGOralTablet[Emflaza]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|861237-24HRAmphetamineaspartate1.25MG/AmphetamineSulfate1.25MG/Dextroamphetaminesaccharate1.25MG/DextroamphetamineSulfate1.25|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|861232-24HRAmphetamineaspartate7.5MG/AmphetamineSulfate7.5MG/Dextroamphetaminesaccharate7.5MG/DextroamphetamineSulfate7.5MGEx|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|861227-24HRAmphetamineaspartate6.25MG/AmphetamineSulfate6.25MG/Dextroamphetaminesaccharate6.25MG/DextroamphetamineSulfate6.25|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|861225-24HRAmphetamineaspartate5MG/AmphetamineSulfate5MG/Dextroamphetaminesaccharate5MG/DextroamphetamineSulfate5MGExtendedRe|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|861223-24HRAmphetamineaspartate3.75MG/AmphetamineSulfate3.75MG/Dextroamphetaminesaccharate3.75MG/DextroamphetamineSulfate3.75|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|861221-24HRAmphetamineaspartate2.5MG/AmphetamineSulfate2.5MG/Dextroamphetaminesaccharate2.5MG/DextroamphetamineSulfate2.5MGEx|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|1988977-24HRpregabalin330MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|857366-EconazoleNitrate10MG/MLTopicalCream|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|857005-Acetaminophen325MG/HydrocodoneBitartrate7.5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|857002-Acetaminophen325MG/HydrocodoneBitartrate5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|824295-rufinamide200MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|856999-Acetaminophen325MG/HydrocodoneBitartrate10MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|856940-Acetaminophen21.7MG/ML/HydrocodoneBitartrate0.5MG/MLOralSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|855633-DiclofenacSodium0.01MG/MGTopicalGel|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1870968-deflazacort22.75MG/MLOralSuspension[Emflaza]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|854876-Zolpidemtartrate5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|854873-Zolpidemtartrate10MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|854252-1MLEnoxaparinsodium150MG/MLPrefilledSyringe|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|854248-1MLEnoxaparinsodium100MG/MLPrefilledSyringe|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1871459-lisdexamfetaminedimesylate40MGChewableTablet[Vyvanse]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|854245-0.8MLEnoxaparinsodium150MG/MLPrefilledSyringe|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|854241-0.8MLEnoxaparinsodium100MG/MLPrefilledSyringe|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|824301-rufinamide400MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|854238-0.6MLEnoxaparinsodium100MG/MLPrefilledSyringe|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|854235-0.4MLEnoxaparinsodium100MG/MLPrefilledSyringe|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|854228-0.3MLEnoxaparinsodium100MG/MLPrefilledSyringe|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|1988974-24HRpregabalin165MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|847252-3MLInsulinLispro25UNT/ML/insulinlisproprotamine,human75UNT/MLPenInjector|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|847191-3MLinsulinaspartprotamine,human70UNT/ML/insulinaspart,human30UNT/MLPenInjector|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|846378-24HRLevetiracetam750MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|833234-mesalamine800MGDelayedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1870950-deflazacort6MGOralTablet[Emflaza]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|845488-Ramipril1.25MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|835829-testosteronecypionate100MG/MLInjectableSolution|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1729076-UptraviTitrationPack|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|835603-tramadolhydrochloride50MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|834022-KetorolacTromethamine10MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|830861-24HRDiltiazemHydrochloride120MGExtendedReleaseOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|198200-Rifabutin150MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|830845-24HRDiltiazemHydrochloride180MGExtendedReleaseOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1871465-lisdexamfetaminedimesylate10MGChewableTablet[Vyvanse]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|830837-24HRDiltiazemHydrochloride240MGExtendedReleaseOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|830801-24HRDiltiazemHydrochloride300MGExtendedReleaseOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|807832-24HRLevetiracetam500MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|801966-4MLDiazepam5MG/MLRectalGel|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|801961-2MLDiazepam5MG/MLRectalGel|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|801957-0.5MLDiazepam5MG/MLRectalGel|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|728113-Oseltamivir45MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|728109-Oseltamivir30MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|834241-febuxostat80MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|834235-febuxostat40MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|687043-Amphetamineaspartate3.125MG/AmphetamineSulfate3.125MG/Dextroamphetaminesaccharate3.125MG/DextroamphetamineSulfate3.125|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|686379-celecoxib50MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1871467-lisdexamfetaminedimesylate60MGChewableTablet[Vyvanse]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|636045-Hydrochlorothiazide25MG/valsartan320MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|636042-Hydrochlorothiazide12.5MG/valsartan320MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|845515-everolimus5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|608143-atomoxetine80MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|608139-atomoxetine100MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|198243-Temazepam7.5MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|596934-duloxetine60MGDelayedReleaseOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|596930-duloxetine30MGDelayedReleaseOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|596926-duloxetine20MGDelayedReleaseOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|577961-Amphetamineaspartate5MG/AmphetamineSulfate5MG/Dextroamphetaminesaccharate5MG/DextroamphetamineSulfate5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|848131-Amlodipine10MG/Hydrochlorothiazide12.5MG/valsartan160MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|577957-Amphetamineaspartate3.75MG/AmphetamineSulfate3.75MG/Dextroamphetaminesaccharate3.75MG/DextroamphetamineSulfate3.75MGOr|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|541892-Amphetamineaspartate2.5MG/AmphetamineSulfate2.5MG/Dextroamphetaminesaccharate2.5MG/DextroamphetamineSulfate2.5MGOralTa|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|541878-Amphetamineaspartate1.25MG/AmphetamineSulfate1.25MG/Dextroamphetaminesaccharate1.25MG/DextroamphetamineSulfate1.25MGOr|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|541363-Amphetamineaspartate7.5MG/AmphetamineSulfate7.5MG/Dextroamphetaminesaccharate7.5MG/DextroamphetamineSulfate7.5MGOralTa|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|485486-tizanidine2MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|485485-tizanidine4MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|485484-tizanidine6MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|485465-Eszopiclone3MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|485442-Eszopiclone2MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|848140-Amlodipine5MG/Hydrochlorothiazide12.5MG/valsartan160MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|485440-Eszopiclone1MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|477562-Fenofibrate48MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|477560-Fenofibrate145MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1873087-HumiraPrefilledSyringe80MG/0.8MLStarterPack-PediatricCrohn'sDisease(3count)|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|403923-168HREstradiol0.0025MG/HRTransdermalSystem|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1872980-0.4MLadalimumab100MG/MLAuto-Injector[Humira]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|403922-168HREstradiol0.00156MG/HRTransdermalSystem|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|403884-Levetiracetam100MG/MLOralSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|359818-Nicotine4MGOralLozenge|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1873704-Mibelas24FeChewable28DayPack|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|359817-Nicotine2MGOralLozenge|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|351297-insulinaspartprotamine,human70UNT/ML/insulinaspart,human30UNT/MLInjectableSuspension|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|848145-Amlodipine5MG/Hydrochlorothiazide25MG/valsartan160MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|351246-montelukast4MGOralGranules|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|351133-Fenofibrate54MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1871463-lisdexamfetaminedimesylate20MGChewableTablet[Vyvanse]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|351109-Budesonide0.25MG/MLInhalationSuspension|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|349595-atomoxetine60MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|349594-atomoxetine40MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|349593-atomoxetine25MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|349592-atomoxetine18MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1876609-naldemedine0.2MGOralTablet[Symproic]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|349591-atomoxetine10MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|349514-celecoxib400MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|349483-valsartan40MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|850087-24HRlamotrigine100MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|349353-Hydrochlorothiazide25MG/valsartan160MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|349287-Fenofibrate160MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|349201-valsartan160MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|349200-valsartan320MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|848151-Amlodipine10MG/Hydrochlorothiazide25MG/valsartan160MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|349199-valsartan80MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|349198-Clonazepam0.5MGDisintegratingOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|349197-Clonazepam2MGDisintegratingOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|349196-Clonazepam1MGDisintegratingOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|349195-Clonazepam0.25MGDisintegratingOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|349194-Clonazepam0.125MGDisintegratingOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|850091-24HRlamotrigine50MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|349094-Budesonide0.125MG/MLInhalationSuspension|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|318202-Erythromycin20MG/MLTopicalSolution|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1921017-0.2MLadalimumab100MG/MLPrefilledSyringe[Humira]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|315223-Sumatriptan25MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|314285-zonisamide100MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|854880-Zolpidemtartrate12.5MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|314209-rizatriptan10MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|314200-pantoprazole40MGDelayedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|314135-naratriptan2.5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197409-Betamethasone0.001MG/MGTopicalOintment|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|313762-zaleplon5MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|313761-zaleplon10MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|313571-Vancomycin250MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|854894-Zolpidemtartrate6.25MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1921240-0.8MLadalimumab100MG/MLAuto-Injector[Humira]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|313570-Vancomycin125MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|313566-valganciclovir450MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|313415-Tobramycin3MG/MLOphthalmicSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|313413-tizanidine4MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|855626-Twice-Dailydiclofenacepolamine0.013MG/MGMedicatedPatch|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|313412-tizanidine2MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|313222-terbinafine250MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|198071-Penicillamine250MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|313161-Sumatriptan50MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|313160-Sumatriptan100MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|312840-rizatriptan5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|855642-DiclofenacSodium0.03MG/MGTopicalGel|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|312087-Ondansetron8MGDisintegratingOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|312086-Ondansetron8MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|312075-Ofloxacin3MG/MLOphthalmicSolution|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1921245-HumiraPen80MG/0.8ML-StarterPackageforCrohn'sDisease,UlcerativeColitisorHidradenitisSuppurativa(3count)|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|311975-Nicotine4MGChewingGum|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|311918-naratriptan1MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|311759-montelukast4MGChewableTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|311265-lamotrigine5MGChewableTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1921468-HumiraPen80MG/0.8MLand40MG/0.4ML-Psoriasis/UveitisStarterPackage(3count)|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|311237-Ketotifen0.25MG/MLOphthalmicSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|311207-Ivermectin3MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|310793-Hydrochlorothiazide12.5MG/irbesartan300MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|310792-Hydrochlorothiazide12.5MG/irbesartan150MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|310467-Gentamicin3MG/MLOphthalmicSolution|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|198070-Penicillamine250MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|310465-Gentamicin0.001MG/MGTopicalOintment|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|310289-Fenofibrate200MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|310288-Fenofibrate134MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|857224-Sevelamerhydrochloride800MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|310191-estradiolvalerate40MG/MLInjectableSolution|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1923347-1.14MLsarilumab175MG/MLPrefilledSyringe[Kevzara]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|310190-estradiolvalerate20MG/MLInjectableSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|310152-Erythromycin0.02MG/MGTopicalGel|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|310149-Erythromycin0.005MG/MGOphthalmicOintment|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|309314-Citalopram40MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|309309-Ciprofloxacin500MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1925255-0.4MLabatacept125MG/MLPrefilledSyringe[Orencia]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|309307-Ciprofloxacin3MG/MLOphthalmicSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|283407-Mirtazapine30MGDisintegratingOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|261962-Ramipril10MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|259081-12HRAspirin25MG/Dipyridamole200MGExtendedReleaseOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|252559-Budesonide0.5MG/MLInhalationSuspension|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|251872-pantoprazole20MGDelayedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|248478-84HREstradiol0.00104MG/HRTransdermalSystem|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|242892-84HREstradiol0.00417MG/HRTransdermalSystem|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|860103-KetorolacTromethamine4MG/MLOphthalmicSolution|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|857700-DiclofenacSodium15MG/MLTopicalSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|242891-84HREstradiol0.00208MG/HRTransdermalSystem|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|242462-cilostazol50MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|857216-Sevelamerhydrochloride400MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|242461-cilostazol100MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|242438-montelukast5MGChewableTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|860695-24HRgalantaminehydrobromide16MGExtendedReleaseOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|242333-168HREstradiol0.00104MG/HRTransdermalSystem|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|241946-84HREstradiol0.00156MG/HRTransdermalSystem|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|197845-Isotretinoin40MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|241527-168HREstradiol0.00312MG/HRTransdermalSystem|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|238004-168HREstradiol0.00417MG/HRTransdermalSystem|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|238003-168HREstradiol0.00208MG/HRTransdermalSystem|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|2123111-NDA020503200ACTUATAlbuterol0.09MG/ACTUATMeteredDoseInhaler|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|860707-24HRgalantaminehydrobromide24MGExtendedReleaseOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|205323-celecoxib200MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|205322-celecoxib100MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|2047882-1MLtestosteronecypionate200MG/MLInjection|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|203088-Ketoconazole20MG/MLTopicalCream|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|860715-24HRgalantaminehydrobromide8MGExtendedReleaseOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|200345-Simvastatin80MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|200329-Omeprazole40MGDelayedReleaseOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|200311-Fenofibrate67MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|200285-Hydrochlorothiazide12.5MG/valsartan160MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|200284-Hydrochlorothiazide12.5MG/valsartan80MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|200224-montelukast10MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1925257-0.7MLabatacept125MG/MLPrefilledSyringe[Orencia]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|200096-irbesartan300MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|200095-irbesartan150MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1946520-3-Month1.5MLLeuprolideAcetate20MG/MLPrefilledSyringe[Lupron]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|200094-irbesartan75MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1945048-30ACTUATfluticasonefuroate0.1MG/ACTUAT/umeclidinium0.0625MG/ACTUAT/vilanterol0.025MG/ACTUATDryPowderInhaler[Trelegy]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|199381-potassiumcitrate10MEQExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|199376-potassiumcitrate5MEQExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|199370-Ciprofloxacin100MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1946522-4-Month1.5MLLeuprolideAcetate20MG/MLPrefilledSyringe[Lupron]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|199206-Riluzole50MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|198342-Urea400MG/MLTopicalCream|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|861370-sevelamercarbonate2400MGPowderforOralSuspension|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|198318-Triazolam0.25MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|198317-Triazolam0.125MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|198252-tetracyclinehydrochloride500MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|197844-Isotretinoin20MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|198250-tetracyclinehydrochloride250MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|198242-Temazepam30MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|198241-Temazepam15MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|198189-Ramipril5MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1989109-1MLbenralizumab30MG/MLPrefilledSyringe[Fasenra]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|198188-Ramipril2.5MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|198052-Ondansetron4MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|198051-Omeprazole20MGDelayedReleaseOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|861960-armodafinil200MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|198036-24HRNifedipine90MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|198035-24HRNifedipine60MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1990869-0.85MLexenatide2.35MG/MLAuto-Injector[Bydureon]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|198034-24HRNifedipine30MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|197902-Lorazepam2MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|861375-sevelamercarbonate800MGPowderforOralSuspension|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|197900-Lorazepam0.5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|197877-Lidocaine25MG/ML/Prilocaine25MG/MLTopicalCream|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|197739-Glycopyrrolate2MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|197738-Glycopyrrolate1MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|197735-Gentamicin1MG/MLTopicalCream|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|197591-Diazepam5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|863038-bepotastinebesilate15MG/MLOphthalmicSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|197590-Diazepam2MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|197589-Diazepam10MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1999389-symdeko100MG/150MGand150MGPack|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|197541-Colchicine0.6MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|197529-Clonazepam2MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|864675-Atovaquone250MG/proguanilhydrochloride100MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|197528-Clonazepam1MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|197527-Clonazepam0.5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|197512-Ciprofloxacin750MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197454-Cephalexin500MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|197511-Ciprofloxacin250MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|1926331-0.5UNTDoses3MLInsulinLispro100UNT/MLPenInjector|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|1918209-60ACTUATfluticasonepropionate0.055MG/ACTUAT/salmeterol0.014MG/ACTUATDryPowderInhaler|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|864681-Atovaquone62.5MG/proguanilhydrochloride25MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|1918203-60ACTUATfluticasonepropionate0.232MG/ACTUAT/salmeterol0.014MG/ACTUATDryPowderInhaler|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|1918194-60ACTUATfluticasonepropionate0.113MG/ACTUAT/salmeterol0.014MG/ACTUATDryPowderInhaler|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|1812015-Osmotic24HRNifedipine90MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|1812013-Osmotic24HRNifedipine60MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|860901-galantaminehydrobromide4MG/MLOralSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|1812011-Osmotic24HRNifedipine30MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|1806197-30/70Release24HRMethylphenidateHydrochloride60MGExtendedReleaseOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|197843-Isotretinoin10MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|1806193-30/70Release24HRMethylphenidateHydrochloride50MGExtendedReleaseOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|1806191-30/70Release24HRMethylphenidateHydrochloride40MGExtendedReleaseOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|1650142-DoxycyclineMonohydrate100MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|864718-MethadoneHydrochloride5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|1649990-DoxycyclineMonohydrate100MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|1649401-DoxycyclineMonohydrate50MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|1596780-60ACTUATTestosterone12.5MG/ACTUATTopicalGel|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|1550940-Colchicine0.6MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|1543069-Lidocaine0.05MG/MGTopicalOintment|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|1298091-FlurazepamHydrochloride30MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|1298088-FlurazepamHydrochloride15MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2003767-1.14MLsarilumab175MG/MLAuto-Injector[Kevzara]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|1244214-Budesonide3MGDelayedReleaseOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|1149632-84HREstradiol0.00313MG/HRTransdermalSystem|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|864761-MethadoneHydrochloride1MG/MLOralSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|1115698-Oseltamivir6MG/MLOralSuspension|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|1091497-MethylphenidateHydrochloride5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|1091392-MethylphenidateHydrochloride20MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|197730-Furosemide10MG/MLOralSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|1091225-8HRMethylphenidateHydrochloride20MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|1091150-MethylphenidateHydrochloride10MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|1091145-8HRMethylphenidateHydrochloride10MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|864769-MethadoneHydrochloride2MG/MLOralSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|106346-Mupirocin0.02MG/MGTopicalOintment|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2045959-Doptelet40MGDailyDoseCartonPack|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|1049225-Acetaminophen325MG/OxycodoneHydrochloride7.5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|1049221-Acetaminophen325MG/OxycodoneHydrochloride5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|1049214-Acetaminophen325MG/OxycodoneHydrochloride10MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|104894-Ondansetron4MGDisintegratingOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|1923828-deferasirox180MGOralGranules|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|1009145-Amphetamineaspartate1.875MG/AmphetamineSulfate1.875MG/Dextroamphetaminesaccharate1.875MG/DextroamphetamineSulfate1.87|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2045961-Doptelet60MGDailyDoseCartonPack|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|1000153-1MLmedroxyprogesteroneacetate150MG/MLPrefilledSyringe|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Generic|1000126-1MLmedroxyprogesteroneacetate150MG/MLInjection|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|999965-Glycopyrrolate0.2MG/MLOralSolution[Cuvposa]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197517-Clarithromycin500MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|998666-carboxymethylcellulosesodium0.01MG/MGOphthalmicGel[TheraTears]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|901644-0.5MLStreptococcuspneumoniaeserotype1capsularantigendiphtheriaCRM197proteinconjugatevaccine0.0044MG/ML/Streptococcuspn|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|901518-0.5MLNeisseriameningitidisserogroupAoligosaccharidediphtheriaCRM197proteinconjugatevaccine0.02MG/ML/Neisseriameningiti|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|895756-PolyethyleneGlycol4000.004MG/MG/Propyleneglycol0.003MG/MGOphthalmicGel[Systane]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|864650-Ganciclovir0.0015MG/MGOphthalmicGel[Zirgan]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|876514-Amlodipine10MG/telmisartan40MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|864978-MethadoneHydrochloride40MGTabletforOralSuspension|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|847213-3MLInsulinLispro50UNT/ML/insulinlisproprotamine,human50UNT/MLPenInjector[HumalogMix]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|847199-3MLinsulinisophane,human100UNT/MLPenInjector[HumulinN]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2047596-1MLepoetinalfa-epbx10000UNT/MLInjection[Retacrit]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|847189-3MLinsulinisophane,human70UNT/ML/insulin,regular,human30UNT/MLPenInjector[Humulin]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|836634-1MLhepatitisAvirusstrainCR326Fantigen,inactivated50UNT/MLPrefilledSyringe[Vaqta]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|876519-Amlodipine10MG/telmisartan80MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|830263-1MLHepatitisBSurfaceAntigenVaccine0.04MG/MLInjection[Recombivax]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|830253-0.5MLHepatitisBSurfaceAntigenVaccine0.01MG/MLPrefilledSyringe[Recombivax]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|197696-72HRFentanyl0.075MG/HRTransdermalSystem|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|830245-1MLHepatitisBSurfaceAntigenVaccine0.01MG/MLPrefilledSyringe[Recombivax]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|804186-0.5MLMeaslesVirusVaccineLive,Enders'attenuatedEdmonstonstrain2000UNT/ML/MumpsVirusVaccineLive,JerylLynnStrain25000UNT/|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|864706-MethadoneHydrochloride10MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|803371-1MLHepatitisAVaccine(Inactivated)StrainHM175720UNT/ML/HepatitisBSurfaceAntigenVaccine0.02MG/MLPrefilledSyringe[Twinrix|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|798482-0.5MLHepatitisAVaccine(Inactivated)StrainHM1751440UNT/MLPrefilledSyringe[Havrix]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|876524-Amlodipine5MG/telmisartan40MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|798479-1MLHepatitisAVaccine(Inactivated)StrainHM1751440UNT/MLPrefilledSyringe[Havrix]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|798428-1MLHepatitisBSurfaceAntigenVaccine0.02MG/MLPrefilledSyringe[Engerix-B]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|797641-0.5MLNeisseriameningitidisserogroupAcapsularpolysaccharidediphtheriatoxoidproteinconjugatevaccine0.104MG/ML/Neisseriam|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|795737-ChantixStartingMonthPAK|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|795735-ChantixContinuingMonthsOfTherapy1MGPack|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|762602-SalmonellatyphiTy21aliveantigen2000000000UNTDelayedReleaseOralCapsule[Vivotif]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|752388-InsulinLispro25UNT/ML/insulinlisproprotamine,human75UNT/MLInjectableSuspension[HumalogMix]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|731281-InsulinLispro50UNT/ML/insulinlisproprotamine,human50UNT/MLInjectableSuspension[HumalogMix]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|707566-PolyethyleneGlycol4004MG/ML/Propyleneglycol3MG/MLOphthalmicSolution[Systane]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|881341-adefovirdipivoxil10MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|637190-varenicline1MGOralTablet[Chantix]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|637188-varenicline0.5MGOralTablet[Chantix]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|630981-PolyvinylAlcohol27MG/ML/Povidone20MG/MLOphthalmicSolution[Freshkote]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2047614-1MLepoetinalfa-epbx4000UNT/MLInjection[Retacrit]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|404448-84HRoxybutynin0.162MG/HRTransdermalSystem[Oxytrol]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2047608-1MLepoetinalfa-epbx3000UNT/MLInjection[Retacrit]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|351859-insulin,regular,human500UNT/MLInjectableSolution[HumulinR]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|351433-24HRNicotine0.292MG/HRTransdermalSystem[NicodermC-Q]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|351429-24HRNicotine0.875MG/HRTransdermalSystem[NicodermC-Q]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2047623-1MLepoetinalfa-epbx40000UNT/MLInjection[Retacrit]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|351427-24HRNicotine0.583MG/HRTransdermalSystem[NicodermC-Q]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|311036-insulin,regular,human100UNT/MLInjectableSolution[HumulinR]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|886634-ButorphanolTartrate1MG/ACTUATMeteredDoseNasalSpray|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|311033-insulin,regular,human100UNT/MLInjectableSolution[NovolinR]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|311027-insulinisophane,human100UNT/MLInjectableSuspension[NovolinN]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|311026-insulinisophane,human100UNT/MLInjectableSuspension[HumulinN]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|261315-Oseltamivir75MGOralCapsule[Tamiflu]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|2360588-0.5MLNeisseriameningitidisserogroupAcapsularpolysaccharidetetanustoxoidproteinconjugatevaccine0.02MG/ML/Neisseriameni|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|2166928-10ACTUATolodaterol0.0025MG/ACTUAT/tiotropium0.0025MG/ACTUATInhalationSpray[Stiolto]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|2166204-10ACTUATtiotropium0.0025MG/ACTUATInhalationSpray[Spiriva]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2048568-tofacitinib10MGOralTablet[Xeljanz]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|213442-insulinisophane,human70UNT/ML/insulin,regular,human30UNT/MLInjectableSuspension[Novolin]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|211947-Atovaquone150MG/MLOralSuspension[Mepron]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|211609-hypromellose5MG/MLOphthalmicSolution[IsoptoAlkaline]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|892349-24HRMorphineSulfate60MGExtendedReleaseOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|211140-PentosanPolysulfate100MGOralCapsule[Elmiron]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|2106334-0.5MLdiphtheriatoxoidvaccine,inactivated4UNT/ML/tetanustoxoidvaccine,inactivated4UNT/MLInjection[Tdvax]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|208821-Dexamethasone0.001MG/MG/Tobramycin0.003MG/MGOphthalmicOintment[Tobradex]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1858833-12HRTreprostinil5MGExtendedReleaseOralTablet[Orenitram]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|2059017-rivaroxaban2.5MGOralTablet[Xarelto]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|892342-24HRMorphineSulfate30MGExtendedReleaseOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|2053927-sodiumzirconiumcyclosilicate10000MGPowderforOralSuspension[Lokelma]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|2050059-0.5MLHepatitisBSurfaceAntigenVaccine0.04MG/MLPrefilledSyringe[Heplisav-B]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|2047639-sodiumzirconiumcyclosilicate5000MGPowderforOralSuspension[Lokelma]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|2045382-30ACTUATfluticasonefuroate0.05MG/ACTUATDryPowderInhaler[Arnuity]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|2000136-Vancomycin50MG/MLOralSolution[Firvanq]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|2000133-Vancomycin25MG/MLOralSolution[Firvanq]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|897021-12HRdalfampridine10MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|1994352-0.5MLHepatitisBSurfaceAntigenVaccine0.04MG/MLInjection[Heplisav-B]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|1992428-Eliquis30-DayStarterPack|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2053519-ivacaftor188MG/lumacaftor150MGOralGranules[ORKAMBI]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|1992171-3MLInsulinLispro100UNT/MLPenInjector[Admelog]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|1992169-InsulinLispro100UNT/MLInjectableSolution[Admelog]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|898715-pregabalin20MG/MLOralSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|1986830-0.5MLVaricellazostervirusglycoproteinE,recombinant0.1MG/MLInjection[Shingrix]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|1797888-Nicotine0.5MG/ACTUATMeteredDoseNasalSpray[Nicotrol]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|1736863-3MLInsulinGlargine100UNT/MLPenInjector[Basaglar]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197558-Dapsone25MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|1731317-3MLinsulin,regular,human500UNT/MLPenInjector[HumulinR]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|1723478-dabigatranetexilate110MGOralCapsule[Pradaxa]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|1667882-60ACTUATtiotropium0.00125MG/ACTUATInhalationSpray[Spiriva]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|900038-PhentermineHydrochloride30MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|205532-DornaseAlfa1MG/MLInhalationSolution[Pulmozyme]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|1658472-0.5MLStreptococcuspneumoniaetype1capsularpolysaccharideantigen0.05MG/ML/Streptococcuspneumoniaetype10Acapsularpolysac|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|1658157-1MLHepatitisBSurfaceAntigenVaccine0.02MG/MLInjection[Engerix-B]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|1658155-0.5MLHepatitisBSurfaceAntigenVaccine0.01MG/MLInjection[Recombivax]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|1658150-1MLHepatitisBSurfaceAntigenVaccine0.01MG/MLInjection[Recombivax]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|900156-24HRlamotrigine200MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|1658106-0.5MLhepatitisAvirusstrainCR326Fantigen,inactivated50UNT/MLInjection[Vaqta]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|1658102-1MLhepatitisAvirusstrainCR326Fantigen,inactivated50UNT/MLInjection[Vaqta]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|1923826-deferasirox360MGOralGranules|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|1658060-1MLHepatitisAVaccine(Inactivated)StrainHM1751440UNT/MLInjection[Havrix]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|1656356-sacubitril97MG/valsartan103MGOralTablet[Entresto]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|1656351-sacubitril49MG/valsartan51MGOralTablet[Entresto]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|900164-24HRlamotrigine25MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|1656346-sacubitril24MG/valsartan26MGOralTablet[Entresto]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|1601407-0.5MLmeningococcalgroupBvaccine0.1MG/ML/NeisseriameningitidisserogroupBrecombinantFHBPfusionproteinantigen0.1MG/ML/Ne|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|1597103-0.5MLL1protein,Humanpapillomavirustype11Vaccine0.08MG/ML/L1protein,Humanpapillomavirustype16Vaccine0.12MG/ML/L1protei|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2056670-AimovigAutoinjector2-Pack(140MGDose)|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|1597099-0.5MLL1protein,Humanpapillomavirustype11Vaccine0.08MG/ML/L1protein,Humanpapillomavirustype16Vaccine0.12MG/ML/L1protei|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|1596445-7ACTUATumeclidinium0.0625MG/ACTUATDryPowderInhaler[Incruse]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|1811182-icosapentethyl500MGOralCapsule[Vascepa]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|1593140-0.5MLNeisseriameningitidisserogroupBrecombinantLP2086A05proteinvariantantigen0.12MG/ML/Neisseriameningitidisserogroup|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|1549683-Xarelto30-DayStarterPackKit|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2056700-1.5MLfremanezumab-vfrm150MG/MLPrefilledSyringe[Ajovy]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|1547950-CarboxymethylcelluloseSodium2.5MG/MLOphthalmicSolution[TheraTears]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|1547672-30ACTUATfluticasonefuroate0.2MG/ACTUATDryPowderInhaler[Arnuity]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|1547664-14ACTUATfluticasonefuroate0.1MG/ACTUATDryPowderInhaler[Arnuity]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|1547582-0.5MLStreptococcuspneumoniaetype1capsularpolysaccharideantigen0.05MG/ML/Streptococcuspneumoniaetype10Acapsularpolysac|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|1364447-apixaban5MGOralTablet[Eliquis]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|1923822-deferasirox90MGOralGranules|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|1364441-apixaban2.5MGOralTablet[Eliquis]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|1363484-hypromellose0.003MG/MGOphthalmicGel[SystaneOvernightTherapy]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|1300468-0.5MLHaemophilusinfluenzaetypebstrain1482,capsularpolysaccharideinactivatedtetanustoxoidconjugatevaccine0.068MG/MLInj|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|903847-PyridostigmineBromide180MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|1300378-0.5MLBordetellapertussisfilamentoushemagglutininvaccine,inactivated0.016MG/ML/Bordetellapertussispertactinvaccine,ina|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2057216-0.8MLfilgrastim-aafi0.6MG/MLPrefilledSyringe[Nivestym]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|1300370-0.5MLBordetellapertussisfilamentoushemagglutininvaccine,inactivated0.016MG/ML/Bordetellapertussispertactinvaccine,ina|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|1300206-0.5MLBordetellapertussisfilamentoushemagglutininvaccine,inactivated0.01MG/ML/Bordetellapertussisfimbriae2/3vaccine,in|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|1292459-0.5MLVaricella-ZosterVirusVaccineLive(Oka-Merck)strain2700UNT/MLInjection[Varivax]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|1190919-0.5MLdiphtheriatoxoidvaccine,inactivated4UNT/ML/tetanustoxoidvaccine,inactivated10UNT/MLPrefilledSyringe[Tenivac]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|1190916-0.5MLdiphtheriatoxoidvaccine,inactivated4UNT/ML/tetanustoxoidvaccine,inactivated10UNT/MLInjection[Tenivac]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2058877-1MLgalcanezumab-gnlm120MG/MLAuto-Injector[Emgality]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|1115892-MineralOil0.15MG/MG/Petrolatum0.85MG/MGOphthalmicOintment[Puralube]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|106892-insulinisophane,human70UNT/ML/insulin,regular,human30UNT/MLInjectableSuspension[Humulin]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|1049216-Acetaminophen325MG/OxycodoneHydrochloride10MGOralTablet[Endocet]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|1046920-Nicotine4MGInhalationSolution[Nicotrol]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|Y||Preferred Brand|1037181-dabigatranetexilate75MGOralCapsule[Pradaxa]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|999613-SulfacetamideSodium100MG/ML/Sulfur50MG/MLMedicatedLiquidSoap|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|997501-Fexofenadinehydrochloride60MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|997491-Fexofenadinehydrochloride6MG/MLOralSuspension|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|904952-3MLibandronicacid1MG/MLPrefilledSyringe|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|903857-PyridostigmineBromide60MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|997420-Fexofenadinehydrochloride180MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|997229-Donepezilhydrochloride5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|903843-PyridostigmineBromide12MG/MLOralSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|997226-Donepezilhydrochloride5MGDisintegratingOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|997223-Donepezilhydrochloride10MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|968766-PhentermineHydrochloride15MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|997220-Donepezilhydrochloride10MGDisintegratingOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|996824-MethylergonovineMaleate0.2MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|1918042-abirateroneacetate500MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|996572-{21(Memantinehydrochloride10MGOralTablet)/28(Memantinehydrochloride5MGOralTablet)}Pack|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|996571-Memantinehydrochloride5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|996561-Memantinehydrochloride10MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|996520-DextromethorphanHydrobromide2MG/ML/Guaifenesin20MG/MLOralSolution|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|990982-2MLphysostigminesalicylate1MG/MLInjection|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|995666-MeclizineHydrochloride25MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|995632-MeclizineHydrochloride25MGChewableTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|142034-BenzoylPeroxide100MG/MLMedicatedLiquidSoap|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|995624-MeclizineHydrochloride12.5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|995607-EthambutolHydrochloride400MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|992395-gatifloxacin5MG/MLOphthalmicSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|995599-EthambutolHydrochloride100MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|995281-HydroxyzineHydrochloride50MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|995278-HydroxyzinePamoate50MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|995258-HydroxyzineHydrochloride25MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|995253-HydroxyzinePamoate25MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|998189-everolimus2.5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|995241-HydroxyzineHydrochloride2MG/MLOralSolution|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2058887-1MLgalcanezumab-gnlm120MG/MLPrefilledSyringe[Emgality]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|995232-HydroxyzinePamoate100MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|995218-HydroxyzineHydrochloride10MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2058950-0.5MLomalizumab150MG/MLPrefilledSyringe[Xolair]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|993943-Acetaminophen325MG/butalbital50MG/Caffeine40MG/CodeinePhosphate30MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2058946-1MLomalizumab150MG/MLPrefilledSyringe[Xolair]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|993691-BupropionHydrochloride75MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|993687-BupropionHydrochloride100MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|993557-24HRBupropionHydrochloride300MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|205912-EpoetinAlfa10000UNT/MLInjectableSolution[Epogen]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|993541-24HRBupropionHydrochloride150MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|993536-12HRBupropionHydrochloride200MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|999967-Amlodipine5MG/Hydrochlorothiazide12.5MG/Olmesartanmedoxomil20MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|993518-12HRBupropionHydrochloride150MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|993503-12HRBupropionHydrochloride100MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|992780-MiconazoleNitrate100MGVaginalInsert|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|1874559-24HRdesvenlafaxinesuccinate50MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|992775-{1(MiconazoleNitrate1200MGVaginalInsert)/1(9000MG)(MiconazoleNitrate20MG/MLVaginalCream)}Pack|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|992528-Terbinafinehydrochloride10MG/MLTopicalCream|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|992475-PromethazineHydrochloride50MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|992454-PromethazineHydrochloride25MGRectalSuppository|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|205917-1MLEpoetinAlfa2000UNT/MLInjection[Epogen]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|992447-PromethazineHydrochloride25MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|992441-PromethazineHydrochloride12.5MGRectalSuppository|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|992438-PromethazineHydrochloride12.5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|999991-Amlodipine10MG/Hydrochlorothiazide25MG/Olmesartanmedoxomil40MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|992432-PromethazineHydrochloride1.25MG/MLOralSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|992184-methenaminemandelate500MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|992153-methenaminemandelate1000MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|991086-DicyclomineHydrochloride20MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|999986-Amlodipine10MG/Hydrochlorothiazide12.5MG/Olmesartanmedoxomil40MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|991061-DicyclomineHydrochloride10MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|979492-LosartanPotassium50MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|979485-LosartanPotassium25MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|979480-LosartanPotassium100MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|979475-MetaproterenolSulfate20MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|979471-Hydrochlorothiazide25MG/LosartanPotassium100MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|999996-Amlodipine5MG/Hydrochlorothiazide12.5MG/Olmesartanmedoxomil40MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|979468-Hydrochlorothiazide12.5MG/LosartanPotassium50MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|979464-Hydrochlorothiazide12.5MG/LosartanPotassium100MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2059189-amikacinliposomal70.3MG/MLInhalationSuspension[Arikayce]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|979444-MetaproterenolSulfate2MG/MLOralSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|979409-MetaproterenolSulfate10MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|979092-HydroxychloroquineSulfate200MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|978006-LoperamideHydrochloride2MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|966920-POLYETHYLENEGLYCOL3350236000MG/PotassiumChloride2970MG/SodiumBicarbonate6740MG/SodiumChloride5860MG/sodiumsulfate22740|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197595-Dicloxacillin250MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|966914-POLYETHYLENEGLYCOL3350240000MG/PotassiumChloride2980MG/SodiumBicarbonate6720MG/SodiumChloride5840MG/sodiumsulfate22720|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|966270-LevothyroxineSodium0.137MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|966253-LevothyroxineSodium0.088MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|Y||Preferred Brand|665036-sitagliptin100MGOralTablet[Januvia]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|205922-1MLEpoetinAlfa3000UNT/MLInjection[Procrit]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|966249-LevothyroxineSodium0.175MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|966248-LevothyroxineSodium0.112MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|966225-LevothyroxineSodium0.15MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|966224-LevothyroxineSodium0.125MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|Y||Preferred Brand|665040-sitagliptin25MGOralTablet[Januvia]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|966222-LevothyroxineSodium0.075MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|966221-LevothyroxineSodium0.05MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|1874553-24HRdesvenlafaxinesuccinate100MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|966220-LevothyroxineSodium0.025MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|905395-HydralazineHydrochloride50MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|905225-HydralazineHydrochloride25MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|Y||Preferred Brand|665044-sitagliptin50MGOralTablet[Januvia]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|905222-HydralazineHydrochloride100MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|905199-HydralazineHydrochloride10MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|905158-Sirolimus0.5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|205923-1MLEpoetinAlfa4000UNT/MLInjection[Epogen]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|904932-ibandronicacid150MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|904481-PravastatinSodium80MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|904475-PravastatinSodium40MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|904467-PravastatinSodium20MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|205924-1MLEpoetinAlfa4000UNT/MLInjection[Procrit]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|904458-PravastatinSodium10MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|904431-Alendronicacid70MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|Y||Preferred Brand|804547-difluprednate0.5MG/MLOphthalmicSuspension[Durezol]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|904396-Alendronicacid35MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|904170-PrimaquinePhosphate26.3MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|903891-FluvoxamineMaleate50MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|1860157-Abuse-Deterrent12HROxycodoneHydrochloride10MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|903887-FluvoxamineMaleate25MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|903884-FluvoxamineMaleate100MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|903703-liothyroninesodium0.05MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|Y||Preferred Brand|861771-Metforminhydrochloride1000MG/sitagliptin50MGOralTablet[Janumet]|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|205918-1MLEpoetinAlfa2000UNT/MLInjection[Procrit]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|903697-liothyroninesodium0.025MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|903456-liothyroninesodium0.005MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|898723-Benazeprilhydrochloride5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|898690-Benazeprilhydrochloride20MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|898687-Benazeprilhydrochloride10MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|1860151-Abuse-Deterrent12HROxycodoneHydrochloride30MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|898378-Benazeprilhydrochloride5MG/Hydrochlorothiazide6.25MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|208083-sargramostim0.25MG/MLInjectableSolution[Leukine]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|898372-Benazeprilhydrochloride20MG/Hydrochlorothiazide25MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|898367-Benazeprilhydrochloride20MG/Hydrochlorothiazide12.5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|898359-Amlodipine5MG/Benazeprilhydrochloride40MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197622-Dipyridamole50MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|898356-Amlodipine5MG/Benazeprilhydrochloride20MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|898353-Amlodipine5MG/Benazeprilhydrochloride10MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|898350-Amlodipine2.5MG/Benazeprilhydrochloride10MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|898346-Amlodipine10MG/Benazeprilhydrochloride40MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|898342-Amlodipine10MG/Benazeprilhydrochloride20MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|Y||Preferred Generic|106302-Tretinoin0.25MG/MLTopicalCream|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|Y||Preferred Brand|861821-Metforminhydrochloride500MG/sitagliptin50MGOralTablet[Janumet]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|897722-Verapamilhydrochloride40MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|897683-Verapamilhydrochloride80MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2102705-0.6MLpegfilgrastim-cbqv10MG/MLPrefilledSyringe[Udenyca]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|897666-Verapamilhydrochloride120MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|897649-Verapamilhydrochloride240MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|Y||Preferred Generic|106303-Tretinoin0.5MG/MLTopicalCream|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|897624-24HRVerapamilhydrochloride240MGExtendedReleaseOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|897596-24HRVerapamilhydrochloride300MGExtendedReleaseOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|1860154-Abuse-Deterrent12HROxycodoneHydrochloride15MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|897590-24HRVerapamilhydrochloride200MGExtendedReleaseOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|897584-24HRVerapamilhydrochloride100MGExtendedReleaseOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|896766-Labetalolhydrochloride300MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|896762-Labetalolhydrochloride200MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|Y||Preferred Generic|197634-dronabinol10MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|896758-Labetalolhydrochloride100MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|896209-60ACTUATFluticasonepropionate0.25MG/ACTUAT/salmeterol0.05MG/ACTUATDryPowderInhaler|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|895987-Fluticasonepropionate0.5MG/MLTopicalCream|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|895487-Fluticasonepropionate0.00005MG/MGTopicalOintment|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|892255-LevothyroxineSodium0.3MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|892251-LevothyroxineSodium0.2MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|892246-LevothyroxineSodium0.1MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|886671-FlecainideAcetate150MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|886666-FlecainideAcetate100MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|Y||Preferred Generic|197636-dronabinol5MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|886662-FlecainideAcetate50MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|885857-Balsalazidedisodium750MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|884707-Estradiol0.01MGVaginalInsert|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2107351-prucalopride1MGOralTablet[Motegrity]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|884308-Nystatin100UNT/MGTopicalOintment|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2106362-rifamycinSV194MGDelayedReleaseOralTablet[Aemcolo]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|884189-ClonidineHydrochloride0.3MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|884185-ClonidineHydrochloride0.2MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|884173-ClonidineHydrochloride0.1MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2107355-prucalopride2MGOralTablet[Motegrity]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|876193-POLYETHYLENEGLYCOL335017000MGPowderforOralSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|866924-MetoprololTartrate25MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|Y||Preferred Generic|198300-Tretinoin1MG/MLTopicalCream|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|866514-MetoprololTartrate50MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|866511-MetoprololTartrate100MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|207059-interferonbeta-1b0.3MGInjection[Betaseron]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|866436-24HRmetoprololsuccinate50MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|866427-24HRmetoprololsuccinate25MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|866419-24HRmetoprololsuccinate200MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|866412-24HRmetoprololsuccinate100MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|866144-Cyproheptadinehydrochloride4MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|1734399-1MLGranisetron1MG/MLInjection|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|866111-buspironehydrochloride7.5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|866094-buspironehydrochloride5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|866090-buspironehydrochloride30MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|Y||Preferred Generic|310140-eprosartan600MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|866083-buspironehydrochloride10MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|866018-buspironehydrochloride15MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|863669-Tamsulosinhydrochloride0.4MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|863664-Oxybutyninchloride5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|Y||Preferred Generic|245723-Tretinoin0.0005MG/MGTopicalGel|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|863636-24HROxybutyninchloride5MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|863628-24HROxybutyninchloride15MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|863619-24HROxybutyninchloride10MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|861753-Glyburide5MG/Metforminhydrochloride500MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|861748-Glyburide2.5MG/Metforminhydrochloride500MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|861743-Glyburide1.25MG/Metforminhydrochloride250MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|Y||Preferred Generic|312084-Ondansetron24MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|861657-24HRNitroglycerin0.1MG/HRTransdermalSystem|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|861495-ClobetasolPropionate0.5MG/MLTopicalCream|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|1597123-2500MGTestosterone0.01MG/MGTopicalGel|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|861487-ClobetasolPropionate0.5MG/MLTopicalSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|861448-ClobetasolPropionate0.0005MG/MGTopicalOintment|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|Y||Preferred Generic|313450-Tretinoin0.0001MG/MGTopicalGel|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|861430-PropafenoneHydrochloride300MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|861427-PropafenoneHydrochloride225MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|861424-PropafenoneHydrochloride150MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|197626-Doxazosin2MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|861416-Azithromycin1000MGPowderforOralSuspension|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|861200-Brimonidinetartrate2MG/MLOphthalmicSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|861171-12HRPropafenoneHydrochloride425MGExtendedReleaseOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|Y||Preferred Generic|313451-Tretinoin0.00025MG/MGTopicalGel|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|212218-EpoetinAlfa20000UNT/MLInjectableSolution[Epogen]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|861164-12HRPropafenoneHydrochloride325MGExtendedReleaseOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|861156-12HRPropafenoneHydrochloride225MGExtendedReleaseOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|861132-24HRAlfuzosinhydrochloride10MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|861064-Sertraline20MG/MLOralSolution|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|Y||Preferred Generic|577033-sildenafil20MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|861010-Metforminhydrochloride850MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|861007-Metforminhydrochloride500MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|1860148-Abuse-Deterrent12HROxycodoneHydrochloride80MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|861004-Metforminhydrochloride1000MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|860981-24HRMetforminhydrochloride750MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|860975-24HRMetforminhydrochloride500MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|Y||Preferred Generic|835809-testosteroneenanthate200MG/MLInjectableSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|860805-Azelastinehydrochloride0.5MG/MLOphthalmicSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|860225-MegestrolAcetate40MG/MLOralSuspension|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|860221-MegestrolAcetate40MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|212219-EpoetinAlfa20000UNT/MLInjectableSolution[Procrit]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|860215-MegestrolAcetate20MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|860107-KetorolacTromethamine5MG/MLOphthalmicSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|859751-Rosuvastatincalcium20MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|859747-Rosuvastatincalcium10MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2123314-Mayzent0.25MGStarterPack|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|859424-Rosuvastatincalcium5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|859419-Rosuvastatincalcium40MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|859193-selegilinehydrochloride5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|859186-selegilinehydrochloride5MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|859052-Pramipexoledihydrochloride1MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|1860137-Abuse-Deterrent12HROxycodoneHydrochloride40MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|859048-Pramipexoledihydrochloride1.5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|859044-Pramipexoledihydrochloride0.5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|859040-Pramipexoledihydrochloride0.25MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|Y||Preferred Generic|891874-MorphineSulfate100MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|213475-1MLEpoetinAlfa40000UNT/MLInjection[Procrit]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|859033-Pramipexoledihydrochloride0.125MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|858828-EnalaprilMaleate10MG/Hydrochlorothiazide25MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|858824-EnalaprilMaleate5MG/Hydrochlorothiazide12.5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|858817-EnalaprilMaleate10MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|858813-EnalaprilMaleate5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|858810-EnalaprilMaleate20MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2166401-ivacaftor25MGOralGranules[Kalydeco]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|858804-EnalaprilMaleate2.5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|858747-Ursodiol300MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|858625-Pramipexoledihydrochloride0.75MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|858616-Nicardipinehydrochloride30MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|858613-Nicardipinehydrochloride20MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|857683-TerbutalineSulfate5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|857677-TerbutalineSulfate2.5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|857461-ClemastineFumarate2.68MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|Y||Preferred Generic|891888-MorphineSulfate30MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|857340-BethanecholChloride50MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|857336-BethanecholChloride5MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|Y||Preferred Generic|883826-TranexamicAcid650MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|857328-BethanecholChloride25MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|857321-BethanecholChloride10MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|Y||Preferred Generic|891893-MorphineSulfate60MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|857305-ClomipramineHydrochloride75MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|857301-ClomipramineHydrochloride50MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Generic|1860129-Abuse-Deterrent12HROxycodoneHydrochloride20MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|857297-ClomipramineHydrochloride25MGOralCapsule|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|857187-FosinoprilSodium40MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|857183-FosinoprilSodium20MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|857169-FosinoprilSodium10MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|Y||Preferred Generic|892646-MorphineSulfate200MGExtendedReleaseOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|856853-AmitriptylineHydrochloride75MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|856845-AmitriptylineHydrochloride50MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|856840-AmitriptylineHydrochloride50MG/Perphenazine4MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|856834-AmitriptylineHydrochloride25MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|856825-AmitriptylineHydrochloride25MG/Perphenazine4MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|856797-AmitriptylineHydrochloride25MG/Perphenazine2MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2001321-Roflumilast0.25MGOralTablet[Daliresp]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|856783-AmitriptylineHydrochloride10MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|856773-AmitriptylineHydrochloride150MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|856762-AmitriptylineHydrochloride100MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|856733-PropranololHydrochloride8MG/MLOralSolution|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2170613-1MLgalcanezumab-gnlm100MG/MLPrefilledSyringe[Emgality]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|856724-PropranololHydrochloride4MG/MLOralSolution|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|856720-AmitriptylineHydrochloride10MG/Perphenazine4MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|856706-AmitriptylineHydrochloride10MG/Perphenazine2MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|Y|N|N||Preferred Brand|2173822-1MLmepolizumab100MG/MLPrefilledSyringe[Nucala]|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|856578-PropranololHydrochloride80MGOralTablet|ADULT FULL DUALS/PARTIAL 632|2002|N|N|N||Preferred Generic|856556-PropranololHydrochloride60MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|856519-PropranololHydrochloride40MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|856457-PropranololHydrochloride20MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1005856-SulfacetamideSodium100MG/ML/Sulfur50MG/MLTopicalLotion|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|856448-PropranololHydrochloride10MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2182340-1MLEtanercept50MG/MLCartridge[Enbrel]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|856429-Hydrochlorothiazide25MG/PropranololHydrochloride80MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|856422-Hydrochlorothiazide25MG/PropranololHydrochloride40MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|1000487-Premphase28DayPack|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|856377-TrazodoneHydrochloride50MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1801278-HumiraPsoriasisStarterPack40MG/0.8MLPen(4count)|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|856373-TrazodoneHydrochloride100MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|856364-TrazodoneHydrochloride150MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|855926-DiclofenacSodium75MGDelayedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|855911-2MLPhenytoinsodium50MG/MLCartridge|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|855906-DiclofenacSodium50MGDelayedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|855873-Phenytoinsodium300MGExtendedReleaseOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|855861-Phenytoinsodium200MGExtendedReleaseOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2201540-romiplostim0.125MGInjection[Nplate]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|855818-prasugrel5MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|855812-prasugrel10MGOralTablet|AGED FULL DUALS 632|2002|N|Y|N||Preferred Generic|1368410-alogliptin12.5MG/pioglitazone30MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|855671-Phenytoinsodium100MGExtendedReleaseOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|855664-DiclofenacSodium25MGDelayedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|855480-alclometasonedipropionate0.0005MG/MGTopicalOintment|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2196592-120ACTUATformoterolfumarate0.005MG/ACTUAT/mometasonefuroate0.05MG/ACTUATMeteredDoseInhaler[Dulera]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|855474-alclometasonedipropionate0.5MG/MLTopicalCream|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|855344-WarfarinSodium7.5MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1006120-SulfacetamideSodium100MG/MLOphthalmicSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|855338-WarfarinSodium6MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|855332-WarfarinSodium5MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|855324-WarfarinSodium4MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2203893-sofosbuvir200MGOralTablet[Sovaldi]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|855318-WarfarinSodium3MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|855312-WarfarinSodium2.5MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|855302-WarfarinSodium2MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1006688-SulfacetamideSodium100MG/MLTopicalLotion|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|855296-WarfarinSodium10MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2203897-ledipasvir45MG/sofosbuvir200MGOralTablet[Harvoni]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|855288-WarfarinSodium1MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|855172-levocetirizinedihydrochloride5MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|855168-levocetirizinedihydrochloride0.5MG/MLOralSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|854905-BisoprololFumarate5MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|854901-BisoprololFumarate10MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|854801-DiclofenacSodium1MG/MLOphthalmicSolution|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2205634-1MLbenralizumab30MG/MLAuto-Injector[Fasenra]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|852913-QuinidineSulfate300MGOralTablet|AGED FULL DUALS 632|2002|N|Y|N||Preferred Generic|1368431-alogliptin25MG/pioglitazone30MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|852877-QuinidineSulfate200MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1799212-sofosbuvir400MG/velpatasvir100MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|1000497-Prempro0.45/1.528DayPack|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|849515-DesmopressinAcetate0.1MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|849506-DesmopressinAcetate0.01MG/ACTUATNasalSpray|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2174390-symdeko50MG/75MGand75MGPack|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|848943-CholestyramineResin4000MGPowderforOralSuspension|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|848176-AugmentedBetamethasone0.5MG/MLTopicalCream|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1799230-1MLabatacept125MG/MLAuto-Injector[Orencia]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|847121-CalciumCitrate1500MG/Cholecalciferol250UNTOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|1000491-Prempro0.3/1.528DayPack|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|836358-IpratropiumBromide0.2MG/MLInhalationSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|835925-cyclosporine,modified50MGOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2256947-lasmiditan50MGOralTablet[Reyvow]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|835913-MefloquineHydrochloride250MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|1000499-Prempro0.625/2.528DayPack|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|835894-cyclosporine,modified25MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|835886-cyclosporine,modified100MG/MLOralSolution|AGED FULL DUALS 632|2002|N|Y|N||Preferred Generic|1368438-alogliptin25MG/pioglitazone45MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|835593-ImipramineHydrochloride10MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|835568-ImipramineHydrochloride50MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|835564-ImipramineHydrochloride25MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|834127-chlorhexidinegluconate1.2MG/MLMouthwash|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|834102-PenicillinVPotassium500MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|834061-PenicillinVPotassium250MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2257013-trikafta100MG/50MG/75MGand150MGPack|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|834046-PenicillinVPotassium25MG/MLOralSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|834040-PenicillinVPotassium50MG/MLOralSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|1000500-Prempro0.625/528DayPack|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|833528-Amiodaronehydrochloride200MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|833217-DiltiazemHydrochloride30MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|833008-DesmopressinAcetate0.2MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|832909-CalciumCarbonate1250MG/Cholecalciferol100UNTChewableTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2262713-MicronizedIsotretinoin16MGOralCapsule[Absorica]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|831261-CromolynSodium20MG/MLOralSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|831109-CromolynSodium40MG/MLOphthalmicSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|831103-DiltiazemHydrochloride60MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1010878-LidocaineHydrochloride40MG/MLMucousMembraneTopicalSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|831102-DiltiazemHydrochloride90MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|831054-DiltiazemHydrochloride120MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1011852-LidocaineHydrochloride0.02MG/MGTopicalGel|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|830882-24HRDiltiazemHydrochloride300MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|828348-Cyclobenzaprinehydrochloride10MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|828320-Cyclobenzaprinehydrochloride5MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|801054-POLYETHYLENEGLYCOL3350420000MG/PotassiumChloride1480MG/SodiumBicarbonate5720MG/SodiumChloride11200MGPowderforOralSolut|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|763185-{21(Prednisone10MGOralTablet)}Pack|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|1005928-ulipristalacetate30MGOralTablet[Ella]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|763181-{21(Prednisone5MGOralTablet)}Pack|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1012021-Prednisolonesodiumphosphate2.5MG/ML/SulfacetamideSodium100MG/MLOphthalmicSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|762675-{21(Methylprednisolone4MGOralTablet)}Pack|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|756209-Zidovudine10MG/MLOralSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|755497-Albuterol0.4MG/MLOralSolution|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2262727-MicronizedIsotretinoin32MGOralCapsule[Absorica]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|751901-{84(EthinylEstradiol0.03MG/Levonorgestrel0.15MGOralTablet)/7(InertIngredients1MGOralTablet)}Pack|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2262719-MicronizedIsotretinoin24MGOralCapsule[Absorica]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|749860-{21(EthinylEstradiol0.035MG/norgestimate0.25MGOralTablet)/7(InertIngredients1MGOralTablet)}Pack|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|200220-tolcapone100MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|749784-{7(EthinylEstradiol0.035MG/norgestimate0.18MGOralTablet)/7(EthinylEstradiol0.035MG/norgestimate0.215MGOralTablet)/7(Et|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1014314-TriamcinoloneAcetonide1MG/MLTopicalCream|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|749783-{6(Azithromycin250MGOralTablet)}Pack|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2262731-MicronizedIsotretinoin8MGOralCapsule[Absorica]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|749780-{3(Azithromycin500MGOralTablet)}Pack|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|749157-{7(EthinylEstradiol0.025MG/norgestimate0.18MGOralTablet)/7(EthinylEstradiol0.025MG/norgestimate0.215MGOralTablet)/7(Et|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|748961-{28(Norethindrone0.35MGOralTablet)}Pack|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1796091-24HRLinagliptin2.5MG/Metforminhydrochloride1000MGExtendedReleaseOralTablet[Jentadueto]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|748868-{21(EthinylEstradiol0.02MG/Levonorgestrel0.1MGOralTablet)/7(InertIngredients1MGOralTablet)}Pack|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2256943-lasmiditan100MGOralTablet[Reyvow]|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|1000158-0.65MLmedroxyprogesteroneacetate160MG/MLPrefilledSyringe[depo-subQprovera]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|748800-{21(drospirenone3MG/EthinylEstradiol0.03MGOralTablet)/7(InertIngredients1MGOralTablet)}Pack|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|727316-NDA0194300.3MLEpinephrine0.5MG/MLAuto-Injector|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|722137-Amlodipine5MG/valsartan320MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|722134-Amlodipine5MG/valsartan160MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|1020155-Introvale91DayPack|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|722131-Amlodipine10MG/valsartan320MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|722126-Amlodipine10MG/valsartan160MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2268227-ubrogepant100MGOralTablet[Ubrelvy]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|702519-Phenobarbital4MG/MLOralSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1014571-12HRcetirizinehydrochloride5MG/PseudoephedrineHydrochloride120MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|702249-ferroussulfate44MG/MLOralSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|692783-Loratadine1MG/MLOralSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|686924-carvedilol3.125MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|686418-ErythromycinEthylsuccinate80MG/MLOralSuspension|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2268231-ubrogepant50MGOralTablet[Ubrelvy]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|686405-ErythromycinEthylsuccinate400MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|102250-Hydrocortisone1.67MG/MLEnema[Cortenema]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|686400-ErythromycinEthylsuccinate40MG/MLOralSuspension|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|647121-5MLLevetiracetam100MG/MLInjection|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|753482-Apri28DayPack|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|646456-Nystatin100UNT/MGTopicalPowder|AGED FULL DUALS 632|2002|N|Y|N||Preferred Generic|197505-Cimetidine200MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|646333-Capsaicin1MG/MLTopicalCream|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|643102-Ibuprofen200MGOralTablet[Wal-Profen]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|639566-VitaminB650MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|628953-PotassiumChloride10MEQExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1014673-cetirizinehydrochloride1MG/MLOralSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|617993-Amoxicillin120MG/ML/Clavulanate8.58MG/MLOralSuspension|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|226917-orlistat120MGOralCapsule[Xenical]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|617430-Amoxicillin80MG/ML/Clavulanate11.4MG/MLOralSuspension|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|617423-Amoxicillin40MG/ML/Clavulanate5.7MG/MLOralSuspension|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|1039273-Hydrocortisone10MG/MLTopicalSolution[ScalpicinItchRelief]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|617322-Amoxicillin50MG/ML/Clavulanate12.5MG/MLOralSuspension|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1790546-infliximab-dyyb100MGInjection[Inflectra]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|617316-Amoxicillin400MG/Clavulanate57MGChewableTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|617312-atorvastatin10MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|617311-atorvastatin40MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1793916-0.5MLSumatriptan8MG/MLAuto-Injector|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|617310-atorvastatin20MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|617309-Amoxicillin200MG/Clavulanate28.5MGChewableTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|617296-Amoxicillin500MG/Clavulanate125MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|598025-Amoxicillin250MGChewableTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2282320-Rimegepant75MGDisintegratingOralTablet[Nurtec]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|598006-Erythromycin250MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|597852-anagrelide1MGOralCapsule|AGED FULL DUALS 632|2002|N|Y|N||Preferred Generic|197984-Minocycline100MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|596843-lansoprazole15MGDelayedReleaseOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|583170-Salsalate750MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|582926-podofilox5MG/MLTopicalSolution|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2273115-24HRtofacitinib22MGExtendedReleaseOralTablet[Xeljanz]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|577040-CalciumCarbonate648MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|1046771-12HRHyoscyamineSulfate0.375MGExtendedReleaseOralTablet[Levbid]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|562704-ropinirole4MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1014676-cetirizinehydrochloride5MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|562524-12HRAcetazolamide500MGExtendedReleaseOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|562510-SodiumFluoride2MG/MLMouthwash|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|562508-Amoxicillin875MG/Clavulanate125MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2282414-bempedoicacid180MGOralTablet[Nexletol]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|562251-Amoxicillin250MG/Clavulanate125MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|544455-Lactulose667MG/MLOralSolution[Generlac]|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|750839-erythromycinstearate250MGOralTablet[ErythrocinStearate]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|543546-Nystatin100000UNT/MLTopicalCream|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1014678-cetirizinehydrochloride10MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|486152-24HRNitroglycerin0.4MG/HRTransdermalSystem|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2283236-bempedoicacid180MG/ezetimibe10MGOralTablet[Nexlizet]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|486148-24HRNitroglycerin0.2MG/HRTransdermalSystem|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|486146-24HRNitroglycerin0.6MG/HRTransdermalSystem|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|486131-BenzoylPeroxide0.1MG/MGTopicalGel|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|476809-Mirtazapine7.5MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|476576-cefdinir50MG/MLOralSuspension|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|432402-cinacalcet30MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2287905-1.5MLfremanezumab-vfrm150MG/MLAuto-Injector[Ajovy]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|432401-cinacalcet60MGOralTablet|AGED FULL DUALS 632|2002|N|Y|N||Preferred Generic|239239-Griseofulvin250MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|432400-cinacalcet90MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1737461-PamidronateDisodium90MGInjection|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|1048452-ColestipolHydrochloride5000MGGranulesforOralSuspension[Colestid]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|429503-Hydrochlorothiazide12.5MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|403967-zonisamide50MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|403966-zonisamide25MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1020477-DiphenhydramineHydrochloride50MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|403855-Hydrochlorothiazide25MG/Olmesartanmedoxomil40MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197311-Acyclovir400MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|403854-Hydrochlorothiazide12.5MG/Olmesartanmedoxomil40MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|403853-Hydrochlorothiazide12.5MG/Olmesartanmedoxomil20MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|402698-24HRFelodipine2.5MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2359290-24HRempagliflozin12.5MG/linagliptin2.5MG/metforminhydrochloride1000MGExtendedReleaseOralTablet[Trijardy]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|402696-24HRFelodipine5MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|105551-Busulfan2MGOralTablet[Myleran]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|402695-24HRFelodipine10MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|393245-Digoxin0.05MG/MLOralSolution|AGED FULL DUALS 632|2002|N|Y|N||Preferred Generic|242754-Levalbuterol0.417MG/MLInhalationSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|391937-Lactulose667MG/MLOralSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|387003-Levetiracetam1000MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|381056-IsosorbideDinitrate10MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|360110-Sirolimus2MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|359601-Guaifenesin400MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|359296-calciumacetate667MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|353538-24HRIsosorbideMononitrate60MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|351250-Escitalopram20MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|105553-Chlorambucil2MGOralTablet[Leukeran]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|351249-Escitalopram5MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|351172-Dutasteride0.5MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|351137-Albuterol0.21MG/MLInhalationSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|351136-Albuterol0.417MG/MLInhalationSolution|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2359358-24HRempagliflozin5MG/linagliptin2.5MG/metforminhydrochloride1000MGExtendedReleaseOralTablet[Trijardy]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|349420-desloratadine5MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|349405-Olmesartanmedoxomil40MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|349401-Olmesartanmedoxomil20MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|349373-Olmesartanmedoxomil5MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|349332-Escitalopram10MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|103401-Hydrocortisone0.025MG/MGTopicalOintment|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|349208-Sirolimus1MGOralTablet|AGED FULL DUALS 632|2002|N|Y|N||Preferred Generic|310600-Griseofulvin500MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|348472-Theophylline600MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|343033-Dexamethasone0.75MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|328161-Methylprednisolone16MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|328160-Cyclosporine100MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|105590-Thioguanine40MGOralTablet[Tabloid]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|318272-Aspirin81MGChewableTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|103403-Hydrocortisone10MG/MLTopicalLotion|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|317769-Theophylline300MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|317573-pioglitazone15MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2265689-Voxelotor500MGOralTablet[Oxbryta]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|317173-Captopril25MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|317136-Nortriptyline25MGOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2371768-Oriahnn28DayKit|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|317128-Misoprostol0.2MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|754766-Metronidazole0.0075MG/MGVaginalGel[MetroGel]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2359353-24HRempagliflozin25MG/linagliptin5MG/metforminhydrochloride1000MGExtendedReleaseOralTablet[Trijardy]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|317110-24HRIsosorbideMononitrate30MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|103456-Fluocinonide0.5MG/MLTopicalCream|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|315187-Prednisone1MG/MLOralSolution|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1597123-2500MGTestosterone0.01MG/MGTopicalGel|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|315183-PotassiumChloride8MEQExtendedReleaseOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|315134-Levocarnitine100MG/MLOralSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|315107-24HRGlipizide10MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1747181-0.4MLMethotrexate31.3MG/MLAuto-Injector[Otrexup]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|315102-SodiumFluoride1.1MG/MLOralSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|315090-Erythromycin333MGDelayedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|314277-venlafaxine50MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|314241-Theophylline450MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|314238-Tropicamide10MG/MLOphthalmicSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|1087012-thyroid(USP)32.5MGOralTablet[Westhroid]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|314234-Sucralfate1000MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|314231-Simvastatin10MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2395775-30ACTUATfluticasonefuroate0.2MG/ACTUAT/umeclidinium0.0625MG/ACTUAT/vilanterol0.025MG/ACTUATDryPowderInhaler[Trelegy]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|314208-ropinirole1MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|103457-Fluocinonide0.0005MG/MGTopicalOintment|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|314203-quinapril40MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|314182-PotassiumChloride2.67MEQ/MLOralSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|314165-prednisolone10MG/MLOphthalmicSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|314131-Niacin250MGExtendedReleaseOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2463733-epoetinalfa-epbx10000UNT/MLInjectableSolution[Retacrit]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|314111-Mirtazapine30MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|1095362-Balziva28DayPack|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|314106-Metronidazole250MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|314077-Lisinopril20MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|751884-Lutera28DayPack|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|314076-Lisinopril10MGOralTablet|AGED FULL DUALS 632|2002|N|Y|N||Preferred Generic|311347-linezolid600MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|314072-latanoprost0.05MG/MLOphthalmicSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|314055-IsosorbideDinitrate5MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|314006-24HRGlipizide5MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|314000-Glyburide1.5MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|103951-Tolnaftate10MG/MLTopicalCream|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|313989-Fluoxetine40MGOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2463737-epoetinalfa-epbx20000UNT/MLInjectableSolution[Retacrit]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|313988-Furosemide40MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|313979-fludrocortisoneacetate0.1MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|1098924-SodiumFluoride11MG/MLOralSolution[Flura-Drops]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|313919-salmoncalcitonin200UNT/ACTUATNasalSpray|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1746898-10MLreslizumab10MG/MLInjection[Cinqair]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|313888-Cefaclor50MG/MLOralSuspension|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|313850-Amoxicillin40MG/MLOralSuspension|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|313797-Amoxicillin25MG/MLOralSuspension|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|313786-AceticAcid20MG/ML/Hydrocortisone10MG/MLOticSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|313586-venlafaxine75MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|313585-24HRvenlafaxine75MGExtendedReleaseOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|313584-venlafaxine37.5MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2475406-voclosporin7.9MGOralCapsule[Lupkynis]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|313583-24HRvenlafaxine37.5MGExtendedReleaseOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|313582-venlafaxine25MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|313581-24HRvenlafaxine150MGExtendedReleaseOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|313580-venlafaxine100MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|313565-valacyclovir500MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2473042-ponatinib10MGOralTablet[Iclusig]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|313564-valacyclovir1000MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|313521-Tropicamide5MG/MLOphthalmicSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1043690-hydrocortisoneacetate10MG/MLTopicalCream|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|313477-Trifluridine10MG/MLOphthalmicSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|313428-Toremifene60MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|313423-Tolnaftate10MG/MLTopicalSolution|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2475852-vericiguat10MGOralTablet[Verquvo]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|313306-Theophylline5.33MG/MLOralSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|313291-Theophylline400MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1745108-1MLixekizumab80MG/MLAuto-Injector[Taltz]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|313227-terconazole8MG/MLVaginalCream|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1046985-HyoscyamineSulfate0.125MGDisintegratingOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|313226-terconazole4MG/MLVaginalCream|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2475856-vericiguat2.5MGOralTablet[Verquvo]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|313219-Terazosin5MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|313217-Terazosin2MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|313215-Terazosin1MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|313195-Tamoxifen20MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|313190-Tacrolimus0.5MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|313142-Sulfasalazine500MGDelayedReleaseOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2475860-vericiguat5MGOralTablet[Verquvo]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|313134-Sulfamethoxazole40MG/ML/Trimethoprim8MG/MLOralSuspension|AGED FULL DUALS 632|2002|N|Y|N||Preferred Generic|403852-Carbidopa37.5MG/entacapone200MG/Levodopa150MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|313123-Sucralfate100MG/MLOralSuspension|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1657173-0.5MLSumatriptan8MG/MLCartridge|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|1101778-Monobasicpotassiumphosphate0.0408MEQ/MLOralSolution[K-Phos]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|313096-Spironolactone25MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|313092-Sorbitol700MG/MLOralSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|312997-SodiumChloride9MG/MLInhalationSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|312962-Simvastatin5MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1745114-1MLixekizumab80MG/MLPrefilledSyringe[Taltz]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|312961-Simvastatin20MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|1099026-Loryna28DayPack|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|312941-Sertraline50MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|312940-Sertraline25MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2536554-24HRviloxazine100MGExtendedReleaseOralCapsule[Qelbree]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|312938-Sertraline100MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|1112715-Amethyst28DayPack|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|312899-Salsalate500MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|312849-ropinirole5MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|751875-Necon0.5/3528DayPack|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|312847-ropinirole2MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|312846-ropinirole0.5MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|312845-ropinirole0.25MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|312750-quinapril5MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|312749-quinapril20MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|312748-quinapril10MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2536752-24HRviloxazine150MGExtendedReleaseOralCapsule[Qelbree]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|312641-Progesterone200MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|312635-Prochlorperazine5MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|1113046-amylase15000UNT/lipase3000UNT/protease9500UNTDelayedReleaseOralCapsule[Creon]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|312617-Prednisone5MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|312615-Prednisone20MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|312594-Prazosin2MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|312593-Prazosin1MGOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2536758-24HRviloxazine200MGExtendedReleaseOralCapsule[Qelbree]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|312529-PotassiumChloride8MEQExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|Y|N||Preferred Generic|349590-Levalbuterol0.103MG/MLInhalationSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|312515-PotassiumChloride1.33MEQ/MLOralSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|312504-PotassiumChloride10MEQExtendedReleaseOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1047881-HyoscyamineSulfate0.025MG/MLOralSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|312441-pioglitazone45MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|312440-pioglitazone30MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1047895-HyoscyamineSulfate0.125MG/MLOralSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|312362-Phenobarbital30MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|312357-Phenobarbital15MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|312301-Pentoxifylline400MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|312289-Naloxone0.5MG/Pentazocine50MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|312138-oxcarbazepine600MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|1114041-DextromethorphanHydrobromide1MG/MLOralSolution[DayQuilCough]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|312137-oxcarbazepine300MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1047905-HyoscyamineSulfate0.125MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|312136-oxcarbazepine150MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|312059-Nystatin500000UNTOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|312055-Nystatin100000UNT/MLOralSuspension|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2557216-trikafta50MG/37.5MG/25MGand75MGPack|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|312036-Nortriptyline2MG/MLOralSolution|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2550713-0.5MLsecukinumab150MG/MLPrefilledSyringe[Cosentyx]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|312013-Nitroglycerin2.5MGExtendedReleaseOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|200328-capecitabine500MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|311995-NITROFURANTOIN,MACROCRYSTALS50MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|104884-Metoclopramide1MG/MLOralSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|311994-NITROFURANTOIN,MACROCRYSTALS25MGOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2559707-1.14MLdupilumab175MG/MLAuto-Injector[Dupixent]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|311989-Nitrofurantoin5MG/MLOralSuspension|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|311963-Niacin750MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|311960-Niacin500MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1741049-24HRtofacitinib11MGExtendedReleaseOralTablet[Xeljanz]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|311955-Niacin250MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|311893-nabumetone750MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|311892-nabumetone500MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|261105-Etanercept25MG/MLInjectableSolution[Enbrel]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|311727-Misoprostol0.1MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|311726-Mirtazapine45MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|1114135-amylase16000UNT/lipase3000UNT/protease10000UNTDelayedReleaseOralCapsule[Zenpep]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|311725-Mirtazapine15MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|311681-Metronidazole500MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|261362-alosetron1MGOralTablet[Lotronex]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|311679-Metronidazole0.0075MG/MGTopicalGel|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1049167-PseudoephedrineHydrochloride60MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|311678-Metronidazole7.5MG/MLTopicalCream|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|311668-Metoclopramide5MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|311666-Metoclopramide10MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|311665-Metipranolol3MG/MLOphthalmicSolution|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|352044-1MLdarbepoetinalfa0.025MG/MLInjection[Aranesp]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|311486-meloxicam7.5MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|1148646-28ACTUATFluticasonepropionate0.25MG/ACTUATDryPowderInhaler[Flovent]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|311376-Lorazepam2MG/MLOralSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|311372-Loratadine10MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|751871-Nortrel1/3521DayPack|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|311354-Lisinopril5MGOralTablet|AGED FULL DUALS 632|2002|N|Y|N||Preferred Generic|810090-Carbidopa18.75MG/entacapone200MG/Levodopa75MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|311353-Lisinopril2.5MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|311296-Levofloxacin750MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|311290-Levetiracetam750MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|311289-Levetiracetam500MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1049630-DiphenhydramineHydrochloride25MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|311288-Levetiracetam250MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|352045-1MLdarbepoetinalfa0.04MG/MLInjection[Aranesp]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|311277-lansoprazole30MGDelayedReleaseOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|311264-lamotrigine25MGChewableTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|311197-IsosorbideMononitrate20MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1734642-elbasvir50MG/grazoprevir100MGOralTablet[Zepatier]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|311196-24HRIsosorbideMononitrate120MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|311194-IsosorbideDinitrate40MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|311192-IsosorbideMononitrate10MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1607990-{24(EthinylEstradiol0.025MG/Norethindrone0.8MGChewableTablet)/4(Ferrousfumarate75MGChewableTablet)}Pack|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|311166-isoniazid100MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|310982-imiquimod50MG/MLTopicalCream|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|310965-Ibuprofen200MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|310964-Ibuprofen200MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1359779-Fluticasonepropionate0.1MG/ACTUAT/salmeterol0.05MG/ACTUATDryPowderInhaler|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|310891-Hydrocortisone25MG/MLTopicalCream|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|310818-Hydrochlorothiazide50MG/Triamterene75MGOralTablet|AGED FULL DUALS 632|2002|N|Y|N||Preferred Generic|855194-tolterodinetartrate2MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|310812-Hydrochlorothiazide25MG/Triamterene37.5MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|310809-Hydrochlorothiazide25MG/quinapril20MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|310798-Hydrochlorothiazide25MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|352046-1MLdarbepoetinalfa0.06MG/MLInjection[Aranesp]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|310797-Hydrochlorothiazide12.5MG/quinapril20MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|1233850-Vestura28DayPack|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|310796-Hydrochlorothiazide12.5MG/quinapril10MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1049906-DiphenhydramineHydrochloride2.5MG/MLOralSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|310687-Hydrocortisone10MG/ML/Neomycin3.5MG/ML/PolymyxinB10000UNT/MLOticSuspension|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|310594-Gramicidin0.025MG/ML/Neomycin1.75MG/ML/PolymyxinB10000UNT/MLOphthalmicSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|310539-Glyburide6MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|352262-1MLdarbepoetinalfa0.3MG/MLInjection[Aranesp]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|310537-Glyburide5MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|310536-Glyburide3MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1732161-incobotulinumtoxinA100UNTInjection[Xeomin]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|310534-Glyburide2.5MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1049909-DiphenhydramineHydrochloride25MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|310490-Glipizide5MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|404059-Isotretinoin10MGOralCapsule[Claravis]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|310489-24HRGlipizide2.5MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|310488-Glipizide10MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|310459-Gemfibrozil600MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|310442-Ganciclovir500MGInjection|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|310434-gabapentin800MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|310433-gabapentin600MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|404062-Isotretinoin20MGOralCapsule[Claravis]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|310432-gabapentin400MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|310431-gabapentin300MGOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1607792-deferasirox360MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|1250090-Nonoxynol-90.03MG/MGVaginalGel[GynolII]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|310430-gabapentin100MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|310429-Furosemide20MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|310410-FolicAcid1MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1050077-DiphenhydramineHydrochloride20MG/MLTopicalCream|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|310386-Fluoxetine4MG/MLOralSolution|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1732165-incobotulinumtoxinA200UNTInjection[Xeomin]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|310385-Fluoxetine20MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|310384-Fluoxetine10MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|310380-Fluorouracil50MG/MLTopicalSolution|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|404449-Thalidomide100MGOralCapsule[Thalomid]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|310379-Fluorouracil20MG/MLTopicalSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|1293639-Caffeine100MG/ErgotamineTartrate2MGRectalSuppository[Migergot]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|310377-Fluorometholone1MG/MLOphthalmicSuspension|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|310364-Fluocinonide0.5MG/MLTopicalSolution|AGED FULL DUALS 632|2002|N|Y|N||Preferred Generic|996603-24HRMemantinehydrochloride21MGExtendedReleaseOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|310362-Fluocinonide0.0005MG/MGTopicalGel|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|310353-Fluconazole40MG/MLOralSuspension|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|1190225-120ACTUATAlbuterol0.1MG/ACTUAT/IpratropiumBromide0.02MG/ACTUATInhalationSpray[Combivent]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|310352-Fluconazole10MG/MLOralSuspension|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|310346-Finasteride5MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2373941-bedaquiline20MGOralTablet[Sirturo]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|310325-ferroussulfate325MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|310324-ferroussulfate325MGDelayedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|310273-Famotidine20MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|310261-exemestane25MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|1293864-ErgotamineTartrate2MGSublingualTablet[Ergomar]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|310169-Estradiol0.1MG/MLVaginalCream|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|310157-Erythromycin500MGDelayedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|310155-Erythromycin250MGDelayedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|310154-Erythromycin250MGDelayedReleaseOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|540181-alosetron0.5MGOralTablet[Lotronex]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|310015-dorzolamide20MG/MLOphthalmicSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|309955-Dipyridamole75MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|309952-Dipyridamole25MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|309686-Dexamethasone0.1MG/MLOralSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|309680-Dexamethasone1MG/ML/Neomycin3.5MG/ML/PolymyxinB10000UNT/MLOphthalmicSuspension|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1052760-magnesiumcitrate58.2MG/MLOralSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|309679-Dexamethasone0.001MG/MG/Neomycin0.0035MG/MG/PolymyxinB10UNT/MGOphthalmicOintment|AGED FULL DUALS 632|2002|N|Y|Y||Preferred Brand|1716215-patiromer8400MGPowderforOralSuspension[Veltassa]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|309594-vitaminB121MG/MLInjectableSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|309371-Clotrimazole10MGOralLozenge|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|309370-Clotrimazole10MG/MLTopicalSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|309367-Clotrimazole10MG/MLTopicalCream|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|1358765-JunelFe1/2028DayPack|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|309362-clopidogrel75MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|105292-isoniazid10MG/MLOralSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|309337-Clindamycin20MG/MLVaginalCream|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|309313-Citalopram2MG/MLOralSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|309291-ciclopirox80MG/MLTopicalSolution|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|582595-Iloprost0.01MG/MLInhalationSolution[Ventavis]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|309290-ciclopirox7.7MG/MLTopicalLotion|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|580286-mesalamine500MGExtendedReleaseOralCapsule[Pentasa]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|309273-cholinesalicylate58.6MG/ML/MagnesiumSalicylate72.4MG/MLOralSolution|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|404450-Thalidomide200MGOralCapsule[Thalomid]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|309115-Cephalexin250MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1053697-Nystatin100UNT/MG/TriamcinoloneAcetonide0.001MG/MGTopicalOintment|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|309114-Cephalexin500MGOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|602862-magnesiumaminoacidchelate133MGOralTablet[MGPlusProtein]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|309113-Cephalexin50MG/MLOralSuspension|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|309112-Cephalexin250MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|309110-Cephalexin25MG/MLOralSuspension|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1732157-incobotulinumtoxinA50UNTInjection[Xeomin]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|309098-Cefuroxime500MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|309054-cefdinir25MG/MLOralSuspension|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|309045-Cefaclor250MGOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|603978-nepafenac1MG/MLOphthalmicSuspension[Nevanac]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|309044-Cefaclor25MG/MLOralSuspension|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|308989-Carbidopa50MG/Levodopa200MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|1358775-MicrogestinFe1/2028DayPack|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|308988-Carbidopa25MG/Levodopa100MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|308979-Carbamazepine200MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|607579-entecavir0.05MG/MLOralSolution[Baraclude]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|308976-Carbamazepine20MG/MLOralSuspension|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1053753-Nystatin100000UNT/ML/TriamcinoloneAcetonide1MG/MLTopicalCream|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|308973-Carbamazepine100MGChewableTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|308964-Captopril50MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|308963-Captopril12.5MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|308962-Captopril100MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|308891-CalciumCarbonate250MG/MLOralSuspension|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|1358780-Junel1/2021DayPack|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|308868-Calcitriol0.0005MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|308867-Calcitriol0.00025MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|308725-bexarotene75MGOralCapsule|AGED FULL DUALS 632|2002|N|Y|Y||Preferred Brand|2200650-semaglutide14MGOralTablet[Rybelsus]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|308714-Betamethasone0.5MG/ML/Clotrimazole10MG/MLTopicalCream|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|308696-BenzoylPeroxide50MG/MLMedicatedLiquidSoap|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|308694-BenzoylPeroxide0.05MG/MGTopicalGel|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|308689-BenzoylPeroxide0.025MG/MGTopicalGel|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|105583-Fluorouracil50MG/MLTopicalCream|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|308512-Bacitracin0.5UNT/MG/PolymyxinB10UNT/MGTopicalOintment|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|616018-abatacept250MGInjection[Orencia]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|308508-Bacitracin0.5UNT/MGOphthalmicOintment|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|308493-Bacitracin0.4UNT/MG/Neomycin0.0035MG/MG/PolymyxinB10UNT/MGOphthalmicOintment|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|1359020-Microgestin1/2021DayPack|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|308459-Azithromycin20MG/MLOralSuspension|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|308416-Aspirin81MGDelayedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|308345-apraclonidine5MG/MLOphthalmicSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|308212-Ampicillin500MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|308194-Amoxicillin875MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|308191-Amoxicillin500MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|308189-Amoxicillin80MG/MLOralSuspension|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|308182-Amoxicillin250MGOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|616116-lenalidomide5MGOralCapsule[Revlimid]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|308177-Amoxicillin125MGChewableTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|308136-Amlodipine2.5MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|308135-Amlodipine10MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|308078-AluminumHydroxide64MG/MLOralSuspension|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|307730-Acyclovir40MG/MLOralSuspension|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|616114-lenalidomide10MGOralCapsule[Revlimid]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|307719-Acetylcysteine200MG/MLInhalationSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|307718-Acetylcysteine100MG/MLInhalationSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|105585-Methotrexate2.5MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|307675-Acetaminophen32MG/MLOralSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|284988-Didanosine400MGDelayedReleaseOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|284245-Famotidine40MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|616283-sunitinib12.5MGOralCapsule[Sutent]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|284215-Clindamycin300MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|284185-Didanosine200MGDelayedReleaseOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1729061-selexipag0.6MGOralTablet[Uptravi]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|284184-Didanosine250MGDelayedReleaseOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|106258-Hydrocortisone10MG/MLTopicalCream|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|283858-ropinirole3MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|616287-sunitinib25MGOralCapsule[Sutent]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|283672-Citalopram10MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|283523-gabapentin50MG/MLOralSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|283485-Mirtazapine45MGDisintegratingOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|283433-Melatonin10MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|283406-Mirtazapine15MGDisintegratingOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|283077-prednisolone3MG/MLOralSolution|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|616292-sunitinib50MGOralCapsule[Sutent]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|282755-telmisartan20MGOralTablet|AGED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|197519-Clindamycin10MG/MLTopicalLotion|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|282401-lamotrigine25MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1597129-5000MGTestosterone0.01MG/MGTopicalGel|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|1359027-MicrogestinFe1.5/3028DayPack|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|260376-Terazosin10MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|260243-Progesterone100MGOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|615979-sorafenib200MGOralTablet[Nexavar]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|259966-Methylprednisolone4MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|259255-atorvastatin80MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1729065-selexipag0.8MGOralTablet[Uptravi]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|2532159-PMDDfluoxetine10MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|1359025-JunelFe28DayPack|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|253059-Levocarnitine500MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|253039-Melatonin1MG/MLOralSolution|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|643175-dasatinib50MGOralTablet[Sprycel]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|252732-Melatonin5MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|1359030-Junel1.5/3021DayPack|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|251322-Ethosuximide50MG/MLOralSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|251156-ferroussulfate75MG/MLOralSolution|AGED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|197978-Metolazone10MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|248420-mesalamine1000MGRectalSuppository|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|248109-Ribavirin200MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|245314-Albuterol5MG/MLInhalationSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|244967-PolymyxinB10000UNT/ML/Trimethoprim1MG/MLOphthalmicSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|242590-ferrousgluconate240MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|242446-Ofloxacin3MG/MLOticSolution|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|643177-dasatinib70MGOralTablet[Sprycel]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|241834-cyclosporine,modified100MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|240209-Betamethasone0.5MG/MLTopicalLotion|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|1359032-Microgestin1.5/3021DayPack|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|240029-Cholecalciferol0.125MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|239238-Griseofulvin25MG/MLOralSuspension|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|239191-Amoxicillin50MG/MLOralSuspension|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|238920-Betamethasone0.5MG/MLTopicalCream|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|238600-seleniumsulfide25MG/MLMedicatedShampoo|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|238154-Acetaminophen325MG/butalbital50MG/Caffeine40MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|238151-mesalamine66.7MG/MLEnema|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|106336-Ketoconazole20MG/MLMedicatedShampoo|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|238006-Estrogens,Esterified(USP)0.625MG/Methyltestosterone1.25MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|237776-vitaminB121MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|106351-SilverSulfadiazine10MG/MLTopicalCream|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|237723-Ergocalciferol0.2MG/MLOralSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|237420-CalciumCarbonate1500MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|226343-Dexamethasonephosphate1MG/MLOphthalmicSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|211365-chlorhexidinegluconate40MG/MLMedicatedLiquidSoap|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|2101899-Sodiumpolystyrenesulfonate15000MGPowderforOralSuspension|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|1359134-TiliaFe28DayPack|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|209890-Acetaminophen500MGOralCapsule[Mapap]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|106387-Permethrin50MG/MLTopicalCream|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|206842-IsosorbideDinitrate20MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|205326-Lisinopril30MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|205305-telmisartan80MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|643722-lenalidomide25MGOralCapsule[Revlimid]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|205304-telmisartan40MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|643714-lenalidomide15MGOralCapsule[Revlimid]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|205285-leflunomide20MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|205316-topiramate15MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|205284-leflunomide10MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1085633-TriamcinoloneAcetonide0.00025MG/MGTopicalOintment|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|204844-Azithromycin600MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|668606-Vorinostat100MGOralCapsule[Zolinza]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|204423-Hydrocortisone10MG/ML/Neomycin3.5MG/ML/PolymyxinB10000UNT/MLOticSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|204135-Desonide0.0005MG/MGTopicalOintment|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|200371-Citalopram20MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1729057-selexipag0.4MGOralTablet[Uptravi]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|200346-cefdinir300MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|200257-repaglinide0.5MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|200256-repaglinide1MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|700418-Thalidomide150MGOralCapsule[Thalomid]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|200133-12HRCarbamazepine200MGExtendedReleaseOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|200132-Acarbose25MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|1359135-Tri-LegestFe28DayPack|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|200131-12HRCarbamazepine300MGExtendedReleaseOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|200064-letrozole2.5MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|706872-Azithromycin10MG/MLOphthalmicSolution[AzaSite]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|200060-mycophenolatemofetil500MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1085636-TriamcinoloneAcetonide0.001MG/MGTopicalOintment|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|200033-carvedilol25MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|200032-carvedilol12.5MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|200031-carvedilol6.25MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|199903-Hydrochlorothiazide12.5MGOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|723846-orlistat60MGOralCapsule[Alli]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|199890-topiramate200MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|1373327-amylase180000UNT/lipase36000UNT/protease114000UNTDelayedReleaseOralCapsule[Creon]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|199889-topiramate100MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|199888-topiramate25MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|750244-Low-Ogestrel28DayPack|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|199885-Levofloxacin500MGOralTablet|AGED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|200194-zolmitriptan5MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|199884-Levofloxacin250MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|199703-cabergoline0.5MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|199425-Melatonin1MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|199390-Etodolac500MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1085640-TriamcinoloneAcetonide0.005MG/MGTopicalOintment|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|199353-trandolapril1MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|727705-0.8MLadalimumab50MG/MLPrefilledSyringe[Humira]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|199352-trandolapril4MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|199351-trandolapril2MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|1422081-Enskyce28DayPack|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|199246-glimepiride2MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1729053-selexipag0.2MGOralTablet[Uptravi]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|199245-glimepiride1MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1992303-12HRTimolol5MG/MLOphthalmicSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|199224-anastrozole1MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1591943-ledipasvir90MG/sofosbuvir400MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|199193-famciclovir250MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|199192-famciclovir125MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|199168-Phenobarbital64.8MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|199167-Phenobarbital32.4MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|727816-0.5MLInterferonbeta-1a0.06MG/MLPrefilledSyringe[Avonex]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|199164-Phenobarbital97.2MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|199163-Melatonin3MGOralTablet|AGED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|311671-Metolazone5MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|199159-Tretinoin10MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|199150-Acarbose100MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|199149-Acarbose50MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|727714-0.67MLanakinra149MG/MLPrefilledSyringe[Kineret]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|199143-Niacin250MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|1426881-Levonorgestrel1.5MGOralTablet[MyWay]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|199058-mycophenolatemofetil250MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1085644-TriamcinoloneAcetonide0.25MG/MLTopicalCream|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|199047-Famotidine10MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|198861-SodiumBicarbonate650MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|198857-Simethicone66.7MG/MLOralSuspension|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|730046-0.5MLdarbepoetinalfa0.2MG/MLPrefilledSyringe[Aranesp]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|198760-Niacin50MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|198759-Niacin100MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1729033-selexipag1.4MGOralTablet[Uptravi]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|198741-MagnesiumOxide400MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|198707-Hydrocortisone5MG/MLTopicalCream|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|198630-ferrousgluconate324MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|198555-Capsaicin0.25MG/MLTopicalCream|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|198546-CalciumGluconate500MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|198509-Bisacodyl10MGRectalSuppository|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|198440-Acetaminophen500MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|198429-lamotrigine200MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|731229-0.6MLdarbepoetinalfa0.5MG/MLPrefilledSyringe[Aranesp]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|198428-lamotrigine150MGOralTablet|AGED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|314227-Sumatriptan20MG/ACTUATNasalSpray|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|198427-lamotrigine100MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1547561-Isotretinoin25MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|1440936-Hydrocortisone25MG/MLTopicalCream[ProctozoneHC]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|198382-famciclovir500MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|198380-tioconazole0.065MG/MGVaginalOintment|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|198378-Tacrolimus5MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1085741-TriamcinoloneAcetonide0.25MG/MLTopicalLotion|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|198377-Tacrolimus1MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1923428-Timolol2.5MG/MLOphthalmicSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|198372-torsemide5MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|198371-torsemide20MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|198370-torsemide100MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|731235-0.4MLdarbepoetinalfa0.5MG/MLPrefilledSyringe[Aranesp]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|198369-torsemide10MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|150840-Estrogens,Conjugated(USP)0.625MGOralTablet[Premarin]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|198365-Prochlorperazine10MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|198352-Zidovudine100MGOralCapsule|AGED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|314266-Tacrolimus0.001MG/MGTopicalOintment|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|198335-Sulfamethoxazole800MG/Trimethoprim160MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|198334-Sulfamethoxazole400MG/Trimethoprim80MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|198332-Trimethoprim100MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|198316-Hydrochlorothiazide25MG/Triamterene37.5MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|198293-Tolazamide500MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|198292-Tolazamide250MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|198240-Tamoxifen10MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|198239-Sulindac200MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|152854-Itraconazole10MG/MLOralSolution[Sporanox]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|198238-Sulindac150MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|198232-Sulfasalazine500MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|198224-Hydrochlorothiazide25MG/Spironolactone25MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|198223-Spironolactone50MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|731245-0.42MLdarbepoetinalfa0.06MG/MLPrefilledSyringe[Aranesp]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|198222-Spironolactone100MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|198211-Simvastatin40MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|198202-Rifampin300MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|198201-Rifampin150MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|198181-Pyrazinamide500MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1085745-TriamcinoloneAcetonide1MG/MLTopicalLotion|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|198175-Propylthiouracil50MGOralTablet|AGED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|483442-pregabalin25MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|198165-Propantheline15MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|198153-Colchicine0.5MG/Probenecid500MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|198152-Probenecid500MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|198148-Prednisone50MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|153183-adapalene0.001MG/MGTopicalGel[Differin]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|198146-Prednisone2.5MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1094104-Phenazopyridinehydrochloride200MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|198145-Prednisone10MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|198144-Prednisone1MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|198141-Prazosin5MGOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|746609-nilotinib200MGOralCapsule[Tasigna]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|198116-PotassiumChloride20MEQExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|731250-0.3MLdarbepoetinalfa0.2MG/MLPrefilledSyringe[Aranesp]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|198108-Piroxicam20MGOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|731241-1MLdarbepoetinalfa0.5MG/MLPrefilledSyringe[Aranesp]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|198107-Piroxicam10MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1094107-Phenazopyridinehydrochloride100MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|198105-Pindolol5MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|748738-Topotecan0.25MGOralCapsule[Hycamtin]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|198104-Pindolol10MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|198102-vitaminK15MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|198089-Phenobarbital60MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1729029-selexipag1.2MGOralTablet[Uptravi]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|198086-Phenobarbital16.2MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2047608-1MLepoetinalfa-epbx3000UNT/MLInjection[Retacrit]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|198083-Phenobarbital100MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|198049-Ofloxacin300MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|198047-Nortriptyline75MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|198046-Nortriptyline50MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|153473-Altretamine50MGOralCapsule[Hexalen]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|198045-Nortriptyline10MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|198040-Nitroglycerin0.6MGSublingualTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|753437-9HRMethylphenidate1.11MG/HRTransdermalSystem[Daytrana]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|198039-Nitroglycerin0.4MGSublingualTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1094543-Briellyn28DayPack|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|198038-Nitroglycerin0.3MGSublingualTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|198033-Nifedipine20MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|198032-Nifedipine10MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|198024-Niacin500MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|753442-9HRMethylphenidate2.22MG/HRTransdermalSystem[Daytrana]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|198014-Naproxen500MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|1536586-168HREthinylEstradiol0.00146MG/HR/norelgestromin0.00625MG/HRTransdermalSystem[Xulane]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|198013-Naproxen250MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|198012-Naproxen375MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|749151-Tri-Norinyl28DayPack|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197987-Minoxidil2.5MGOralTablet|AGED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|483448-pregabalin50MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197986-Minoxidil10MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197973-Methylprednisolone8MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197971-Methylprednisolone32MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197963-Hydrochlorothiazide15MG/Methyldopa250MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1095725-ClemastineFumarate1.34MGOralTablet[Dayhist-1]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197960-Hydrochlorothiazide25MG/Methyldopa250MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|753443-9HRMethylphenidate3.33MG/HRTransdermalSystem[Daytrana]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197958-Methyldopa500MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197956-Methyldopa250MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|1594673-amylase105000UNT/lipase25000UNT/protease79000UNTDelayedReleaseOralCapsule[Zenpep]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197944-Methocarbamol750MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1729013-selexipag1MGOralTablet[Uptravi]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197943-Methocarbamol500MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197942-Methimazole5MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197941-Methimazole10MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197940-Methazolamide50MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197939-Methazolamide25MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197931-mercaptopurine50MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197919-Melphalan2MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|758032-0.5MLInterferonbeta-1a0.044MG/MLPrefilledSyringe[Rebif]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197905-Lovastatin40MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197904-Lovastatin20MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197903-Lovastatin10MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1085686-TriamcinoloneAcetonide5MG/MLTopicalCream|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197887-Hydrochlorothiazide25MG/Lisinopril20MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197886-Hydrochlorothiazide12.5MG/Lisinopril20MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|758027-0.5MLInterferonbeta-1a0.088MG/MLPrefilledSyringe[Rebif]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197885-Hydrochlorothiazide12.5MG/Lisinopril10MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197884-Lisinopril40MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1098134-24HRNiacin1000MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197863-Leucovorin5MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197862-Leucovorin25MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197861-Leucovorin15MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|763565-0.4MLadalimumab50MG/MLPrefilledSyringe[Humira]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197860-Leucovorin10MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197856-Ketoprofen75MGOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1728095-romiplostim0.25MGInjection[Nplate]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197855-Ketoprofen50MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1099288-DesipramineHydrochloride10MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197854-Ketoprofen25MGOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|795085-certolizumabpegol200MGInjection[Cimzia]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197853-Ketoconazole200MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197839-IsosorbideDinitrate30MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197832-isoniazid300MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197818-Indomethacin50MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197817-Indomethacin25MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197816-Indapamide2.5MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|795749-RebifTitrationPack|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197815-Indapamide1.25MGOralTablet|AGED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|856481-24HRPropranololHydrochloride160MGExtendedReleaseOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197807-Ibuprofen800MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1487361-1MLglatirameracetate40MG/MLPrefilledSyringe|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|1595457-amylase24000UNT/lipase5000UNT/protease17000UNTDelayedReleaseOralCapsule[Zenpep]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197806-Ibuprofen600MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197805-Ibuprofen400MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197803-Ibuprofen20MG/MLOralSuspension|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197797-hydroxyurea500MGOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1728099-romiplostim0.5MGInjection[Nplate]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197787-Hydrocortisone5MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|1595292-amylase14000UNT/lipase3000UNT/protease10000UNTDelayedReleaseOralCapsule[Zenpep]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197785-Hydrocortisone25MG/MLTopicalLotion|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197783-Hydrocortisone20MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|802652-1MLEtanercept50MG/MLPrefilledSyringe[Enbrel]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197782-Hydrocortisone10MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|1595462-amylase42000UNT/lipase10000UNT/protease32000UNTDelayedReleaseOralCapsule[Zenpep]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197770-Hydrochlorothiazide50MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197746-Guanfacine2MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|748865-Trivora28DayPack|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197745-Guanfacine1MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197741-Guaifenesin200MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197737-Glyburide1.25MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197732-Furosemide80MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197726-Flutamide125MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197701-Fluconazole50MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|809159-0.5MLEtanercept50MG/MLPrefilledSyringe[Enbrel]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197700-Fluconazole200MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197699-Fluconazole150MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|1595473-amylase63000UNT/lipase15000UNT/protease47000UNTDelayedReleaseOralCapsule[Zenpep]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197698-Fluconazole100MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197686-Etodolac400MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197685-Etodolac300MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197684-Etodolac200MGOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|809990-lacosamide100MGOralTablet[Vimpat]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197682-Ethosuximide250MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197670-Estrogens,Esterified(USP)1.25MG/Methyltestosterone2.5MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197659-Estradiol2MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1099300-DesipramineHydrochloride25MGOralTablet|AGED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|798133-Erythromycin20MG/MLMedicatedPad[Ery]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1099296-DesipramineHydrochloride150MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1099292-DesipramineHydrochloride100MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|809994-lacosamide150MGOralTablet[Vimpat]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|810002-lacosamide50MGOralTablet[Vimpat]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1099304-DesipramineHydrochloride50MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|810075-24HRFesoterodineFumarate4MGExtendedReleaseOralTablet[Toviaz]|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|1667916-5MLIsoproterenolHydrochloride0.2MG/MLInjection[Isuprel]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1426600-{24(EthinylEstradiol0.02MG/norethindroneacetate1MGChewableTablet)/4(Ferrousfumarate75MGOralTablet)}Pack|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1002300-nilotinib150MGOralCapsule[Tasigna]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1726846-0.4MLadalimumab100MG/MLPrefilledSyringe[Humira]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1099316-DesipramineHydrochloride75MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|748859-Zovia1/35E28DayPack|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|825170-HumiraPen40MG/0.8ML-Crohn'sDiseaseStarterPack|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|1797880-Nafarelin0.2MG/ACTUATMeteredDoseNasalSpray[Synarel]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|810079-24HRFesoterodineFumarate8MGExtendedReleaseOralTablet[Toviaz]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|825425-eltrombopag25MGOralTablet[Promacta]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|809998-lacosamide200MGOralTablet[Vimpat]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|825429-eltrombopag50MGOralTablet[Promacta]|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|198467-Aspirin325MGDelayedReleaseOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1726639-ponatinib30MGOralTablet[Iclusig]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1099569-24HRDivalproexSodium500MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1012899-fingolimod0.5MGOralCapsule[Gilenya]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|828696-Zolpidemtartrate5MG/ACTUATOralSpray[Zolpimist]|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|1989117-0.3MLEpinephrine1MG/MLPrefilledSyringe[Symjepi]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1250490-hydrocortisoneacetate5MG/MLTopicalCream|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1721685-1MLEpoetinAlfa10000UNT/MLInjection[Epogen]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|828703-1.2MLPlerixafor20MG/MLInjection[Mozobil]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1099596-DivalproexSodium125MGDelayedReleaseOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|836645-Zolpidemtartrate10MGSublingualTablet[Edluar]|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|1995479-amylase168000UNT/lipase40000UNT/protease126000UNTDelayedReleaseOralCapsule[Zenpep]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1373497-{14(dimethylfumarate120MGDelayedReleaseOralCapsule)/46(dimethylfumarate240MGDelayedReleaseOralCapsule)}Pack|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1099563-24HRDivalproexSodium250MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|1595478-amylase84000UNT/lipase20000UNT/protease63000UNTDelayedReleaseOralCapsule[Zenpep]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1721690-1MLEpoetinAlfa10000UNT/MLInjection[Procrit]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1099625-DivalproexSodium125MGDelayedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|707333-SodiumChloride0.111MEQ/MLNasalSolution[AyrSalineNasal]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|845512-everolimus10MGOralTablet[Afinitor]|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|1998772-Breath-Actuated120ACTUATBeclomethasoneDipropionate0.08MG/ACTUATMeteredDoseInhaler[Qvar]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|847913-60ACTUATexenatide0.01MG/ACTUATPenInjector[Byetta]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1099648-5MLValproicAcid100MG/MLInjection|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|847917-60ACTUATexenatide0.005MG/ACTUATPenInjector[Byetta]|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|1998774-Breath-Actuated120ACTUATBeclomethasoneDipropionate0.04MG/ACTUATMeteredDoseInhaler[Qvar]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1099678-DivalproexSodium250MGDelayedReleaseOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1046402-1.7MLdenosumab70MG/MLInjection[Xgeva]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1043567-24HRMetforminhydrochloride1000MG/saxagliptin2.5MGExtendedReleaseOralTablet[Kombiglyze]|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|201337-Nadolol40MGOralTablet[Corgard]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|848164-0.5MLgolimumab100MG/MLPrefilledSyringe[Simponi]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|853354-0.5MLustekinumab90MG/MLPrefilledSyringe[Stelara]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1099681-ValproicAcid250MGOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|853356-1MLustekinumab90MG/MLPrefilledSyringe[Stelara]|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|201338-Nadolol80MGOralTablet[Corgard]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1091843-Roflumilast0.5MGOralTablet[Daliresp]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1720606-mepolizumab100MGInjection[Nucala]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1099687-ValproicAcid50MG/MLOralSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|705008-Cefixime40MG/MLOralSuspension[Suprax]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|854836-lisdexamfetaminedimesylate30MGOralCapsule[Vyvanse]|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|201747-Primidone250MGOralTablet[Mysoline]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|854832-lisdexamfetaminedimesylate20MGOralCapsule[Vyvanse]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|731227-0.4MLdarbepoetinalfa0.1MG/MLPrefilledSyringe[Aranesp]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|849599-1MLcertolizumabpegol200MG/MLPrefilledSyringe[Cimzia]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|794639-lubiprostone0.008MGOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|854844-lisdexamfetaminedimesylate70MGOralCapsule[Vyvanse]|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|202301-Estrogens,Conjugated(USP)1.25MGOralTablet[Premarin]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1666334-Ticagrelor60MGOralTablet[Brilinta]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1100457-PyridoxineHydrochloride25MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1115259-1.5MLLeuprolideAcetate30MG/MLPrefilledSyringe[Lupron]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|854852-lisdexamfetaminedimesylate50MGOralCapsule[Vyvanse]|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|2045958-avatrombopag20MGOralTablet[Doptelet]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|854848-lisdexamfetaminedimesylate60MGOralCapsule[Vyvanse]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|857799-Treprostinil0.6MG/MLInhalationSolution[Tyvaso]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1115005-DocusateSodium100MGOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|858040-saxagliptin5MGOralTablet[Onglyza]|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|205562-Estramustine140MGOralCapsule[Emcyt]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1360304-Budesonide0.08MG/ACTUAT/formoterolfumarate0.0045MG/ACTUATMeteredDoseInhaler|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1099870-DivalproexSodium500MGDelayedReleaseOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1665906-1MLevolocumab140MG/MLPrefilledSyringe[Repatha]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1116150-bacitracinzinc0.4UNT/MG/hydrocortisoneacetate0.01MG/MG/NeomycinSulfate0.0035MG/MG/PolymyxinBSulfate10UNT/MGOphthalmic|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1115464-1MLLeuprolideAcetate7.5MG/MLPrefilledSyringe[Lupron]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|858366-KetorolacTromethamine4.5MG/MLOphthalmicSolution[Acuvail]|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|205669-Dexamethasone1MG/MLOphthalmicSuspension[Maxidex]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|858044-saxagliptin2.5MGOralTablet[Onglyza]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|860244-interferonbeta-1b0.3MGInjection[Extavia]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1116758-chloroquinephosphate500MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|860898-Vigabatrin500MGPowderforOralSolution[Sabril]|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|206208-aluminumchloride200MG/MLTopicalSolution[Drysol]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1150836-LevobunololHydrochloride5MG/MLOphthalmicSolution|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1115459-1MLLeuprolideAcetate3.75MG/MLPrefilledSyringe[Lupron]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|854840-lisdexamfetaminedimesylate40MGOralCapsule[Vyvanse]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|861043-2.7MLpramlintideacetate1MG/MLPenInjector[Symlin]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|240912-Granisetron1MG/MLInjectableSolution|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|861966-Iloprost0.02MG/MLInhalationSolution[Ventavis]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1190568-AtropineSulfate0.005MG/ML/DiphenoxylateHydrochloride0.5MG/MLOralSolution|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|864820-Oxybutyninchloride0.1MG/MGTopicalGel[Gelnique]|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|206314-Hydrocortisone0.01MG/MGTopicalOintment[Cortizone]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1308569-24HRrivastigmine0.554MG/HRTransdermalSystem|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1149617-COLLAGENASE0.25UNT/MGTopicalOintment[Santyl]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1663728-Isotretinoin30MGOralCapsule[Myorisan]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1190570-AtropineSulfate0.01MG/MGOphthalmicOintment|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|688242-Estrogens,Conjugated(USP)0.625MG/MLVaginalCream[Premarin]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|884619-eltrombopag75MGOralTablet[Promacta]|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|206961-Nadolol20MGOralTablet[Corgard]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|867506-pazopanib200MGOralTablet[Votrient]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|896237-120ACTUATFluticasonepropionate0.045MG/ACTUAT/salmeterol0.021MG/ACTUATMeteredDoseInhaler[Advair]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|861045-1.5MLpramlintideacetate1MG/MLPenInjector[Symlin]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|896245-120ACTUATFluticasonepropionate0.115MG/ACTUAT/salmeterol0.021MG/ACTUATMeteredDoseInhaler[Advair]|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|206978-Ketoconazole20MG/MLMedicatedShampoo[Nizoral]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1661567-TOBIPodhalerDailyKit,8|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1190655-AtropineSulfate10MG/MLOphthalmicSolution|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1232204-Zolpidemtartrate3.5MGSublingualTablet[Intermezzo]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|897126-3MLliraglutide6MG/MLPenInjector[Victoza]|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|207136-Methylprednisolone2MGOralTablet[Medrol]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|896273-120ACTUATFluticasonepropionate0.23MG/ACTUAT/salmeterol0.021MG/ACTUATMeteredDoseInhaler[Advair]|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|616444-mycophenolatemofetil200MG/MLOralSuspension[Cellcept]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|901614-Aztreonam75MG/MLInhalationSolution[Cayston]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1191013-Proparacainehydrochloride5MG/MLOphthalmicSolution|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|902624-dexlansoprazole30MGDelayedReleaseOralCapsule[Dexilant]|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|207273-Nitroglycerin0.02MG/MGTopicalOintment[Nitro-Bid]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1190572-AtropineSulfate0.025MG/DiphenoxylateHydrochloride2.5MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|206216-2MLIron-DextranComplex50MG/MLInjection[InFed]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1806187-30/70Release24HRMethylphenidateHydrochloride20MGExtendedReleaseOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1191256-FluocinoloneAcetonide0.00025MG/MGTopicalOintment|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|644304-Tamoxifen2MG/MLOralSolution[Soltamox]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|903855-2MLPyridostigmineBromide5MG/MLInjection[Regonol]|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|207373-Mitotane500MGOralTablet[Lysodren]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|978950-Natazia28DayPack|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1191310-FluocinoloneAcetonide0.1MG/MLTopicalSolution|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|979115-0.6MLMethylnaltrexonebromide20MG/MLInjection[Relistor]|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|207478-Primidone50MGOralTablet[Mysoline]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1191315-FluocinoloneAcetonide0.25MG/MLTopicalCream|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1242968-exenatide2MGInjection[Bydureon]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1235267-CamreseLo91DayPack|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|207588-Procarbazine50MGOralCapsule[Matulane]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|993456-1MLdenosumab60MG/MLPrefilledSyringe[Prolia]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1050493-{21(drospirenone3MG/EthinylEstradiol0.03MG/levomefolatecalcium0.451MGOralTablet)/7(levomefolatecalcium0.451MGOralTabl|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1193358-100MLLevetiracetam10MG/MLInjection|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|207864-crotamiton100MG/MLTopicalCream[Eurax]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1243040-Linagliptin2.5MG/Metforminhydrochloride850MGOralTablet[Jentadueto]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1657982-20MLtocilizumab20MG/MLInjection[Actemra]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1193360-100MLLevetiracetam15MG/MLInjection|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|630475-SodiumFluoride5.56MG/MLOralSolution[FluoraDay]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1013629-{24(drospirenone3MG/EthinylEstradiol0.02MG/levomefolatecalcium0.451MGOralTablet)/4(levomefolatecalcium0.451MGOralTabl|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|207949-Succimer100MGOralCapsule[Chemet]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1011739-aliskiren300MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|995156-lacosamide10MG/MLOralSolution[Vimpat]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1087964-hydroxyprogesteronecaproate(USP)250MG/MLInjectableSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|208513-Estrogens,Conjugated(USP)0.3MGOralTablet[Premarin]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1657980-10MLtocilizumab20MG/MLInjection[Actemra]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1234571-PhenylephrineHydrochloride100MG/MLOphthalmicSolution|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1244062-0.6MLMethylnaltrexonebromide20MG/MLPrefilledSyringe[Relistor]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1095229-FlavoxateHydrochloride100MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|208547-thyroid(USP)180MGOralTablet[ArmourThyroid]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1092357-rufinamide40MG/MLOralSuspension|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1657212-omalizumab150MGInjection[Xolair]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1098608-24HRlamotrigine300MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1242786-Alyacen1/3528-DayKit|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1100075-abirateroneacetate250MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|208549-thyroid(USP)240MGOralTablet[ArmourThyroid]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1299903-Tiagabinehydrochloride12MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1193362-100MLLevetiracetam5MG/MLInjection|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1657976-4MLtocilizumab20MG/MLInjection[Actemra]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1242787-Alyacen7/7/7Kit|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|617333-Amoxicillin25MG/ML/Clavulanate6.25MG/MLOralSuspension[Augmentin]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1119400-everolimus7.5MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|208551-thyroid(USP)300MGOralTablet[ArmourThyroid]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1146690-24HRlamotrigine250MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1243585-Flurbiprofensodium0.3MG/MLOphthalmicSolution|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1111641-1MLglatirameracetate20MG/MLPrefilledSyringe|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|208949-Estrogens,Conjugated(USP)0.9MGOralTablet[Premarin]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1245230-chlorhexidinegluconate20MG/MLMedicatedLiquidSoap|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1304979-icosapentethyl1000MGOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1245003-eltrombopag12.5MGOralTablet[Promacta]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1011736-aliskiren150MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1000001-Amlodipine5MG/Hydrochlorothiazide25MG/Olmesartanmedoxomil40MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1299909-Tiagabinehydrochloride16MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|245135-72HRFentanyl0.05MG/HRTransdermalSystem|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1299917-Tiagabinehydrochloride4MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1245468-DocusateSodium250MGOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|902626-dexlansoprazole60MGDelayedReleaseOralCapsule[Dexilant]|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|209360-Acetaminophen325MGRectalSuppository[Acephen]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1307635-bosutinib500MGOralTablet[Bosulif]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1655934-ivacaftor125MG/lumacaftor200MGOralTablet[ORKAMBI]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1245919-Marlissa28DayPack|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|616450-MycophenolicAcid180MGDelayedReleaseOralTablet[Myfortic]|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|209531-Acetaminophen80MGRectalSuppository[Feverall]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1307427-sildenafil10MG/MLOralSuspension|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1359861-Budesonide0.16MG/ACTUAT/formoterolfumarate0.0045MG/ACTUATMeteredDoseInhaler|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1299911-Tiagabinehydrochloride2MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|210000-AluminumHydroxide80MG/ML/MagnesiumHydroxide80MG/ML/Simethicone8MG/MLOralSuspension[Almacone]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1654955-1MLdarbepoetinalfa0.2MG/MLInjection[Aranesp]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1291082-hydrocortisoneacetate25MGRectalSuppository|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1310535-teriflunomide7MGOralTablet[Aubagio]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1373483-dimethylfumarate120MGDelayedReleaseOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|2110510-60ACTUATFluticasonepropionate0.1MG/ACTUAT/salmeterol0.05MG/ACTUATDryPowderInhaler[Wixela]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1366550-24HRBudesonide9MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1654079-0.5MLustekinumab90MG/MLInjection[Stelara]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1373491-dimethylfumarate240MGDelayedReleaseOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1298066-Cyclopentolatehydrochloride10MG/MLOphthalmicSolution|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|836649-Zolpidemtartrate5MGSublingualTablet[Edluar]|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|2110513-60ACTUATFluticasonepropionate0.25MG/ACTUAT/salmeterol0.05MG/ACTUATDryPowderInhaler[Wixela]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|828364-hydrocortisoneacetate10MG/ML/Pramoxinehydrochloride10MG/MLRectalFoam[Proctofoam-HC]|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|209002-prednisolone1.2MG/MLOphthalmicSuspension[PredMild]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1654630-1MLglatirameracetate20MG/MLPrefilledSyringe[Glatopa]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1298070-Cyclopentolatehydrochloride20MG/MLOphthalmicSolution|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1364362-ponatinib45MGOralTablet[Iclusig]|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|2110516-60ACTUATFluticasonepropionate0.5MG/ACTUAT/salmeterol0.05MG/ACTUATDryPowderInhaler[Wixela]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1373503-{7(EthinylEstradiol0.01MGOralTablet)/42(EthinylEstradiol0.02MG/Levonorgestrel0.15MGOralTablet)/21(EthinylEstradiol0.0|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1435115-28ACTUATTeriparatide0.02MG/ACTUATPenInjector|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1298072-Cyclopentolatehydrochloride5MG/MLOphthalmicSolution|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|799830-dasatinib100MGOralTablet[Sprycel]|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|211633-AluminumHydroxide200MG/MagnesiumHydroxide200MG/Simethicone25MGChewableTablet[Gelusil]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1313112-Phenytoin25MG/MLOralSuspension|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1373333-Isotretinoin10MGOralCapsule[Zenatane]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|748740-Topotecan1MGOralCapsule[Hycamtin]|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|212039-Estrogens,Esterified(USP)0.3MGOralTablet[Menest]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1490065-RaloxifeneHydrochloride60MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|153823-candesartancilexetil8MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1313885-Phenytoin50MGChewableTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|731231-0.3MLdarbepoetinalfa0.5MG/MLPrefilledSyringe[Aranesp]|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|212232-Estrogens,Esterified(USP)0.625MGOralTablet[Menest]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1374574-TOBIPodhalerKit,224|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1653243-1MLsecukinumab150MG/MLAuto-Injector[Cosentyx]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1359117-{24(EthinylEstradiol0.02MG/norethindroneacetate1MGOralTablet)/4(Ferrousfumarate75MGOralTablet)}Pack|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|212373-Estrogens,Esterified(USP)1.25MGOralTablet[Menest]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1547565-Isotretinoin35MGOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|643488-Isotretinoin30MGOralCapsule[Claravis]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|153822-candesartancilexetil4MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|643173-dasatinib20MGOralTablet[Sprycel]|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|213282-hydroxyurea200MGOralCapsule[Droxia]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1653225-1MLEtanercept50MG/MLAuto-Injector[Enbrel]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1359858-Fluticasonepropionate0.5MG/ACTUAT/salmeterol0.05MG/ACTUATDryPowderInhaler|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1431647-4MLgolimumab12.5MG/MLInjection[Simponi]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1607617-24HRdesvenlafaxinesuccinate25MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|213283-hydroxyurea300MGOralCapsule[Droxia]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1599949-60ACTUATTestosterone30MG/ACTUATTopicalSolution|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1607784-deferasirox180MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1362706-MexiletineHydrochloride150MGOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|404065-Isotretinoin40MGOralCapsule[Claravis]|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|213284-hydroxyurea400MGOralCapsule[Droxia]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|352047-1MLdarbepoetinalfa0.1MG/MLInjection[Aranesp]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1945048-30ACTUATfluticasonefuroate0.1MG/ACTUAT/umeclidinium0.0625MG/ACTUAT/vilanterol0.025MG/ACTUATDryPowderInhaler[Trelegy]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1653166-1MLgolimumab100MG/MLAuto-Injector[Simponi]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1362712-MexiletineHydrochloride200MGOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1439901-riociguat2MGOralTablet[Adempas]|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|213291-ParoxetineHydrochloride2MG/MLOralSuspension[Paxil]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1607796-deferasirox90MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1657160-0.5MLSumatriptan12MG/MLCartridge|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1362720-MexiletineHydrochloride250MGOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2531134-HumiraPen80MG/0.8ML-StarterPackageforPediatricUlcerativeColitis(4count)|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|213510-Auranofin3MGOralCapsule[Ridaura]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1363309-ChlorpheniramineMaleate4MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1439899-riociguat1.5MGOralTablet[Adempas]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2392142-0.5MLetanercept50MG/MLInjection[Enbrel]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2387331-120ACTUATbudesonide0.16MG/ACTUAT/formoterolfumarate0.0048MG/ACTUAT/glycopyrrolate0.009MG/ACTUATMeteredDoseInhaler[Bre|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1728055-5MLpalonosetron0.05MG/MLInjection|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|260218-modafinil100MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1737459-PamidronateDisodium30MGInjection|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1366116-bacitracinzinc0.5UNT/MGTopicalOintment|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2359285-24HRempagliflozin10MG/linagliptin5MG/metforminhydrochloride1000MGExtendedReleaseOralTablet[Trijardy]|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|2173508-Nonoxynol-91000MGVaginalSponge[TodaySponge]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1442143-Macitentan10MGOralTablet[Opsumit]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1650901-0.5MLInterferonbeta-1a0.06MG/MLAuto-Injector[Avonex]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1367410-Ergocalciferol1.25MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|542059-Didanosine10MG/MLOralSolution[Videx]|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|2178792-0.3MLEpinephrine0.5MG/MLPrefilledSyringe[Symjepi]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1745091-Lidocaine0.05MG/MGMedicatedPatch|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1796690-1MLhydroxyprogesteronecaproate(USP)250MG/MLInjection|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1734399-1MLGranisetron1MG/MLInjection|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|2561270-0.5MLinfluenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.03MG/|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1650282-RebifRebidoseTitrationPack|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1376336-prednisoloneacetate10MG/MLOphthalmicSuspension|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1486981-dapagliflozin5MGOralTablet[Farxiga]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1860129-Abuse-Deterrent12HROxycodoneHydrochloride20MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|2561275-0.5MLinfluenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.03MG/|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1860127-Abuse-Deterrent12HROxycodoneHydrochloride60MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1649996-0.5MLInterferonbeta-1a0.044MG/MLAuto-Injector[Rebif]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1860137-Abuse-Deterrent12HROxycodoneHydrochloride40MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|141963-Azithromycin40MG/MLOralSuspension|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|212218-EpoetinAlfa20000UNT/MLInjectableSolution[Epogen]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2121100-siponimod2MGOralTablet[Mayzent]|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|2562995-0.5MLinfluenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Washington/19/2020(H1N1)antigen0.03MG/|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2119391-Spravato56MGDoseKit|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|213621-Bacitracin0.5UNT/MG/PolymyxinB10UNT/MGOphthalmicOintment[Polycin]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1797851-CromolynSodium5.2MG/ACTUATMeteredDoseNasalSpray|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|142034-BenzoylPeroxide100MG/MLMedicatedLiquidSoap|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1488675-12HRTreprostinil1MGExtendedReleaseOralTablet[Orenitram]|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|2562996-0.5MLinfluenzaAvirusA/Cambodia/e0826360/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1860151-Abuse-Deterrent12HROxycodoneHydrochloride30MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1860157-Abuse-Deterrent12HROxycodoneHydrochloride10MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1437702-Albuterol0.833MG/ML/IpratropiumBromide0.167MG/MLInhalationSolution|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|205922-1MLEpoetinAlfa3000UNT/MLInjection[Procrit]|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|2563002-0.5MLinfluenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.09MG/ML/influenzaAvirusA/Wisconsin/588/2019(H1N1)antigen0.09MG/|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1440184-hydrocortisoneacetate0.01MG/MGTopicalOintment|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1539893-30ACTUATfluticasonefuroate0.1MG/ACTUAT/vilanterol0.025MG/ACTUATDryPowderInhaler[Breo]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1488671-12HRTreprostinil0.25MGExtendedReleaseOralTablet[Orenitram]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2058906-cannabidiol100MG/MLOralSolution[Epidiolex]|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|2563004-0.7MLinfluenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.0857MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.085|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1874559-24HRdesvenlafaxinesuccinate50MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1923822-deferasirox90MGOralGranules|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|151226-topiramate50MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|205532-DornaseAlfa1MG/MLInhalationSolution[Pulmozyme]|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|2563020-influenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Washington/19/2020(H1N1)antigen0.03MG/ML/in|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1544386-0.25MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1649605-PlegridyPenStarterPack|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|152695-meloxicam15MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|404509-CalciumCarbonate1000MG/Simethicone60MGChewableTablet[MaaloxMaxQuickDissolve]|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|2563031-influenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.03MG/ML/in|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1923828-deferasirox180MGOralGranules|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1918042-abirateroneacetate500MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2001321-Roflumilast0.25MGOralTablet[Daliresp]|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|2563032-0.5MLinfluenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.03MG/|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1649593-0.5MLpeginterferonbeta-1a0.25MG/MLAuto-Injector[Plegridy]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1648755-NITROFURANTOIN,MACROCRYSTALS25MG/Nitrofurantoin,Monohydrate75MGOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1544398-0.5MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|197845-Isotretinoin40MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|2563039-0.5MLinfluenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.03MG/|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|197844-Isotretinoin20MGOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1649491-ivabradine5MGOralTablet[Corlanor]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|198070-Penicillamine250MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1648759-NITROFURANTOIN,MACROCRYSTALS100MGOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1921240-0.8MLadalimumab100MG/MLAuto-Injector[Humira]|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|2564021-0.5MLinfluenzaAvirusA/Cambodia/e0826360/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1876609-naldemedine0.2MGOralTablet[Symproic]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1649495-ivabradine7.5MGOralTablet[Corlanor]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1655968-8MLMethotrexate25MG/MLInjection|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|404492-5MLLaronidase0.58MG/MLInjection[Aldurazyme]|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|2564038-influenzaAvirusA/Cambodia/e0826360/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.03MG/|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|198200-Rifabutin150MGOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1988974-24HRpregabalin165MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1659263-1MLheparinsodium,porcine5000UNT/MLInjection|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1870960-deflazacort36MGOralTablet[Emflaza]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1665050-Cefazolin1000MGInjection|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1544918-0.65MLexenatide3.08MG/MLPenInjector[Bydureon]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1812470-ivacaftor125MG/lumacaftor100MGOralTablet[ORKAMBI]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1811182-icosapentethyl500MGOralCapsule[Vascepa]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1988980-24HRpregabalin82.5MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|199521-Vigabatrin500MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1665188-1MLLorazepam2MG/MLInjection|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1796096-24HRLinagliptin5MG/Metforminhydrochloride1000MGExtendedReleaseOralTablet[Jentadueto]|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|261353-Trimethoprim10MG/MLOralSolution[Primsol]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1592748-nintedanib100MGOralCapsule[Ofev]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1724437-thyroid(USP)90MGOralTablet[NPThyroid]|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|404476-Azathioprine100MGOralTablet[Azasan]|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|284551-nilutamide150MGOralTablet[Nilandron]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|200327-capecitabine150MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|205315-topiramate25MGOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|199378-12HRCarbamazepine100MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|312018-Nitroglycerin6.5MGExtendedReleaseOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1606870-ivacaftor75MGOralGranules[Kalydeco]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1724481-thyroid(USP)60MGOralTablet[NPThyroid]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1593835-24HRdapagliflozin10MG/Metforminhydrochloride500MGExtendedReleaseOralTablet[Xigduo]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|2123194-PulmonaryHypertensiontadalafil20MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|312020-Nitroglycerin9MGExtendedReleaseOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|205324-modafinil200MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1605455-Otezla28-DayStarterPack|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|2198370-pretomanid200MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1731345-deferoxaminemesylate2000MGInjection|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1665900-1MLevolocumab140MG/MLAuto-Injector[Repatha]|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|351487-thyroid(USP)130MGOralTablet[Westhroid]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1660934-60ACTUATformoterolfumarate0.005MG/ACTUAT/mometasonefuroate0.1MG/ACTUATMeteredDoseInhaler[Dulera]|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|260409-prednisolone1MG/MLOralSolution[Pediapred]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1606866-ivacaftor50MGOralGranules[Kalydeco]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1731350-deferoxaminemesylate500MGInjection|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1596778-14ACTUATBudesonide2MG/ACTUATRectalFoam[Uceris]|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|351750-podofilox0.005MG/MGTopicalGel[Condylox]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|245134-72HRFentanyl0.025MG/HRTransdermalSystem|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|245136-72HRFentanyl0.1MG/HRTransdermalSystem|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1738483-ParoxetineHydrochloride10MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1653144-0.5MLgolimumab100MG/MLAuto-Injector[Simponi]|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|351901-Sirolimus1MG/MLOralSolution[Rapamune]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1738495-ParoxetineHydrochloride20MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1605075-0.8MLFILGRASTIM-SNDZ0.6MG/MLPrefilledSyringe[Zarxio]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1648789-30ACTUATfluticasonefuroate0.2MG/ACTUAT/vilanterol0.025MG/ACTUATDryPowderInhaler[Breo]|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|352210-Mesna400MGOralTablet[Mesnex]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|283316-Hydrochlorothiazide12.5MG/telmisartan40MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|310436-Galantamine4MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1605172-0.4MLdarbepoetinalfa0.025MG/MLPrefilledSyringe[Aranesp]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1605071-0.5MLFILGRASTIM-SNDZ0.6MG/MLPrefilledSyringe[Zarxio]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1738503-ParoxetineHydrochloride30MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1601373-naloxegol25MGOralTablet[Movantik]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|310437-Galantamine8MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1599797-1MLsecukinumab150MG/MLPrefilledSyringe[Cosentyx]|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|404475-Azathioprine75MGOralTablet[Azasan]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1596023-ferriccitrate1000MGOralTablet[Auryxia]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1594358-HumiraPediatricCrohn'sDiseaseStarterPackage(3count)|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1593858-lisdexamfetaminedimesylate10MGOralCapsule[Vyvanse]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1593833-24HRdapagliflozin5MG/Metforminhydrochloride1000MGExtendedReleaseOralTablet[Xigduo]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1738511-ParoxetineHydrochloride40MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1593831-24HRdapagliflozin5MG/Metforminhydrochloride500MGExtendedReleaseOralTablet[Xigduo]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|311204-Itraconazole100MGOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1593775-24HRdapagliflozin10MG/Metforminhydrochloride1000MGExtendedReleaseOralTablet[Xigduo]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1592752-nintedanib150MGOralCapsule[Ofev]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|310599-Granisetron1MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1592285-pirfenidone267MGOralCapsule[Esbriet]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1551923-naloxegol12.5MGOralTablet[Movantik]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1551888-0.2MLadalimumab50MG/MLPrefilledSyringe[Humira]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|283317-Hydrochlorothiazide12.5MG/telmisartan80MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1551886-lanthanumcarbonate750MGOralPowder[Fosrenol]|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|2564406-influenzaAvirusA/Tasmania/503/2020(H3N2)antigen158000000UNT/ML/influenzaAvirusA/Victoria/1/2020(H1N1)antigen158000000|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1546198-PlegridyStarterPack|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|313165-0.5MLSumatriptan12MG/MLInjection|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1546189-0.5MLpeginterferonbeta-1a0.25MG/MLPrefilledSyringe[Plegridy]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1545174-hydrocortisoneacetate100MG/MLRectalFoam[Cortifoam]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1544404-0.15MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1544402-0.6MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1544396-0.45MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1797867-Azelastinehydrochloride0.137MG/ACTUATMeteredDoseNasalSpray|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1544394-0.4MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|313210-temozolomide250MGOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1544390-0.35MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1544388-0.3MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|313209-temozolomide20MGOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1544383-0.2MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|313211-temozolomide5MGOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1541928-sunitinib37.5MGOralCapsule[Sutent]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|153324-Interferonbeta-1a0.03MGInjection[Avonex]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1797907-Fluticasonepropionate0.05MG/ACTUATMeteredDoseNasalSpray|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1492746-apremilast30MGOralTablet[Otezla]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|313472-Trientinehydrochloride250MGOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1488679-12HRTreprostinil2.5MGExtendedReleaseOralTablet[Orenitram]|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|404550-Estrogens,Conjugated(USP)0.45MGOralTablet[Premarin]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1488667-12HRTreprostinil0.125MGExtendedReleaseOralTablet[Orenitram]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1487076-DiclofenacSodium20MG/MLTopicalSolution[Pennsaid]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1486977-dapagliflozin10MGOralTablet[Farxiga]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1797913-TriamcinoloneAcetonide0.055MG/ACTUATMeteredDoseNasalSpray|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1484296-sucroferricoxyhydroxide500MGChewableTablet[Velphoro]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|348719-Tobramycin60MG/MLInhalationSolution|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1482814-1MLgolimumab100MG/MLPrefilledSyringe[Simponi]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1482513-eslicarbazepineacetate200MGOralTablet[Aptiom]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|317160-temozolomide100MGOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1441530-0.9MLtocilizumab180MG/MLPrefilledSyringe[Actemra]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|349253-bosentan62.5MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1441424-0.4MLMethotrexate62.5MG/MLAuto-Injector[Otrexup]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1441418-0.4MLMethotrexate50MG/MLAuto-Injector[Otrexup]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1441413-0.4MLMethotrexate37.5MG/MLAuto-Injector[Otrexup]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1801289-SmokingCessation12HRBupropionHydrochloride150MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1441407-0.4MLMethotrexate25MG/MLAuto-Injector[Otrexup]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|349407-Treprostinil1MG/MLInjectableSolution|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1439903-riociguat2.5MGOralTablet[Adempas]|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|544597-PotassiumIodide1000MG/MLOralSolution[SSKIbrandofPotassiumIodide]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1439896-riociguat1MGOralTablet[Adempas]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1439894-riociguat0.5MGOralTablet[Adempas]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1429367-lenalidomide20MGOralCapsule[Revlimid]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1801294-MicroencapsulatedPotassiumChloride20MEQExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1429284-NeostigmineMethylsulfate1MG/MLInjectableSolution[Bloxiverz]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1650004-0.5MLInterferonbeta-1a0.088MG/MLAuto-Injector[Rebif]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1429282-NeostigmineMethylsulfate0.5MG/MLInjectableSolution[Bloxiverz]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|312835-rivastigmine3MGOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1375922-bromfenac0.7MG/MLOphthalmicSolution[Prolensa]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|349408-Treprostinil10MG/MLInjectableSolution|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1373337-Isotretinoin40MGOralCapsule[Zenatane]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|349410-Treprostinil5MG/MLInjectableSolution|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1373335-Isotretinoin20MGOralCapsule[Zenatane]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1365866-nepafenac3MG/MLOphthalmicSuspension[Ilevro]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1801298-MicroencapsulatedPotassiumChloride10MEQExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1364515-Bedaquiline100MGOralTablet[Sirturo]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|349434-voriconazole200MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1364477-teduglutide5MGInjection[Gattex]|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|616449-MycophenolicAcid360MGDelayedReleaseOralTablet[Myfortic]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1364358-ponatinib15MGOralTablet[Iclusig]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1357547-tofacitinib5MGOralTablet[Xeljanz]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1313061-24HRPhentermine11.25MG/topiramate69MGExtendedReleaseOralCapsule[Qsymia]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1310531-teriflunomide14MGOralTablet[Aubagio]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1806181-30/70Release24HRMethylphenidateHydrochloride10MGExtendedReleaseOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1310147-everolimus5MGTabletforOralSuspension[Afinitor]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|351114-5MLzoledronicacid0.8MG/MLInjection|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1310144-everolimus3MGTabletforOralSuspension[Afinitor]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1310138-everolimus2MGTabletforOralSuspension[Afinitor]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|349435-voriconazole50MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1307630-bosutinib100MGOralTablet[Bosulif]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|402505-12HRCarbamazepine200MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1302856-24HRPhentermine15MG/topiramate92MGExtendedReleaseOralCapsule[Qsymia]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1302845-24HRPhentermine3.75MG/topiramate23MGExtendedReleaseOralCapsule[Qsymia]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|349409-Treprostinil2.5MG/MLInjectableSolution|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1302833-24HRPhentermine7.5MG/topiramate46MGExtendedReleaseOralCapsule[Qsymia]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1300803-24HRmirabegron50MGExtendedReleaseOralTablet[Myrbetriq]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|402506-12HRCarbamazepine400MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1300797-24HRmirabegron25MGExtendedReleaseOralTablet[Myrbetriq]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1291092-hydrocortisoneacetate30MGRectalSuppository[Proctocort]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1244632-AmethiaLo91DayPack|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1244064-0.4MLMethylnaltrexonebromide20MG/MLPrefilledSyringe[Relistor]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1243848-24HRMetforminhydrochloride500MG/sitagliptin50MGExtendedReleaseOralTablet[Janumet]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1806189-30/70Release24HRMethylphenidateHydrochloride30MGExtendedReleaseOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1243843-24HRMetforminhydrochloride1000MG/sitagliptin50MGExtendedReleaseOralTablet[Janumet]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|403818-moxifloxacin5MG/MLOphthalmicSolution|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1243833-24HRMetforminhydrochloride1000MG/sitagliptin100MGExtendedReleaseOralTablet[Janumet]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1243052-ivacaftor150MGOralTablet[Kalydeco]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|403811-aprepitant125MGOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1243033-Linagliptin2.5MG/Metforminhydrochloride500MGOralTablet[Jentadueto]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|403878-imatinib100MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1243026-Linagliptin2.5MG/Metforminhydrochloride1000MGOralTablet[Jentadueto]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1242615-Isotretinoin40MGOralCapsule[Myorisan]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1855086-thyroid(USP)15MGOralTablet[NPThyroid]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1242613-Isotretinoin20MGOralCapsule[Myorisan]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|403879-imatinib400MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1242611-Isotretinoin10MGOralCapsule[Myorisan]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1242233-lenalidomide2.5MGOralCapsule[Revlimid]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1235157-azilsartanmedoxomil40MG/Chlorthalidone25MGOralTablet[Edarbyclor]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1724439-thyroid(USP)30MGOralTablet[NPThyroid]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1235150-azilsartanmedoxomil40MG/Chlorthalidone12.5MGOralTablet[Edarbyclor]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1232200-Zolpidemtartrate1.75MGSublingualTablet[Intermezzo]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1860100-ferroussulfate324MGDelayedReleaseOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1232190-asparaginaseErwiniachrysanthemi10000UNTInjection[Erwinaze]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|465355-voriconazole40MG/MLOralSuspension|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1191128-EdrophoniumChloride10MG/MLInjectableSolution[Enlon]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1149667-Camrese91DayPack|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|403930-Isotretinoin30MGOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1148506-crizotinib250MGOralCapsule[Xalkori]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|477130-Hydrochlorothiazide25MG/telmisartan80MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1148502-crizotinib200MGOralCapsule[Xalkori]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1145932-1MLabatacept125MG/MLPrefilledSyringe[Orencia]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1116639-Ticagrelor90MGOralTablet[Brilinta]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1870230-NDA0208000.3MLEpinephrine1MG/MLAuto-Injector|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1115473-1.5MLLeuprolideAcetate7.5MG/MLPrefilledSyringe[Lupron]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|477347-lanthanumcarbonate500MGChewableTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1115468-1.5MLLeuprolideAcetate15MG/MLPrefilledSyringe[Lupron]|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|692694-thyroid(USP)65MGOralTablet[Westhroid]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1115456-1MLLeuprolideAcetate15MG/MLPrefilledSyringe[Lupron]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1115449-1MLLeuprolideAcetate11.25MG/MLPrefilledSyringe[Lupron]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1114096-Vandetanib300MGOralTablet[Caprelsa]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1923422-SotalolHydrochloride120MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1114074-Vandetanib100MGOralTablet[Caprelsa]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1660938-60ACTUATformoterolfumarate0.005MG/ACTUAT/mometasonefuroate0.2MG/ACTUATMeteredDoseInhaler[Dulera]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1112687-Amethia91DayPack|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1100706-Linagliptin5MGOralTablet[Tradjenta]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|477367-solifenacinsuccinate5MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1091654-azilsartanmedoxomil80MGOralTablet[Edarbi]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|485421-24HRdarifenacin15MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1091650-azilsartanmedoxomil40MGOralTablet[Edarbi]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1045408-dasatinib80MGOralTablet[Sprycel]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1923424-SotalolHydrochloride160MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1045404-dasatinib140MGOralTablet[Sprycel]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|485423-24HRdarifenacin7.5MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1043582-24HRMetforminhydrochloride500MG/saxagliptin5MGExtendedReleaseOralTablet[Kombiglyze]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1043574-24HRMetforminhydrochloride1000MG/saxagliptin5MGExtendedReleaseOralTablet[Kombiglyze]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1040058-DextromethorphanHydrobromide20MG/QuinidineSulfate10MGOralCapsule[Nuedexta]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1037185-LoLoestrinFe28DayPack|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1011755-aliskiren300MG/Hydrochlorothiazide25MGOralTablet[TekturnaHCT]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1923426-SotalolHydrochloride80MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1011752-aliskiren300MG/Hydrochlorothiazide12.5MGOralTablet[TekturnaHCT]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|485436-entecavir1MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1011715-aliskiren150MG/Hydrochlorothiazide25MGOralTablet[TekturnaHCT]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1011712-aliskiren150MG/Hydrochlorothiazide12.5MGOralTablet[TekturnaHCT]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|485434-entecavir0.5MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1000089-alcaftadine2.5MG/MLOphthalmicSolution[Lastacaft]|AGED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|998679-168HRClonidine0.0125MG/HRTransdermalSystem|AGED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|998675-168HRClonidine0.00833MG/HRTransdermalSystem|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|477372-solifenacinsuccinate10MGOralTablet|AGED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|998671-168HRClonidine0.00417MG/HRTransdermalSystem|AGED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|860654-epinastinehydrochloride0.5MG/MLOphthalmicSolution|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|543218-1MLGranisetron0.1MG/MLInjection|AGED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|856569-24HRPropranololHydrochloride80MGExtendedReleaseOralCapsule|AGED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|856535-24HRPropranololHydrochloride60MGExtendedReleaseOralCapsule|AGED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|856460-24HRPropranololHydrochloride120MGExtendedReleaseOralCapsule|AGED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|854868-Rabeprazolesodium20MGDelayedReleaseOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1872980-0.4MLadalimumab100MG/MLAuto-Injector[Humira]|AGED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|797274-Clindamycin10MG/MLMedicatedPad|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1923432-dorzolamide20MG/ML/Timolol5MG/MLOphthalmicSolution|AGED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|606726-Esomeprazole20MGDelayedReleaseOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|577057-72HRFentanyl0.012MG/HRTransdermalSystem|AGED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|577127-pregabalin225MGOralCapsule|AGED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|483450-pregabalin75MGOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|545835-LeuprolideAcetate5MG/MLInjectableSolution|AGED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|483446-pregabalin200MGOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|577208-Omega-3AcidEthylEsters(USP)1000MGOralCapsule|AGED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|483444-pregabalin300MGOralCapsule|AGED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|483440-pregabalin150MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1923809-thyroid(USP)120MGOralTablet[NPThyroid]|AGED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|483438-pregabalin100MGOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|577348-ramelteon8MGOralTablet|AGED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|351134-zolmitriptan5MGDisintegratingOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|750243-Ogestrel28DayPack|AGED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|313189-Tacrolimus0.0003MG/MGTopicalOintment|AGED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|313159-Sumatriptan5MG/ACTUATNasalSpray|AGED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|309333-Clindamycin10MG/MLTopicalSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1946772-Methotrexate25MG/MLInjectableSolution|AGED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|309332-Clindamycin0.01MG/MGTopicalGel|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|578018-bromfenac0.9MG/MLOphthalmicSolution|AGED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|284201-zolmitriptan2.5MGDisintegratingOralTablet|AGED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|244374-BenzoylPeroxide0.05MG/MG/Erythromycin0.03MG/MGTopicalGel|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|577776-candesartancilexetil16MGOralTablet|AGED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|200193-zolmitriptan2.5MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|578325-candesartancilexetil16MG/Hydrochlorothiazide12.5MGOralTablet|AGED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|2001568-BXRating24HRMethylphenidateHydrochloride54MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|2001566-BXRating24HRMethylphenidateHydrochloride36MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|2001565-BXRating24HRMethylphenidateHydrochloride27MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197303-Acetazolamide125MGOralTablet|AGED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|2001564-BXRating24HRMethylphenidateHydrochloride18MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|578330-candesartancilexetil32MG/Hydrochlorothiazide12.5MGOralTablet|AGED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|197979-Metolazone2.5MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|750264-Necon7/7/728DayPack|AGED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|1806195-50/50Release24HRMethylphenidateHydrochloride10MGExtendedReleaseOralCapsule|AGED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|1806185-50/50Release24HRMethylphenidateHydrochloride60MGExtendedReleaseOralCapsule|AGED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|1797865-mometasonefuroate0.05MG/ACTUATMeteredDoseNasalSpray|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1860148-Abuse-Deterrent12HROxycodoneHydrochloride80MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|1111343-olopatadine2MG/MLOphthalmicSolution|AGED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|1111339-olopatadine1MG/MLOphthalmicSolution|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1729047-selexipag1.6MGOralTablet[Uptravi]|AGED FULL DUALS 632|2002|N|Y|Y||Preferred Brand|2200658-semaglutide7MGOralTablet[Rybelsus]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|485489-Temazepam22.5MGOralCapsule|AGED FULL DUALS 632|2002|N|Y|Y||Preferred Brand|2200654-semaglutide3MGOralTablet[Rybelsus]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|579148-Galantamine12MGOralTablet|AGED FULL DUALS 632|2002|N|Y|Y||Preferred Brand|1716223-patiromer25200MGPowderforOralSuspension[Veltassa]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|597770-deferasirox250MGTabletforOralSuspension|AGED FULL DUALS 632|2002|N|Y|Y||Preferred Brand|1716219-patiromer16800MGPowderforOralSuspension[Veltassa]|AGED FULL DUALS 632|2002|N|Y|N||Preferred Generic|997406-12HRFexofenadinehydrochloride60MG/PseudoephedrineHydrochloride120MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197305-AceticAcid20MG/MLOticSolution|AGED FULL DUALS 632|2002|N|Y|N||Preferred Generic|996615-24HRMemantinehydrochloride7MGExtendedReleaseOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|597772-deferasirox500MGTabletforOralSuspension|AGED FULL DUALS 632|2002|N|Y|N||Preferred Generic|996609-24HRMemantinehydrochloride28MGExtendedReleaseOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|751870-Nortrel1/3528DayPack|AGED FULL DUALS 632|2002|N|Y|N||Preferred Generic|996594-24HRMemantinehydrochloride14MGExtendedReleaseOralCapsule|AGED FULL DUALS 632|2002|N|Y|N||Preferred Generic|857564-24HRtrospiumchloride60MGExtendedReleaseOralCapsule|AGED FULL DUALS 632|2002|N|Y|N||Preferred Generic|857560-trospiumchloride20MGOralTablet|AGED FULL DUALS 632|2002|N|Y|N||Preferred Generic|855189-24HRtolterodinetartrate4MGExtendedReleaseOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197310-Acyclovir200MGOralCapsule|AGED FULL DUALS 632|2002|N|Y|N||Preferred Generic|855182-24HRtolterodinetartrate2MGExtendedReleaseOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|603203-erlotinib100MGOralTablet|AGED FULL DUALS 632|2002|N|Y|N||Preferred Generic|855178-tolterodinetartrate1MGOralTablet|AGED FULL DUALS 632|2002|N|Y|N||Preferred Generic|825130-24HRmesalamine375MGExtendedReleaseOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|602635-lanthanumcarbonate1000MGChewableTablet|AGED FULL DUALS 632|2002|N|Y|N||Preferred Generic|810083-Carbidopa31.25MG/entacapone200MG/Levodopa125MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|603206-erlotinib150MGOralTablet|AGED FULL DUALS 632|2002|N|Y|N||Preferred Generic|749206-sevelamercarbonate800MGOralTablet|AGED FULL DUALS 632|2002|N|Y|N||Preferred Generic|745791-200ACTUATLevalbuterol0.045MG/ACTUATMeteredDoseInhaler|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|597768-deferasirox125MGTabletforOralSuspension|AGED FULL DUALS 632|2002|N|Y|N||Preferred Generic|730988-Carbidopa50MG/entacapone200MG/Levodopa200MGOralTablet|AGED FULL DUALS 632|2002|N|Y|N||Preferred Generic|686429-mesalamine1200MGDelayedReleaseOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|603208-erlotinib25MGOralTablet|AGED FULL DUALS 632|2002|N|Y|N||Preferred Generic|606730-Esomeprazole40MGDelayedReleaseOralCapsule|AGED FULL DUALS 632|2002|N|Y|N||Preferred Generic|562806-Pimecrolimus10MG/MLTopicalCream|AGED FULL DUALS 632|2002|N|Y|N||Preferred Generic|403851-Carbidopa25MG/entacapone200MG/Levodopa100MGOralTablet|AGED FULL DUALS 632|2002|N|Y|N||Preferred Generic|403850-Carbidopa12.5MG/entacapone200MG/Levodopa50MGOralTablet|AGED FULL DUALS 632|2002|N|Y|N||Preferred Generic|349556-ezetimibe10MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197313-Acyclovir800MGOralTablet|AGED FULL DUALS 632|2002|N|Y|N||Preferred Generic|317094-entacapone200MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|616749-12HRranolazine500MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|Y|N||Preferred Generic|313921-calcipotriene0.05MG/MLTopicalCream|AGED FULL DUALS 632|2002|N|Y|N||Preferred Generic|311787-moxifloxacin400MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|616578-lubiprostone0.024MGOralCapsule|AGED FULL DUALS 632|2002|N|Y|N||Preferred Generic|311345-linezolid20MG/MLOralSuspension|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|639537-candesartancilexetil32MGOralTablet|AGED FULL DUALS 632|2002|N|Y|N||Preferred Generic|311286-Levalbuterol0.21MG/MLInhalationSolution|AGED FULL DUALS 632|2002|N|Y|N||Preferred Generic|308865-calcipotriene0.05MG/MLTopicalSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197316-Albuterol2MGOralTablet|AGED FULL DUALS 632|2002|N|Y|N||Preferred Generic|284008-travoprost0.04MG/MLOphthalmicSolution|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|642452-lanthanumcarbonate750MGChewableTablet|AGED FULL DUALS 632|2002|N|Y|N||Preferred Generic|242831-Griseofulvin125MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|751890-Portia28DayPack|AGED FULL DUALS 632|2002|N|Y|N||Preferred Generic|204119-Malathion5MG/MLTopicalLotion|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1747187-0.4MLMethotrexate43.8MG/MLAuto-Injector[Otrexup]|AGED FULL DUALS 632|2002|N|Y|N||Preferred Generic|198373-calcipotriene0.00005MG/MGTopicalOintment|AGED FULL DUALS 632|2002|N|Y|N||Preferred Generic|197551-Cycloserine250MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197318-Albuterol4MGOralTablet|AGED FULL DUALS 632|2002|N|Y|N||Preferred Generic|197508-Cimetidine800MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|656659-bosentan125MGOralTablet|AGED FULL DUALS 632|2002|N|Y|N||Preferred Generic|197507-Cimetidine400MGOralTablet|AGED FULL DUALS 632|2002|N|Y|N||Preferred Generic|197506-Cimetidine300MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|644088-aprepitant40MGOralCapsule|AGED FULL DUALS 632|2002|N|Y|N||Preferred Generic|197419-Bumetanide2MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|672149-lapatinib250MGOralTablet|AGED FULL DUALS 632|2002|N|Y|N||Preferred Generic|197418-Bumetanide1MGOralTablet|AGED FULL DUALS 632|2002|N|Y|N||Preferred Generic|197417-Bumetanide0.5MGOralTablet|AGED FULL DUALS 632|2002|N|Y|N||Preferred Generic|1855389-Levalbuterol2.5MG/MLInhalationSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197319-Allopurinol100MGOralTablet|AGED FULL DUALS 632|2002|N|Y|N||Preferred Generic|1797863-flunisolide0.025MG/ACTUATMeteredDoseNasalSpray|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|700883-temozolomide140MGOralCapsule|AGED FULL DUALS 632|2002|N|Y|N||Preferred Generic|1368954-mesalamine400MGDelayedReleaseOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|753543-Reclipsen28DayPack|AGED FULL DUALS 632|2002|N|Y|N||Preferred Generic|1368424-alogliptin25MG/pioglitazone15MGOralTablet|AGED FULL DUALS 632|2002|N|Y|N||Preferred Generic|1368417-alogliptin12.5MG/pioglitazone45MGOralTablet|AGED FULL DUALS 632|2002|N|Y|N||Preferred Generic|1368403-alogliptin12.5MG/pioglitazone15MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197320-Allopurinol300MGOralTablet|AGED FULL DUALS 632|2002|N|Y|N||Preferred Generic|1368392-alogliptin12.5MG/Metforminhydrochloride500MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1747194-0.4MLMethotrexate56.3MG/MLAuto-Injector[Otrexup]|AGED FULL DUALS 632|2002|N|Y|N||Preferred Generic|1368385-alogliptin12.5MG/Metforminhydrochloride1000MGOralTablet|AGED FULL DUALS 632|2002|N|Y|N||Preferred Generic|1368034-alogliptin12.5MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|700885-temozolomide180MGOralCapsule|AGED FULL DUALS 632|2002|N|Y|N||Preferred Generic|1368018-alogliptin6.25MGOralTablet|AGED FULL DUALS 632|2002|N|Y|N||Preferred Generic|1368006-alogliptin25MGOralTablet|AGED FULL DUALS 632|2002|N|Y|N||Preferred Generic|1246673-Ivermectin5MG/MLTopicalLotion|AGED FULL DUALS 632|2002|N|Y|N||Preferred Generic|1085816-spinosad9MG/MLMedicatedShampoo|AGED FULL DUALS 632|2002|N|Y|N||Preferred Brand|996633-NamendaXR28DayTitrationPack|AGED FULL DUALS 632|2002|N|Y|N||Preferred Brand|856666-rifaximin550MGOralTablet[XIFAXAN]|AGED FULL DUALS 632|2002|N|Y|N||Preferred Brand|835721-Ethionamide250MGOralTablet[Trecator]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197361-Amlodipine5MGOralTablet|AGED FULL DUALS 632|2002|N|Y|N||Preferred Brand|833151-Savella4-WeekTitrationPack|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1801519-Methylnaltrexonebromide150MGOralTablet[Relistor]|AGED FULL DUALS 632|2002|N|Y|N||Preferred Brand|833149-Milnacipranhydrochloride25MGOralTablet[Savella]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|722116-ambrisentan10MGOralTablet|AGED FULL DUALS 632|2002|N|Y|N||Preferred Brand|833146-Milnacipranhydrochloride50MGOralTablet[Savella]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|705824-100MLzoledronicacid0.05MG/MLInjection|AGED FULL DUALS 632|2002|N|Y|N||Preferred Brand|833143-Milnacipranhydrochloride12.5MGOralTablet[Savella]|AGED FULL DUALS 632|2002|N|Y|N||Preferred Brand|539789-rifaximin200MGOralTablet[XIFAXAN]|AGED FULL DUALS 632|2002|N|Y|N||Preferred Brand|402092-Cyclosporine0.5MG/MLOphthalmicSuspension[Restasis]|AGED FULL DUALS 632|2002|N|Y|N||Preferred Brand|2398842-3MLsemaglutide1.34MG/MLPenInjector[Ozempic]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1806942-carfilzomib60MGInjection[Kyprolis]|AGED FULL DUALS 632|2002|N|Y|N||Preferred Brand|2395785-0.5MLdulaglutide9MG/MLAuto-Injector[Trulicity]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|722122-ambrisentan5MGOralTablet|AGED FULL DUALS 632|2002|N|Y|N||Preferred Brand|2395779-0.5MLdulaglutide6MG/MLAuto-Injector[Trulicity]|AGED FULL DUALS 632|2002|N|Y|N||Preferred Brand|213307-Ciprofloxacin0.003MG/MGOphthalmicOintment[Ciloxan]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1729076-UptraviTitrationPack|AGED FULL DUALS 632|2002|N|Y|N||Preferred Brand|212381-aminosalicylicacid4000MGOralGranules[PaserD/R]|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|759469-Quasense91DayPack|AGED FULL DUALS 632|2002|N|Y|N||Preferred Brand|1992821-ertugliflozin15MGOralTablet[Steglatro]|AGED FULL DUALS 632|2002|N|Y|N||Preferred Brand|1992816-ertugliflozin5MGOralTablet[Steglatro]|AGED FULL DUALS 632|2002|N|Y|N||Preferred Brand|1992703-ertugliflozin7.5MG/Metforminhydrochloride500MGOralTablet[Segluromet]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|724861-armodafinil250MGOralTablet|AGED FULL DUALS 632|2002|N|Y|N||Preferred Brand|1992700-ertugliflozin7.5MG/Metforminhydrochloride1000MGOralTablet[Segluromet]|AGED FULL DUALS 632|2002|N|Y|N||Preferred Brand|1992695-ertugliflozin2.5MG/Metforminhydrochloride500MGOralTablet[Segluromet]|AGED FULL DUALS 632|2002|N|Y|N||Preferred Brand|1992691-ertugliflozin2.5MG/Metforminhydrochloride1000MGOralTablet[Segluromet]|AGED FULL DUALS 632|2002|N|Y|N||Preferred Brand|1991317-1MGDose1.5MLsemaglutide1.34MG/MLPenInjector[Ozempic]|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|759473-20ACTUATZanamivir5MG/ACTUATDryPowderInhaler[Relenza]|AGED FULL DUALS 632|2002|N|Y|N||Preferred Brand|1991311-0.25MG,0.5MGDose1.5MLsemaglutide1.34MG/MLPenInjector[Ozempic]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|724863-armodafinil50MGOralTablet|AGED FULL DUALS 632|2002|N|Y|N||Preferred Brand|1551306-0.5MLdulaglutide3MG/MLAuto-Injector[Trulicity]|AGED FULL DUALS 632|2002|N|Y|N||Preferred Brand|1551300-0.5MLdulaglutide1.5MG/MLAuto-Injector[Trulicity]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|197730-Furosemide10MG/MLOralSolution|AGED FULL DUALS 632|2002|N|Y|N||Preferred Brand|1356673-BenzylAlcohol0.05ML/MLTopicalLotion[Ulesfia]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197379-Atenolol100MGOralTablet|AGED FULL DUALS 632|2002|N|Y|N||Preferred Brand|1190334-24HRFexofenadinehydrochloride180MG/PseudoephedrineHydrochloride240MGExtendedReleaseOralTablet[Wal-FexD]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|996757-CodeinePhosphate2MG/ML/PhenylephrineHydrochloride1MG/ML/PromethazineHydrochloride1.25MG/MLOralSolution|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|995868-CodeinePhosphate2MG/ML/Guaifenesin20MG/MLOralSolution|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|725021-24HRrivastigmine0.192MG/HRTransdermalSystem|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|762001-Kariva28DayPack|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|993890-Acetaminophen300MG/CodeinePhosphate60MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|993781-Acetaminophen300MG/CodeinePhosphate30MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|993770-Acetaminophen300MG/CodeinePhosphate15MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|993755-Acetaminophen24MG/ML/CodeinePhosphate2.4MG/MLOralSolution|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|993470-midodrinehydrochloride5MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1855527-HumiraPediatricCrohn'sDiseaseStarterPackage(2count)|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|993466-midodrinehydrochloride2.5MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|993462-midodrinehydrochloride10MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|992668-homatropinemethylbromide0.3MG/ML/HydrocodoneBitartrate1MG/MLOralSolution|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|991528-DextromethorphanHydrobromide3MG/ML/PromethazineHydrochloride1.25MG/MLOralSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|762007-Nortrel7/7/728DayPack|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1858833-12HRTreprostinil5MGExtendedReleaseOralTablet[Orenitram]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|977880-AmilorideHydrochloride5MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|905516-ChlordiazepoxideHydrochloride5MGOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|727339-0.5MLSumatriptan12MG/MLPrefilledSyringe|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|905495-ChlordiazepoxideHydrochloride25MGOralCapsule|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|905369-ChlordiazepoxideHydrochloride10MGOralCapsule|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|904589-SotalolHydrochloride240MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|904447-Alendronicacid0.933MG/MLOralSolution|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|904419-Alendronicacid10MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|904405-Alendronicacid40MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197380-Atenolol25MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|899557-dexmethylphenidatehydrochloride2.5MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|899548-dexmethylphenidatehydrochloride10MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|899518-dexmethylphenidatehydrochloride5MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197381-Atenolol50MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|897749-HydromorphoneHydrochloride3MGRectalSuppository|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1868020-pirfenidone801MGOralTablet[Esbriet]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|897710-HydromorphoneHydrochloride8MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|728231-12HRranolazine1000MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|897702-HydromorphoneHydrochloride4MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|762334-Velivet28DayPack|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|897696-HydromorphoneHydrochloride2MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197362-ammoniumlactate120MG/MLTopicalLotion|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|897659-Verapamilhydrochloride120MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|897640-Verapamilhydrochloride180MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|897630-24HRVerapamilhydrochloride360MGExtendedReleaseOralCapsule|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|897618-24HRVerapamilhydrochloride180MGExtendedReleaseOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|725023-24HRrivastigmine0.396MG/HRTransdermalSystem|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|897612-24HRVerapamilhydrochloride120MGExtendedReleaseOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|754508-{1(aprepitant125MGOralCapsule)/2(aprepitant80MGOralCapsule)}Pack|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|894780-MorphineSulfate4MG/MLOralSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197382-Atenolol100MG/Chlorthalidone25MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|892672-MorphineSulfate30MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|892625-MorphineSulfate20MG/MLOralSolution|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|892589-MorphineSulfate2MG/MLOralSolution|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1870952-deflazacort30MGOralTablet[Emflaza]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|892582-MorphineSulfate15MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|884386-DextroamphetamineSulfate5MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|802749-candesartancilexetil32MG/Hydrochlorothiazide25MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|884385-DextroamphetamineSulfate10MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|866042-NeomycinSulfate500MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|863559-valganciclovir50MG/MLOralSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|762663-Jolessa91DayPack|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|862025-24HRGuanfacine4MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|862019-24HRGuanfacine3MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1988977-24HRpregabalin330MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|803353-PhentermineHydrochloride37.5MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|862006-24HRGuanfacine1MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|861237-24HRAmphetamineaspartate1.25MG/AmphetamineSulfate1.25MG/Dextroamphetaminesaccharate1.25MG/DextroamphetamineSulfate1.25|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|861232-24HRAmphetamineaspartate7.5MG/AmphetamineSulfate7.5MG/Dextroamphetaminesaccharate7.5MG/DextroamphetamineSulfate7.5MGEx|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197383-Atenolol50MG/Chlorthalidone25MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1870956-deflazacort18MGOralTablet[Emflaza]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|861227-24HRAmphetamineaspartate6.25MG/AmphetamineSulfate6.25MG/Dextroamphetaminesaccharate6.25MG/DextroamphetamineSulfate6.25|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|861225-24HRAmphetamineaspartate5MG/AmphetamineSulfate5MG/Dextroamphetaminesaccharate5MG/DextroamphetamineSulfate5MGExtendedRe|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|861223-24HRAmphetamineaspartate3.75MG/AmphetamineSulfate3.75MG/Dextroamphetaminesaccharate3.75MG/DextroamphetamineSulfate3.75|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|797023-DexPakTaperPak13DayPack|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|861221-24HRAmphetamineaspartate2.5MG/AmphetamineSulfate2.5MG/Dextroamphetaminesaccharate2.5MG/DextroamphetamineSulfate2.5MGEx|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|857366-EconazoleNitrate10MG/MLTopicalCream|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1870950-deflazacort6MGOralTablet[Emflaza]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|857005-Acetaminophen325MG/HydrocodoneBitartrate7.5MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|857002-Acetaminophen325MG/HydrocodoneBitartrate5MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|856999-Acetaminophen325MG/HydrocodoneBitartrate10MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|856940-Acetaminophen21.7MG/ML/HydrocodoneBitartrate0.5MG/MLOralSolution|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|855633-DiclofenacSodium0.01MG/MGTopicalGel|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197388-Azathioprine50MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|854876-Zolpidemtartrate5MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|824295-rufinamide200MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|854873-Zolpidemtartrate10MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|808118-prednisolone5MGOralTablet[MILLIPRED]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|854252-1MLEnoxaparinsodium150MG/MLPrefilledSyringe|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1871459-lisdexamfetaminedimesylate40MGChewableTablet[Vyvanse]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|854248-1MLEnoxaparinsodium100MG/MLPrefilledSyringe|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|854245-0.8MLEnoxaparinsodium150MG/MLPrefilledSyringe|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|854241-0.8MLEnoxaparinsodium100MG/MLPrefilledSyringe|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|854238-0.6MLEnoxaparinsodium100MG/MLPrefilledSyringe|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|854235-0.4MLEnoxaparinsodium100MG/MLPrefilledSyringe|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1871461-lisdexamfetaminedimesylate30MGChewableTablet[Vyvanse]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|854228-0.3MLEnoxaparinsodium100MG/MLPrefilledSyringe|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|847252-3MLInsulinLispro25UNT/ML/insulinlisproprotamine,human75UNT/MLPenInjector|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|847191-3MLinsulinaspartprotamine,human70UNT/ML/insulinaspart,human30UNT/MLPenInjector|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|846378-24HRLevetiracetam750MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|845488-Ramipril1.25MGOralCapsule|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|835829-testosteronecypionate100MG/MLInjectableSolution|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|724859-armodafinil150MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|835603-tramadolhydrochloride50MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|810096-{7(EthinylEstradiol0.01MGOralTablet)/84(EthinylEstradiol0.02MG/Levonorgestrel0.1MGOralTablet)}Pack|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|834022-KetorolacTromethamine10MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|833234-mesalamine800MGDelayedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|830861-24HRDiltiazemHydrochloride120MGExtendedReleaseOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|824301-rufinamide400MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|830845-24HRDiltiazemHydrochloride180MGExtendedReleaseOralCapsule|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|830837-24HRDiltiazemHydrochloride240MGExtendedReleaseOralCapsule|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|830801-24HRDiltiazemHydrochloride300MGExtendedReleaseOralCapsule|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|807832-24HRLevetiracetam500MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|801966-4MLDiazepam5MG/MLRectalGel|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1871465-lisdexamfetaminedimesylate10MGChewableTablet[Vyvanse]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|801961-2MLDiazepam5MG/MLRectalGel|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|834235-febuxostat40MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|801957-0.5MLDiazepam5MG/MLRectalGel|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197392-Baclofen20MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|728113-Oseltamivir45MGOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|834241-febuxostat80MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|728109-Oseltamivir30MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|827713-MineralOil0.03MG/MG/Petrolatum0.94MG/MGOphthalmicOintment[SystaneNighttime]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|687043-Amphetamineaspartate3.125MG/AmphetamineSulfate3.125MG/Dextroamphetaminesaccharate3.125MG/DextroamphetamineSulfate3.125|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|686379-celecoxib50MGOralCapsule|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|636045-Hydrochlorothiazide25MG/valsartan320MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|845515-everolimus5MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|636042-Hydrochlorothiazide12.5MG/valsartan320MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|608143-atomoxetine80MGOralCapsule|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|608139-atomoxetine100MGOralCapsule|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|596934-duloxetine60MGDelayedReleaseOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|830463-1MLrabiesvirusvaccineflury-lepstrain2.5UNT/MLInjection[RabAvert]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|596930-duloxetine30MGDelayedReleaseOralCapsule|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|596926-duloxetine20MGDelayedReleaseOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|198243-Temazepam7.5MGOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|848131-Amlodipine10MG/Hydrochlorothiazide12.5MG/valsartan160MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|577961-Amphetamineaspartate5MG/AmphetamineSulfate5MG/Dextroamphetaminesaccharate5MG/DextroamphetamineSulfate5MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1870968-deflazacort22.75MG/MLOralSuspension[Emflaza]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|577957-Amphetamineaspartate3.75MG/AmphetamineSulfate3.75MG/Dextroamphetaminesaccharate3.75MG/DextroamphetamineSulfate3.75MGOr|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1871467-lisdexamfetaminedimesylate60MGChewableTablet[Vyvanse]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|541892-Amphetamineaspartate2.5MG/AmphetamineSulfate2.5MG/Dextroamphetaminesaccharate2.5MG/DextroamphetamineSulfate2.5MGOralTa|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1871463-lisdexamfetaminedimesylate20MGChewableTablet[Vyvanse]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1871469-lisdexamfetaminedimesylate50MGChewableTablet[Vyvanse]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|541878-Amphetamineaspartate1.25MG/AmphetamineSulfate1.25MG/Dextroamphetaminesaccharate1.25MG/DextroamphetamineSulfate1.25MGOr|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|541363-Amphetamineaspartate7.5MG/AmphetamineSulfate7.5MG/Dextroamphetaminesaccharate7.5MG/DextroamphetamineSulfate7.5MGOralTa|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|485486-tizanidine2MGOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|848135-Amlodipine10MG/Hydrochlorothiazide25MG/valsartan320MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|830470-1MLrabiesvirusvaccinewistarstrainPM-1503-3M(Human),Inactivated2.5UNT/MLInjection[Imovax]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|485485-tizanidine4MGOralCapsule|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|485484-tizanidine6MGOralCapsule|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|485465-Eszopiclone3MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|485442-Eszopiclone2MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|485440-Eszopiclone1MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1873087-HumiraPrefilledSyringe80MG/0.8MLStarterPack-PediatricCrohn'sDisease(3count)|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|477562-Fenofibrate48MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|477560-Fenofibrate145MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|403923-168HREstradiol0.0025MG/HRTransdermalSystem|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|848140-Amlodipine5MG/Hydrochlorothiazide12.5MG/valsartan160MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|403922-168HREstradiol0.00156MG/HRTransdermalSystem|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|836368-200ACTUATIpratropiumBromide0.017MG/ACTUATMeteredDoseInhaler[Atrovent]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|403884-Levetiracetam100MG/MLOralSolution|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1873704-Mibelas24FeChewable28DayPack|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|359818-Nicotine4MGOralLozenge|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|359817-Nicotine2MGOralLozenge|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|848145-Amlodipine5MG/Hydrochlorothiazide25MG/valsartan160MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|351297-insulinaspartprotamine,human70UNT/ML/insulinaspart,human30UNT/MLInjectableSuspension|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|351246-montelukast4MGOralGranules|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|351133-Fenofibrate54MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|351109-Budesonide0.25MG/MLInhalationSuspension|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|349595-atomoxetine60MGOralCapsule|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|349594-atomoxetine40MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197407-Betamethasone1MG/MLTopicalCream|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|349593-atomoxetine25MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197405-Betamethasone0.0005MG/MGTopicalOintment|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|349592-atomoxetine18MGOralCapsule|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|349591-atomoxetine10MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197408-Betamethasone1MG/MLTopicalLotion|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|349514-celecoxib400MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1547771-Tetracainehydrochloride5MG/MLOphthalmicSolution|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|349483-valsartan40MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|848151-Amlodipine10MG/Hydrochlorothiazide25MG/valsartan160MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|349353-Hydrochlorothiazide25MG/valsartan160MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|845305-Nonoxynol-90.04MG/MGVaginalGel[Conceptrol]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|349287-Fenofibrate160MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|349201-valsartan160MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|349200-valsartan320MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|349199-valsartan80MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|349198-Clonazepam0.5MGDisintegratingOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1921010-0.1MLadalimumab100MG/MLPrefilledSyringe[Humira]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|349197-Clonazepam2MGDisintegratingOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|850087-24HRlamotrigine100MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|349196-Clonazepam1MGDisintegratingOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197409-Betamethasone0.001MG/MGTopicalOintment|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|349195-Clonazepam0.25MGDisintegratingOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|850091-24HRlamotrigine50MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|349194-Clonazepam0.125MGDisintegratingOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|349094-Budesonide0.125MG/MLInhalationSuspension|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1921017-0.2MLadalimumab100MG/MLPrefilledSyringe[Humira]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|318202-Erythromycin20MG/MLTopicalSolution|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|315223-Sumatriptan25MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|854880-Zolpidemtartrate12.5MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|314285-zonisamide100MGOralCapsule|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|314209-rizatriptan10MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|314200-pantoprazole40MGDelayedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|854910-BisoprololFumarate10MG/Hydrochlorothiazide6.25MGOralTablet[Ziac]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|314135-naratriptan2.5MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|313762-zaleplon5MGOralCapsule|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|862013-24HRGuanfacine2MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|313761-zaleplon10MGOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|198071-Penicillamine250MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|854894-Zolpidemtartrate6.25MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|313571-Vancomycin250MGOralCapsule|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|313570-Vancomycin125MGOralCapsule|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|313566-valganciclovir450MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197411-Bromocriptine2.5MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1921081-1.56MLabaloparatide2MG/MLPenInjector[Tymlos]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|313415-Tobramycin3MG/MLOphthalmicSolution|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|313413-tizanidine4MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|313412-tizanidine2MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|855626-Twice-Dailydiclofenacepolamine0.013MG/MGMedicatedPatch|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|854918-BisoprololFumarate2.5MG/Hydrochlorothiazide6.25MGOralTablet[Ziac]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|313222-terbinafine250MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|313161-Sumatriptan50MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|313160-Sumatriptan100MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|312840-rizatriptan5MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|312087-Ondansetron8MGDisintegratingOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1921245-HumiraPen80MG/0.8ML-StarterPackageforCrohn'sDisease,UlcerativeColitisorHidradenitisSuppurativa(3count)|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|312086-Ondansetron8MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|312075-Ofloxacin3MG/MLOphthalmicSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197433-calciumacetate667MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|311975-Nicotine4MGChewingGum|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|855642-DiclofenacSodium0.03MG/MGTopicalGel|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|311918-naratriptan1MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1873765-plecanatide3MGOralTablet[Trulance]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|311759-montelukast4MGChewableTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|311265-lamotrigine5MGChewableTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|311237-Ketotifen0.25MG/MLOphthalmicSolution|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|311207-Ivermectin3MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|310793-Hydrochlorothiazide12.5MG/irbesartan300MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|310792-Hydrochlorothiazide12.5MG/irbesartan150MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1923338-1.14MLsarilumab132MG/MLPrefilledSyringe[Kevzara]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|310467-Gentamicin3MG/MLOphthalmicSolution|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|310465-Gentamicin0.001MG/MGTopicalOintment|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|310289-Fenofibrate200MGOralCapsule|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|310288-Fenofibrate134MGOralCapsule|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|310191-estradiolvalerate40MG/MLInjectableSolution|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|310190-estradiolvalerate20MG/MLInjectableSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197443-Carbidopa10MG/Levodopa100MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|310152-Erythromycin0.02MG/MGTopicalGel|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1923347-1.14MLsarilumab175MG/MLPrefilledSyringe[Kevzara]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|310149-Erythromycin0.005MG/MGOphthalmicOintment|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|857224-Sevelamerhydrochloride800MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|309314-Citalopram40MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|857216-Sevelamerhydrochloride400MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|309309-Ciprofloxacin500MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|309307-Ciprofloxacin3MG/MLOphthalmicSolution|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|283407-Mirtazapine30MGDisintegratingOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|261962-Ramipril10MGOralCapsule|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|259081-12HRAspirin25MG/Dipyridamole200MGExtendedReleaseOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1925255-0.4MLabatacept125MG/MLPrefilledSyringe[Orencia]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|252559-Budesonide0.5MG/MLInhalationSuspension|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|857700-DiclofenacSodium15MG/MLTopicalSolution|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|251872-pantoprazole20MGDelayedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197444-Carbidopa25MG/Levodopa100MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|248478-84HREstradiol0.00104MG/HRTransdermalSystem|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|860103-KetorolacTromethamine4MG/MLOphthalmicSolution|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|242892-84HREstradiol0.00417MG/HRTransdermalSystem|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|855205-docosanol100MG/MLTopicalCream[Abreva]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|242891-84HREstradiol0.00208MG/HRTransdermalSystem|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|242462-cilostazol50MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|242461-cilostazol100MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|860695-24HRgalantaminehydrobromide16MGExtendedReleaseOralCapsule|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|242438-montelukast5MGChewableTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|242333-168HREstradiol0.00104MG/HRTransdermalSystem|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|241946-84HREstradiol0.00156MG/HRTransdermalSystem|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|241527-168HREstradiol0.00312MG/HRTransdermalSystem|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|855871-Phenytoinsodium30MGExtendedReleaseOralCapsule[Dilantin]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|238004-168HREstradiol0.00417MG/HRTransdermalSystem|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|238003-168HREstradiol0.00208MG/HRTransdermalSystem|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|860707-24HRgalantaminehydrobromide24MGExtendedReleaseOralCapsule|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|2123111-NDA020503200ACTUATAlbuterol0.09MG/ACTUATMeteredDoseInhaler|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|205323-celecoxib200MGOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1925257-0.7MLabatacept125MG/MLPrefilledSyringe[Orencia]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|205322-celecoxib100MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197445-Carbidopa25MG/Levodopa250MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1927290-infliximab-abda100MGInjection[Renflexis]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|2047882-1MLtestosteronecypionate200MG/MLInjection|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|203088-Ketoconazole20MG/MLTopicalCream|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|200345-Simvastatin80MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|860715-24HRgalantaminehydrobromide8MGExtendedReleaseOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|856467-Tri-Lo-Sprintec28DayPack|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|200329-Omeprazole40MGDelayedReleaseOralCapsule|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|200311-Fenofibrate67MGOralCapsule|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|200285-Hydrochlorothiazide12.5MG/valsartan160MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|200284-Hydrochlorothiazide12.5MG/valsartan80MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|854921-BisoprololFumarate5MG/Hydrochlorothiazide6.25MGOralTablet[Ziac]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|200224-montelukast10MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1946520-3-Month1.5MLLeuprolideAcetate20MG/MLPrefilledSyringe[Lupron]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|200096-irbesartan300MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|200095-irbesartan150MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|200094-irbesartan75MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|199381-potassiumcitrate10MEQExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|861834-amylase82000UNT/lipase15000UNT/protease51000UNTDelayedReleaseOralCapsule[Zenpep]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|199376-potassiumcitrate5MEQExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1946522-4-Month1.5MLLeuprolideAcetate20MG/MLPrefilledSyringe[Lupron]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|199370-Ciprofloxacin100MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|199206-Riluzole50MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|861370-sevelamercarbonate2400MGPowderforOralSuspension|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|198342-Urea400MG/MLTopicalCream|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|198318-Triazolam0.25MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|198317-Triazolam0.125MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1989085-bosentan32MGTabletforOralSuspension[Tracleer]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|198252-tetracyclinehydrochloride500MGOralCapsule|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|198250-tetracyclinehydrochloride250MGOralCapsule|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|198242-Temazepam30MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197448-Levocarnitine330MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|198241-Temazepam15MGOralCapsule|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|198189-Ramipril5MGOralCapsule|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|198188-Ramipril2.5MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197449-Cefaclor500MGOralCapsule|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|198052-Ondansetron4MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1989109-1MLbenralizumab30MG/MLPrefilledSyringe[Fasenra]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|198051-Omeprazole20MGDelayedReleaseOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|861375-sevelamercarbonate800MGPowderforOralSuspension|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|198036-24HRNifedipine90MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|863829-amylase120000UNT/lipase24000UNT/protease76000UNTDelayedReleaseOralCapsule[Creon]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|198035-24HRNifedipine60MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|198034-24HRNifedipine30MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|197902-Lorazepam2MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|197900-Lorazepam0.5MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|197877-Lidocaine25MG/ML/Prilocaine25MG/MLTopicalCream|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|860901-galantaminehydrobromide4MG/MLOralSolution|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|197739-Glycopyrrolate2MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|861960-armodafinil200MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|197738-Glycopyrrolate1MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197454-Cephalexin500MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|197735-Gentamicin1MG/MLTopicalCream|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|863038-bepotastinebesilate15MG/MLOphthalmicSolution|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|197591-Diazepam5MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|197590-Diazepam2MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1999389-symdeko100MG/150MGand150MGPack|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|197589-Diazepam10MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|197541-Colchicine0.6MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|864675-Atovaquone250MG/proguanilhydrochloride100MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|197529-Clonazepam2MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|197528-Clonazepam1MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|197527-Clonazepam0.5MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|863836-amylase30000UNT/lipase6000UNT/protease19000UNTDelayedReleaseOralCapsule[Creon]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|197512-Ciprofloxacin750MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|197511-Ciprofloxacin250MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|1926331-0.5UNTDoses3MLInsulinLispro100UNT/MLPenInjector|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|197843-Isotretinoin10MGOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|864681-Atovaquone62.5MG/proguanilhydrochloride25MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|1918209-60ACTUATfluticasonepropionate0.055MG/ACTUAT/salmeterol0.014MG/ACTUATDryPowderInhaler|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|1918203-60ACTUATfluticasonepropionate0.232MG/ACTUAT/salmeterol0.014MG/ACTUATDryPowderInhaler|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|1918194-60ACTUATfluticasonepropionate0.113MG/ACTUAT/salmeterol0.014MG/ACTUATDryPowderInhaler|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197499-Chlorthalidone25MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2000013-1.1MLhydroxyprogesteronecaproate(USP)250MG/MLAuto-Injector[Makena]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|1812015-Osmotic24HRNifedipine90MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|1812013-Osmotic24HRNifedipine60MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|1812011-Osmotic24HRNifedipine30MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1921468-HumiraPen80MG/0.8MLand40MG/0.4ML-Psoriasis/UveitisStarterPackage(3count)|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|1806197-30/70Release24HRMethylphenidateHydrochloride60MGExtendedReleaseOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197391-Baclofen10MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|1806193-30/70Release24HRMethylphenidateHydrochloride50MGExtendedReleaseOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1990869-0.85MLexenatide2.35MG/MLAuto-Injector[Bydureon]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|1806191-30/70Release24HRMethylphenidateHydrochloride40MGExtendedReleaseOralCapsule|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|1650142-DoxycyclineMonohydrate100MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|1649990-DoxycyclineMonohydrate100MGOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2003757-1.14MLsarilumab132MG/MLAuto-Injector[Kevzara]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|1649401-DoxycyclineMonohydrate50MGOralCapsule|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|1596780-60ACTUATTestosterone12.5MG/ACTUATTopicalGel|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197500-Chlorthalidone50MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|1550940-Colchicine0.6MGOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|864718-MethadoneHydrochloride5MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|1543069-Lidocaine0.05MG/MGTopicalOintment|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|864010-ammoniumlactate120MG/MLTopicalLotion[Geri-Hydrolac]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|1298091-FlurazepamHydrochloride30MGOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2003767-1.14MLsarilumab175MG/MLAuto-Injector[Kevzara]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|1298088-FlurazepamHydrochloride15MGOralCapsule|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|1244214-Budesonide3MGDelayedReleaseOralCapsule|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|1149632-84HREstradiol0.00313MG/HRTransdermalSystem|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|1115698-Oseltamivir6MG/MLOralSuspension|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|1091497-MethylphenidateHydrochloride5MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2045638-1MLerenumab-aooe70MG/MLAuto-Injector[Aimovig]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|1091392-MethylphenidateHydrochloride20MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|1091225-8HRMethylphenidateHydrochloride20MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|1091150-MethylphenidateHydrochloride10MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|1091145-8HRMethylphenidateHydrochloride10MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|106346-Mupirocin0.02MG/MGTopicalOintment|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|1049225-Acetaminophen325MG/OxycodoneHydrochloride7.5MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197516-Clarithromycin250MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|1049221-Acetaminophen325MG/OxycodoneHydrochloride5MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|864706-MethadoneHydrochloride10MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|1049214-Acetaminophen325MG/OxycodoneHydrochloride10MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|864769-MethadoneHydrochloride2MG/MLOralSolution|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|104894-Ondansetron4MGDisintegratingOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|864761-MethadoneHydrochloride1MG/MLOralSolution|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|1009145-Amphetamineaspartate1.875MG/AmphetamineSulfate1.875MG/Dextroamphetaminesaccharate1.875MG/DextroamphetamineSulfate1.87|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|1000153-1MLmedroxyprogesteroneacetate150MG/MLPrefilledSyringe|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|1000126-1MLmedroxyprogesteroneacetate150MG/MLInjection|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|999965-Glycopyrrolate0.2MG/MLOralSolution[Cuvposa]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|998666-carboxymethylcellulosesodium0.01MG/MGOphthalmicGel[TheraTears]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2045961-Doptelet60MGDailyDoseCartonPack|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|901644-0.5MLStreptococcuspneumoniaeserotype1capsularantigendiphtheriaCRM197proteinconjugatevaccine0.0044MG/ML/Streptococcuspn|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|864978-MethadoneHydrochloride40MGTabletforOralSuspension|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|901518-0.5MLNeisseriameningitidisserogroupAoligosaccharidediphtheriaCRM197proteinconjugatevaccine0.02MG/ML/Neisseriameningiti|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197517-Clarithromycin500MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|895756-PolyethyleneGlycol4000.004MG/MG/Propyleneglycol0.003MG/MGOphthalmicGel[Systane]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|876514-Amlodipine10MG/telmisartan40MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|864650-Ganciclovir0.0015MG/MGOphthalmicGel[Zirgan]|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|866049-60ACTUATsalmeterol0.05MG/ACTUATDryPowderInhaler[Serevent]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|847213-3MLInsulinLispro50UNT/ML/insulinlisproprotamine,human50UNT/MLPenInjector[HumalogMix]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|847199-3MLinsulinisophane,human100UNT/MLPenInjector[HumulinN]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|847189-3MLinsulinisophane,human70UNT/ML/insulin,regular,human30UNT/MLPenInjector[Humulin]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|876519-Amlodipine10MG/telmisartan80MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|836634-1MLhepatitisAvirusstrainCR326Fantigen,inactivated50UNT/MLPrefilledSyringe[Vaqta]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|830263-1MLHepatitisBSurfaceAntigenVaccine0.04MG/MLInjection[Recombivax]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|830253-0.5MLHepatitisBSurfaceAntigenVaccine0.01MG/MLPrefilledSyringe[Recombivax]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|830245-1MLHepatitisBSurfaceAntigenVaccine0.01MG/MLPrefilledSyringe[Recombivax]|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|890786-Butoconazolenitrate20MG/MLVaginalCream[Gynazole-1]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|804186-0.5MLMeaslesVirusVaccineLive,Enders'attenuatedEdmonstonstrain2000UNT/ML/MumpsVirusVaccineLive,JerylLynnStrain25000UNT/|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|803371-1MLHepatitisAVaccine(Inactivated)StrainHM175720UNT/ML/HepatitisBSurfaceAntigenVaccine0.02MG/MLPrefilledSyringe[Twinrix|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|197696-72HRFentanyl0.075MG/HRTransdermalSystem|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|798482-0.5MLHepatitisAVaccine(Inactivated)StrainHM1751440UNT/MLPrefilledSyringe[Havrix]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|798479-1MLHepatitisAVaccine(Inactivated)StrainHM1751440UNT/MLPrefilledSyringe[Havrix]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2047596-1MLepoetinalfa-epbx10000UNT/MLInjection[Retacrit]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|798428-1MLHepatitisBSurfaceAntigenVaccine0.02MG/MLPrefilledSyringe[Engerix-B]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2045959-Doptelet40MGDailyDoseCartonPack|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2047602-1MLepoetinalfa-epbx2000UNT/MLInjection[Retacrit]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|797641-0.5MLNeisseriameningitidisserogroupAcapsularpolysaccharidediphtheriatoxoidproteinconjugatevaccine0.104MG/ML/Neisseriam|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|795737-ChantixStartingMonthPAK|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|795735-ChantixContinuingMonthsOfTherapy1MGPack|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|876529-Amlodipine5MG/telmisartan80MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|895996-120ACTUATFluticasonepropionate0.044MG/ACTUATMeteredDoseInhaler[Flovent]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|762602-SalmonellatyphiTy21aliveantigen2000000000UNTDelayedReleaseOralCapsule[Vivotif]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|752388-InsulinLispro25UNT/ML/insulinlisproprotamine,human75UNT/MLInjectableSuspension[HumalogMix]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1868016-pirfenidone267MGOralTablet[Esbriet]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|731281-InsulinLispro50UNT/ML/insulinlisproprotamine,human50UNT/MLInjectableSuspension[HumalogMix]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|707566-PolyethyleneGlycol4004MG/ML/Propyleneglycol3MG/MLOphthalmicSolution[Systane]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|637190-varenicline1MGOralTablet[Chantix]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2047614-1MLepoetinalfa-epbx4000UNT/MLInjection[Retacrit]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|637188-varenicline0.5MGOralTablet[Chantix]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|630981-PolyvinylAlcohol27MG/ML/Povidone20MG/MLOphthalmicSolution[Freshkote]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|404448-84HRoxybutynin0.162MG/HRTransdermalSystem[Oxytrol]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|881341-adefovirdipivoxil10MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|351859-insulin,regular,human500UNT/MLInjectableSolution[HumulinR]|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|896001-120ACTUATFluticasonepropionate0.11MG/ACTUATMeteredDoseInhaler[Flovent]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|351433-24HRNicotine0.292MG/HRTransdermalSystem[NicodermC-Q]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2047623-1MLepoetinalfa-epbx40000UNT/MLInjection[Retacrit]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|351429-24HRNicotine0.875MG/HRTransdermalSystem[NicodermC-Q]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|351427-24HRNicotine0.583MG/HRTransdermalSystem[NicodermC-Q]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|886634-ButorphanolTartrate1MG/ACTUATMeteredDoseNasalSpray|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|311036-insulin,regular,human100UNT/MLInjectableSolution[HumulinR]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|311033-insulin,regular,human100UNT/MLInjectableSolution[NovolinR]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|311027-insulinisophane,human100UNT/MLInjectableSuspension[NovolinN]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2048025-0.6MLpegfilgrastim-jmdb10MG/MLPrefilledSyringe[Fulphila]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|311026-insulinisophane,human100UNT/MLInjectableSuspension[HumulinN]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|261315-Oseltamivir75MGOralCapsule[Tamiflu]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|2360588-0.5MLNeisseriameningitidisserogroupAcapsularpolysaccharidetetanustoxoidproteinconjugatevaccine0.02MG/ML/Neisseriameni|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197553-Cyclosporine25MGOralCapsule|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|2166928-10ACTUATolodaterol0.0025MG/ACTUAT/tiotropium0.0025MG/ACTUATInhalationSpray[Stiolto]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197518-Clindamycin150MGOralCapsule|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|2166204-10ACTUATtiotropium0.0025MG/ACTUATInhalationSpray[Spiriva]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|213442-insulinisophane,human70UNT/ML/insulin,regular,human30UNT/MLInjectableSuspension[Novolin]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197557-Dapsone100MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|211947-Atovaquone150MG/MLOralSuspension[Mepron]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2048568-tofacitinib10MGOralTablet[Xeljanz]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|211609-hypromellose5MG/MLOphthalmicSolution[IsoptoAlkaline]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|892342-24HRMorphineSulfate30MGExtendedReleaseOralCapsule|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|211140-PentosanPolysulfate100MGOralCapsule[Elmiron]|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|896006-120ACTUATFluticasonepropionate0.22MG/ACTUATMeteredDoseInhaler[Flovent]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|2106334-0.5MLdiphtheriatoxoidvaccine,inactivated4UNT/ML/tetanustoxoidvaccine,inactivated4UNT/MLInjection[Tdvax]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|208821-Dexamethasone0.001MG/MG/Tobramycin0.003MG/MGOphthalmicOintment[Tobradex]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|2059017-rivaroxaban2.5MGOralTablet[Xarelto]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|2053927-sodiumzirconiumcyclosilicate10000MGPowderforOralSuspension[Lokelma]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|2050059-0.5MLHepatitisBSurfaceAntigenVaccine0.04MG/MLPrefilledSyringe[Heplisav-B]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2053512-ivacaftor125MG/lumacaftor100MGOralGranules[ORKAMBI]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|2047639-sodiumzirconiumcyclosilicate5000MGPowderforOralSuspension[Lokelma]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|892349-24HRMorphineSulfate60MGExtendedReleaseOralCapsule|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|2045382-30ACTUATfluticasonefuroate0.05MG/ACTUATDryPowderInhaler[Arnuity]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197558-Dapsone25MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|2000136-Vancomycin50MG/MLOralSolution[Firvanq]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|897021-12HRdalfampridine10MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|2000133-Vancomycin25MG/MLOralSolution[Firvanq]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1994352-0.5MLHepatitisBSurfaceAntigenVaccine0.04MG/MLInjection[Heplisav-B]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2053519-ivacaftor188MG/lumacaftor150MGOralGranules[ORKAMBI]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1992428-Eliquis30-DayStarterPack|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1992171-3MLInsulinLispro100UNT/MLPenInjector[Admelog]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|876524-Amlodipine5MG/telmisartan40MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1992169-InsulinLispro100UNT/MLInjectableSolution[Admelog]|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|863841-amylase60000UNT/lipase12000UNT/protease38000UNTDelayedReleaseOralCapsule[Creon]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1986830-0.5MLVaricellazostervirusglycoproteinE,recombinant0.1MG/MLInjection[Shingrix]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1797888-Nicotine0.5MG/ACTUATMeteredDoseNasalSpray[Nicotrol]|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|896019-60ACTUATFluticasonepropionate0.05MG/ACTUATDryPowderInhaler[Flovent]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1736863-3MLInsulinGlargine100UNT/MLPenInjector[Basaglar]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1731317-3MLinsulin,regular,human500UNT/MLPenInjector[HumulinR]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1723478-dabigatranetexilate110MGOralCapsule[Pradaxa]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1923826-deferasirox360MGOralGranules|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|900038-PhentermineHydrochloride30MGOralCapsule|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1667882-60ACTUATtiotropium0.00125MG/ACTUATInhalationSpray[Spiriva]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1658472-0.5MLStreptococcuspneumoniaetype1capsularpolysaccharideantigen0.05MG/ML/Streptococcuspneumoniaetype10Acapsularpolysac|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1658157-1MLHepatitisBSurfaceAntigenVaccine0.02MG/MLInjection[Engerix-B]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197575-Desoximetasone0.0025MG/MGTopicalOintment|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2054995-lusutrombopag3MGOralTablet[Mulpleta]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1658155-0.5MLHepatitisBSurfaceAntigenVaccine0.01MG/MLInjection[Recombivax]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1658150-1MLHepatitisBSurfaceAntigenVaccine0.01MG/MLInjection[Recombivax]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1658106-0.5MLhepatitisAvirusstrainCR326Fantigen,inactivated50UNT/MLInjection[Vaqta]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|900156-24HRlamotrigine200MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|896031-28ACTUATFluticasonepropionate0.1MG/ACTUATDryPowderInhaler[Flovent]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1658102-1MLhepatitisAvirusstrainCR326Fantigen,inactivated50UNT/MLInjection[Vaqta]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1658060-1MLHepatitisAVaccine(Inactivated)StrainHM1751440UNT/MLInjection[Havrix]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1656356-sacubitril97MG/valsartan103MGOralTablet[Entresto]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1656351-sacubitril49MG/valsartan51MGOralTablet[Entresto]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1656346-sacubitril24MG/valsartan26MGOralTablet[Entresto]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2056670-AimovigAutoinjector2-Pack(140MGDose)|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1601407-0.5MLmeningococcalgroupBvaccine0.1MG/ML/NeisseriameningitidisserogroupBrecombinantFHBPfusionproteinantigen0.1MG/ML/Ne|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1597103-0.5MLL1protein,Humanpapillomavirustype11Vaccine0.08MG/ML/L1protein,Humanpapillomavirustype16Vaccine0.12MG/ML/L1protei|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197577-Dexamethasone0.5MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1597099-0.5MLL1protein,Humanpapillomavirustype11Vaccine0.08MG/ML/L1protein,Humanpapillomavirustype16Vaccine0.12MG/ML/L1protei|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|900164-24HRlamotrigine25MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1596445-7ACTUATumeclidinium0.0625MG/ACTUATDryPowderInhaler[Incruse]|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|905379-HydralazineHydrochloride37.5MG/IsosorbideDinitrate20MGOralTablet[Bidil]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1593140-0.5MLNeisseriameningitidisserogroupBrecombinantLP2086A05proteinvariantantigen0.12MG/ML/Neisseriameningitidisserogroup|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2056700-1.5MLfremanezumab-vfrm150MG/MLPrefilledSyringe[Ajovy]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1549683-Xarelto30-DayStarterPackKit|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1547950-CarboxymethylcelluloseSodium2.5MG/MLOphthalmicSolution[TheraTears]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1547672-30ACTUATfluticasonefuroate0.2MG/ACTUATDryPowderInhaler[Arnuity]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1547664-14ACTUATfluticasonefuroate0.1MG/ACTUATDryPowderInhaler[Arnuity]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1547582-0.5MLStreptococcuspneumoniaetype1capsularpolysaccharideantigen0.05MG/ML/Streptococcuspneumoniaetype10Acapsularpolysac|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2057205-0.5MLfilgrastim-aafi0.6MG/MLPrefilledSyringe[Nivestym]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1364447-apixaban5MGOralTablet[Eliquis]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1364441-apixaban2.5MGOralTablet[Eliquis]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1363484-hypromellose0.003MG/MGOphthalmicGel[SystaneOvernightTherapy]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1300468-0.5MLHaemophilusinfluenzaetypebstrain1482,capsularpolysaccharideinactivatedtetanustoxoidconjugatevaccine0.068MG/MLInj|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1300378-0.5MLBordetellapertussisfilamentoushemagglutininvaccine,inactivated0.016MG/ML/Bordetellapertussispertactinvaccine,ina|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1300370-0.5MLBordetellapertussisfilamentoushemagglutininvaccine,inactivated0.016MG/ML/Bordetellapertussispertactinvaccine,ina|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197579-Dexamethasone1MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1300206-0.5MLBordetellapertussisfilamentoushemagglutininvaccine,inactivated0.01MG/ML/Bordetellapertussisfimbriae2/3vaccine,in|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2057216-0.8MLfilgrastim-aafi0.6MG/MLPrefilledSyringe[Nivestym]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1292459-0.5MLVaricella-ZosterVirusVaccineLive(Oka-Merck)strain2700UNT/MLInjection[Varivax]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|903847-PyridostigmineBromide180MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1190919-0.5MLdiphtheriatoxoidvaccine,inactivated4UNT/ML/tetanustoxoidvaccine,inactivated10UNT/MLPrefilledSyringe[Tenivac]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|903843-PyridostigmineBromide12MG/MLOralSolution|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1190916-0.5MLdiphtheriatoxoidvaccine,inactivated4UNT/ML/tetanustoxoidvaccine,inactivated10UNT/MLInjection[Tenivac]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1115892-MineralOil0.15MG/MG/Petrolatum0.85MG/MGOphthalmicOintment[Puralube]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|106892-insulinisophane,human70UNT/ML/insulin,regular,human30UNT/MLInjectableSuspension[Humulin]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1049216-Acetaminophen325MG/OxycodoneHydrochloride10MGOralTablet[Endocet]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1046920-Nicotine4MGInhalationSolution[Nicotrol]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2058877-1MLgalcanezumab-gnlm120MG/MLAuto-Injector[Emgality]|AGED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1037181-dabigatranetexilate75MGOralCapsule[Pradaxa]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|903857-PyridostigmineBromide60MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|999613-SulfacetamideSodium100MG/ML/Sulfur50MG/MLMedicatedLiquidSoap|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|997501-Fexofenadinehydrochloride60MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|904952-3MLibandronicacid1MG/MLPrefilledSyringe|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|997491-Fexofenadinehydrochloride6MG/MLOralSuspension|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|967012-POLYETHYLENEGLYCOL3350236000MG/PotassiumChloride2970MG/SodiumBicarbonate6740MG/SodiumChloride5860MG/sodiumsulfate22740|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|997420-Fexofenadinehydrochloride180MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|997229-Donepezilhydrochloride5MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|997226-Donepezilhydrochloride5MGDisintegratingOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|968766-PhentermineHydrochloride15MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|997223-Donepezilhydrochloride10MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|997220-Donepezilhydrochloride10MGDisintegratingOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|996824-MethylergonovineMaleate0.2MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|996572-{21(Memantinehydrochloride10MGOralTablet)/28(Memantinehydrochloride5MGOralTablet)}Pack|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|991233-bexarotene0.01MG/MGTopicalGel[Targretin]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|996571-Memantinehydrochloride5MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|996561-Memantinehydrochloride10MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|990982-2MLphysostigminesalicylate1MG/MLInjection|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|996520-DextromethorphanHydrobromide2MG/ML/Guaifenesin20MG/MLOralSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|995666-MeclizineHydrochloride25MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2058887-1MLgalcanezumab-gnlm120MG/MLPrefilledSyringe[Emgality]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|995632-MeclizineHydrochloride25MGChewableTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1813112-Rajani28DayPack|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197581-Dexamethasone2MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|995624-MeclizineHydrochloride12.5MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|995607-EthambutolHydrochloride400MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|995599-EthambutolHydrochloride100MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|992395-gatifloxacin5MG/MLOphthalmicSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|992481-PromethazineHydrochloride50MGRectalSuppository[Promethegan]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|995281-HydroxyzineHydrochloride50MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|995278-HydroxyzinePamoate50MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|995258-HydroxyzineHydrochloride25MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|995253-HydroxyzinePamoate25MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|995241-HydroxyzineHydrochloride2MG/MLOralSolution|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2058950-0.5MLomalizumab150MG/MLPrefilledSyringe[Xolair]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|995232-HydroxyzinePamoate100MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|995218-HydroxyzineHydrochloride10MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|993943-Acetaminophen325MG/butalbital50MG/Caffeine40MG/CodeinePhosphate30MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|993691-BupropionHydrochloride75MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|992759-Homatropinehydrobromide50MG/MLOphthalmicSolution[Homatropaire]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|993687-BupropionHydrochloride100MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|205912-EpoetinAlfa10000UNT/MLInjectableSolution[Epogen]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|993557-24HRBupropionHydrochloride300MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|993541-24HRBupropionHydrochloride150MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|999967-Amlodipine5MG/Hydrochlorothiazide12.5MG/Olmesartanmedoxomil20MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|993536-12HRBupropionHydrochloride200MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|993518-12HRBupropionHydrochloride150MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|993503-12HRBupropionHydrochloride100MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|205913-EpoetinAlfa10000UNT/MLInjectableSolution[Procrit]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|992780-MiconazoleNitrate100MGVaginalInsert|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|992775-{1(MiconazoleNitrate1200MGVaginalInsert)/1(9000MG)(MiconazoleNitrate20MG/MLVaginalCream)}Pack|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|992528-Terbinafinehydrochloride10MG/MLTopicalCream|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197582-Dexamethasone4MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|992475-PromethazineHydrochloride50MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|992454-PromethazineHydrochloride25MGRectalSuppository|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|992447-PromethazineHydrochloride25MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197583-Dexamethasone6MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|992441-PromethazineHydrochloride12.5MGRectalSuppository|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|205917-1MLEpoetinAlfa2000UNT/MLInjection[Epogen]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|992438-PromethazineHydrochloride12.5MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|999986-Amlodipine10MG/Hydrochlorothiazide12.5MG/Olmesartanmedoxomil40MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|992432-PromethazineHydrochloride1.25MG/MLOralSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Brand|993804-Gianvi28-DayPack|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|992184-methenaminemandelate500MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197580-Dexamethasone1.5MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|992153-methenaminemandelate1000MGOralTablet|AGED FULL DUALS 632|2002|N|N|Y||Preferred Generic|991486-CodeinePhosphate2MG/ML/PromethazineHydrochloride1.25MG/MLOralSolution|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|898715-pregabalin20MG/MLOralSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|991086-DicyclomineHydrochloride20MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|991061-DicyclomineHydrochloride10MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|979492-LosartanPotassium50MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|998189-everolimus2.5MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|979485-LosartanPotassium25MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|979480-LosartanPotassium100MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197595-Dicloxacillin250MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|979475-MetaproterenolSulfate20MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|999996-Amlodipine5MG/Hydrochlorothiazide12.5MG/Olmesartanmedoxomil40MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|979471-Hydrochlorothiazide25MG/LosartanPotassium100MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|979468-Hydrochlorothiazide12.5MG/LosartanPotassium50MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2059189-amikacinliposomal70.3MG/MLInhalationSuspension[Arikayce]|AGED FULL DUALS 632|2002|N|Y|N||Preferred Brand|1801840-lifitegrast50MG/MLOphthalmicSolution[Xiidra]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|979464-Hydrochlorothiazide12.5MG/LosartanPotassium100MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|979444-MetaproterenolSulfate2MG/MLOralSolution|AGED FULL DUALS 632|2002|Y|N|Y||Preferred Brand|1292435-0.65MLVaricella-ZosterVirusVaccineLive(Oka-Merck)strain29800UNT/MLInjection[Zostavax]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|979409-MetaproterenolSulfate10MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|979092-HydroxychloroquineSulfate200MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|978006-LoperamideHydrochloride2MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1000048-DoxepinHydrochloride10MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|966920-POLYETHYLENEGLYCOL3350236000MG/PotassiumChloride2970MG/SodiumBicarbonate6740MG/SodiumChloride5860MG/sodiumsulfate22740|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|966914-POLYETHYLENEGLYCOL3350240000MG/PotassiumChloride2980MG/SodiumBicarbonate6720MG/SodiumChloride5840MG/sodiumsulfate22720|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|966270-LevothyroxineSodium0.137MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1874553-24HRdesvenlafaxinesuccinate100MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|Y|N|Y||Preferred Brand|665036-sitagliptin100MGOralTablet[Januvia]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|966253-LevothyroxineSodium0.088MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|966249-LevothyroxineSodium0.175MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|966248-LevothyroxineSodium0.112MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197596-Dicloxacillin500MGOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|205921-1MLEpoetinAlfa3000UNT/MLInjection[Epogen]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|966225-LevothyroxineSodium0.15MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|966224-LevothyroxineSodium0.125MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|966222-LevothyroxineSodium0.075MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1000054-DoxepinHydrochloride10MG/MLOralSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|966221-LevothyroxineSodium0.05MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|966220-LevothyroxineSodium0.025MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|205918-1MLEpoetinAlfa2000UNT/MLInjection[Procrit]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|905395-HydralazineHydrochloride50MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|905225-HydralazineHydrochloride25MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|905222-HydralazineHydrochloride100MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|205923-1MLEpoetinAlfa4000UNT/MLInjection[Epogen]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|905199-HydralazineHydrochloride10MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|905158-Sirolimus0.5MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197604-Digoxin0.125MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|904932-ibandronicacid150MGOralTablet|AGED FULL DUALS 632|2002|Y|N|Y||Preferred Brand|665044-sitagliptin50MGOralTablet[Januvia]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|904481-PravastatinSodium80MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1000058-DoxepinHydrochloride100MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|904475-PravastatinSodium40MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|205924-1MLEpoetinAlfa4000UNT/MLInjection[Procrit]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|904467-PravastatinSodium20MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|904458-PravastatinSodium10MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|904431-Alendronicacid70MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|904396-Alendronicacid35MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|904170-PrimaquinePhosphate26.3MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|206791-mesalamine250MGExtendedReleaseOralCapsule[Pentasa]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|903891-FluvoxamineMaleate50MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|903887-FluvoxamineMaleate25MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|903884-FluvoxamineMaleate100MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|903703-liothyroninesodium0.05MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|903697-liothyroninesodium0.025MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|903456-liothyroninesodium0.005MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197606-Digoxin0.25MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|898723-Benazeprilhydrochloride5MGOralTablet|AGED FULL DUALS 632|2002|Y|N|Y||Preferred Brand|665040-sitagliptin25MGOralTablet[Januvia]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|898690-Benazeprilhydrochloride20MGOralTablet|AGED FULL DUALS 632|2002|Y|N|Y||Preferred Brand|861771-Metforminhydrochloride1000MG/sitagliptin50MGOralTablet[Janumet]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|898687-Benazeprilhydrochloride10MGOralTablet|AGED FULL DUALS 632|2002|Y|N|Y||Preferred Brand|804547-difluprednate0.5MG/MLOphthalmicSuspension[Durezol]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|898378-Benazeprilhydrochloride5MG/Hydrochlorothiazide6.25MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|898372-Benazeprilhydrochloride20MG/Hydrochlorothiazide25MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|898367-Benazeprilhydrochloride20MG/Hydrochlorothiazide12.5MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|898359-Amlodipine5MG/Benazeprilhydrochloride40MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|898356-Amlodipine5MG/Benazeprilhydrochloride20MGOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|208083-sargramostim0.25MG/MLInjectableSolution[Leukine]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|898353-Amlodipine5MG/Benazeprilhydrochloride10MGOralCapsule|AGED FULL DUALS 632|2002|Y|N|Y||Preferred Brand|861821-Metforminhydrochloride500MG/sitagliptin50MGOralTablet[Janumet]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|898350-Amlodipine2.5MG/Benazeprilhydrochloride10MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197622-Dipyridamole50MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|898346-Amlodipine10MG/Benazeprilhydrochloride40MGOralCapsule|AGED FULL DUALS 632|2002|Y|N|Y||Preferred Generic|106302-Tretinoin0.25MG/MLTopicalCream|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|898342-Amlodipine10MG/Benazeprilhydrochloride20MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1000064-DoxepinHydrochloride150MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|897722-Verapamilhydrochloride40MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|897683-Verapamilhydrochloride80MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|897666-Verapamilhydrochloride120MGOralTablet|AGED FULL DUALS 632|2002|Y|N|Y||Preferred Generic|106303-Tretinoin0.5MG/MLTopicalCream|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|897649-Verapamilhydrochloride240MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|897624-24HRVerapamilhydrochloride240MGExtendedReleaseOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|897596-24HRVerapamilhydrochloride300MGExtendedReleaseOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|897590-24HRVerapamilhydrochloride200MGExtendedReleaseOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1000070-DoxepinHydrochloride25MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|897584-24HRVerapamilhydrochloride100MGExtendedReleaseOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|896766-Labetalolhydrochloride300MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1860154-Abuse-Deterrent12HROxycodoneHydrochloride15MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|Y|N|Y||Preferred Generic|197634-dronabinol10MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|896762-Labetalolhydrochloride200MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|896758-Labetalolhydrochloride100MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2102705-0.6MLpegfilgrastim-cbqv10MG/MLPrefilledSyringe[Udenyca]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|896209-60ACTUATFluticasonepropionate0.25MG/ACTUAT/salmeterol0.05MG/ACTUATDryPowderInhaler|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|207059-interferonbeta-1b0.3MGInjection[Betaseron]|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2106075-0.9MLtocilizumab180MG/MLAuto-Injector[Actemra]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|895987-Fluticasonepropionate0.5MG/MLTopicalCream|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|895487-Fluticasonepropionate0.00005MG/MGTopicalOintment|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|892255-LevothyroxineSodium0.3MGOralTablet|AGED FULL DUALS 632|2002|Y|N|Y||Preferred Generic|197635-dronabinol2.5MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1000076-DoxepinHydrochloride50MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|892251-LevothyroxineSodium0.2MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2106362-rifamycinSV194MGDelayedReleaseOralTablet[Aemcolo]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|892246-LevothyroxineSodium0.1MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|886671-FlecainideAcetate150MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|886666-FlecainideAcetate100MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|886662-FlecainideAcetate50MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2107351-prucalopride1MGOralTablet[Motegrity]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|885857-Balsalazidedisodium750MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|884707-Estradiol0.01MGVaginalInsert|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|884308-Nystatin100UNT/MGTopicalOintment|AGED FULL DUALS 632|2002|Y|N|Y||Preferred Generic|197636-dronabinol5MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|884189-ClonidineHydrochloride0.3MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1000097-DoxepinHydrochloride75MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|884185-ClonidineHydrochloride0.2MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2107355-prucalopride2MGOralTablet[Motegrity]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|884173-ClonidineHydrochloride0.1MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|876193-POLYETHYLENEGLYCOL335017000MGPowderforOralSolution|AGED FULL DUALS 632|2002|Y|N|Y||Preferred Generic|198300-Tretinoin1MG/MLTopicalCream|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|866924-MetoprololTartrate25MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|866514-MetoprololTartrate50MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|866511-MetoprololTartrate100MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|866436-24HRmetoprololsuccinate50MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|866427-24HRmetoprololsuccinate25MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|866419-24HRmetoprololsuccinate200MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197624-Disulfiram500MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|866412-24HRmetoprololsuccinate100MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197623-Disulfiram250MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|866144-Cyproheptadinehydrochloride4MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|866111-buspironehydrochloride7.5MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197625-Doxazosin1MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|866094-buspironehydrochloride5MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1367436-21DAYEthinylEstradiol0.000625MG/HR/Etonogestrel0.005MG/HRVaginalSystem|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|866090-buspironehydrochloride30MGOralTablet|AGED FULL DUALS 632|2002|Y|N|Y||Preferred Generic|245723-Tretinoin0.0005MG/MGTopicalGel|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|866083-buspironehydrochloride10MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1000114-medroxyprogesteroneacetate10MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|866018-buspironehydrochloride15MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|863669-Tamsulosinhydrochloride0.4MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|863664-Oxybutyninchloride5MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|863636-24HROxybutyninchloride5MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|863628-24HROxybutyninchloride15MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2120195-1MLerenumab-aooe140MG/MLAuto-Injector[Aimovig]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|863619-24HROxybutyninchloride10MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|Y|N||Preferred Brand|833139-Milnacipranhydrochloride100MGOralTablet[Savella]|AGED FULL DUALS 632|2002|Y|N|Y||Preferred Generic|310140-eprosartan600MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|861753-Glyburide5MG/Metforminhydrochloride500MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197626-Doxazosin2MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|861748-Glyburide2.5MG/Metforminhydrochloride500MGOralTablet|AGED FULL DUALS 632|2002|Y|N|Y||Preferred Generic|312084-Ondansetron24MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|861743-Glyburide1.25MG/Metforminhydrochloride250MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|861657-24HRNitroglycerin0.1MG/HRTransdermalSystem|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2121096-siponimod0.25MGOralTablet[Mayzent]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|861495-ClobetasolPropionate0.5MG/MLTopicalCream|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|861487-ClobetasolPropionate0.5MG/MLTopicalSolution|AGED FULL DUALS 632|2002|Y|N|Y||Preferred Generic|313450-Tretinoin0.0001MG/MGTopicalGel|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|861448-ClobetasolPropionate0.0005MG/MGTopicalOintment|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|861430-PropafenoneHydrochloride300MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|861427-PropafenoneHydrochloride225MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1000135-medroxyprogesteroneacetate2.5MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|861424-PropafenoneHydrochloride150MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|861416-Azithromycin1000MGPowderforOralSuspension|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|861200-Brimonidinetartrate2MG/MLOphthalmicSolution|AGED FULL DUALS 632|2002|Y|N|Y||Preferred Generic|313451-Tretinoin0.00025MG/MGTopicalGel|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|861171-12HRPropafenoneHydrochloride425MGExtendedReleaseOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|861164-12HRPropafenoneHydrochloride325MGExtendedReleaseOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|861156-12HRPropafenoneHydrochloride225MGExtendedReleaseOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197627-Doxazosin4MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|861132-24HRAlfuzosinhydrochloride10MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|861064-Sertraline20MG/MLOralSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|861010-Metforminhydrochloride850MGOralTablet|AGED FULL DUALS 632|2002|Y|N|Y||Preferred Generic|577033-sildenafil20MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1000141-medroxyprogesteroneacetate5MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|861007-Metforminhydrochloride500MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|861004-Metforminhydrochloride1000MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|860981-24HRMetforminhydrochloride750MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|860975-24HRMetforminhydrochloride500MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|860805-Azelastinehydrochloride0.5MG/MLOphthalmicSolution|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|212219-EpoetinAlfa20000UNT/MLInjectableSolution[Procrit]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|860225-MegestrolAcetate40MG/MLOralSuspension|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|860221-MegestrolAcetate40MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197628-Doxazosin8MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|860215-MegestrolAcetate20MGOralTablet|AGED FULL DUALS 632|2002|Y|N|Y||Preferred Generic|835809-testosteroneenanthate200MG/MLInjectableSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|860107-KetorolacTromethamine5MG/MLOphthalmicSolution|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2119389-Spravato84MGDoseKit|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|859751-Rosuvastatincalcium20MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2123314-Mayzent0.25MGStarterPack|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|859747-Rosuvastatincalcium10MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|859424-Rosuvastatincalcium5MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|859419-Rosuvastatincalcium40MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|859193-selegilinehydrochloride5MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|859186-selegilinehydrochloride5MGOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|213360-Thalidomide50MGOralCapsule[Thalomid]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|859052-Pramipexoledihydrochloride1MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|859048-Pramipexoledihydrochloride1.5MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|859044-Pramipexoledihydrochloride0.5MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|859040-Pramipexoledihydrochloride0.25MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|859033-Pramipexoledihydrochloride0.125MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|858828-EnalaprilMaleate10MG/Hydrochlorothiazide25MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197650-Erythromycin500MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|858824-EnalaprilMaleate5MG/Hydrochlorothiazide12.5MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|213475-1MLEpoetinAlfa40000UNT/MLInjection[Procrit]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|858817-EnalaprilMaleate10MGOralTablet|AGED FULL DUALS 632|2002|Y|N|Y||Preferred Generic|891874-MorphineSulfate100MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|858813-EnalaprilMaleate5MGOralTablet|AGED FULL DUALS 632|2002|Y|N|Y||Preferred Generic|883826-TranexamicAcid650MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|858810-EnalaprilMaleate20MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|858804-EnalaprilMaleate2.5MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|858747-Ursodiol300MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|858625-Pramipexoledihydrochloride0.75MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|858616-Nicardipinehydrochloride30MGOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2166401-ivacaftor25MGOralGranules[Kalydeco]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|858613-Nicardipinehydrochloride20MGOralCapsule|AGED FULL DUALS 632|2002|Y|N|Y||Preferred Generic|891881-MorphineSulfate15MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|857683-TerbutalineSulfate5MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197657-Estradiol0.5MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|857677-TerbutalineSulfate2.5MGOralTablet|AGED FULL DUALS 632|2002|Y|N|Y||Preferred Generic|891888-MorphineSulfate30MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|857461-ClemastineFumarate2.68MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1000673-SulfacetamideSodium0.1MG/MGOphthalmicOintment|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|857340-BethanecholChloride50MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|857336-BethanecholChloride5MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|857328-BethanecholChloride25MGOralTablet|AGED FULL DUALS 632|2002|Y|N|Y||Preferred Generic|891893-MorphineSulfate60MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|857321-BethanecholChloride10MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|857305-ClomipramineHydrochloride75MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|857301-ClomipramineHydrochloride50MGOralCapsule|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|857297-ClomipramineHydrochloride25MGOralCapsule|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1801322-3.5MLevolocumab120MG/MLCartridge[Repatha]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1000862-PilocarpineHydrochloride20MG/MLOphthalmicSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|857187-FosinoprilSodium40MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|857183-FosinoprilSodium20MGOralTablet|AGED FULL DUALS 632|2002|Y|N|Y||Preferred Generic|892646-MorphineSulfate200MGExtendedReleaseOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|857169-FosinoprilSodium10MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2058946-1MLomalizumab150MG/MLPrefilledSyringe[Xolair]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|856853-AmitriptylineHydrochloride75MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2170613-1MLgalcanezumab-gnlm100MG/MLPrefilledSyringe[Emgality]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|856845-AmitriptylineHydrochloride50MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197658-Estradiol1MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2170993-1MLmepolizumab100MG/MLAuto-Injector[Nucala]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|856840-AmitriptylineHydrochloride50MG/Perphenazine4MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|856834-AmitriptylineHydrochloride25MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|856825-AmitriptylineHydrochloride25MG/Perphenazine4MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1000897-PilocarpineHydrochloride40MG/MLOphthalmicSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|856797-AmitriptylineHydrochloride25MG/Perphenazine2MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2173822-1MLmepolizumab100MG/MLPrefilledSyringe[Nucala]|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|856783-AmitriptylineHydrochloride10MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|856773-AmitriptylineHydrochloride150MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|197304-Acetazolamide250MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|856762-AmitriptylineHydrochloride100MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|1000647-PilocarpineHydrochloride10MG/MLOphthalmicSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|856733-PropranololHydrochloride8MG/MLOralSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|856724-PropranololHydrochloride4MG/MLOralSolution|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|856720-AmitriptylineHydrochloride10MG/Perphenazine4MGOralTablet|AGED FULL DUALS 632|2002|Y|N|N||Preferred Generic|999991-Amlodipine10MG/Hydrochlorothiazide25MG/Olmesartanmedoxomil40MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|856706-AmitriptylineHydrochloride10MG/Perphenazine2MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|856578-PropranololHydrochloride80MGOralTablet|AGED FULL DUALS 632|2002|N|N|N||Preferred Generic|856556-PropranololHydrochloride60MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|856519-PropranololHydrochloride40MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|856457-PropranololHydrochloride20MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|856448-PropranololHydrochloride10MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|856429-Hydrochlorothiazide25MG/PropranololHydrochloride80MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|856422-Hydrochlorothiazide25MG/PropranololHydrochloride40MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|856377-TrazodoneHydrochloride50MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1005856-SulfacetamideSodium100MG/ML/Sulfur50MG/MLTopicalLotion|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|856373-TrazodoneHydrochloride100MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|856364-TrazodoneHydrochloride150MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|855926-DiclofenacSodium75MGDelayedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|855911-2MLPhenytoinsodium50MG/MLCartridge|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|855906-DiclofenacSodium50MGDelayedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|855873-Phenytoinsodium300MGExtendedReleaseOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|855861-Phenytoinsodium200MGExtendedReleaseOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|855818-prasugrel5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|855812-prasugrel10MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|855671-Phenytoinsodium100MGExtendedReleaseOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|855664-DiclofenacSodium25MGDelayedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|855480-alclometasonedipropionate0.0005MG/MGTopicalOintment|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|855474-alclometasonedipropionate0.5MG/MLTopicalCream|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|855344-WarfarinSodium7.5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|855338-WarfarinSodium6MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|855332-WarfarinSodium5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|855324-WarfarinSodium4MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|855318-WarfarinSodium3MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|855312-WarfarinSodium2.5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|855302-WarfarinSodium2MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|855296-WarfarinSodium10MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|855288-WarfarinSodium1MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|855172-levocetirizinedihydrochloride5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|855168-levocetirizinedihydrochloride0.5MG/MLOralSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|854905-BisoprololFumarate5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|854901-BisoprololFumarate10MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|854801-DiclofenacSodium1MG/MLOphthalmicSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|852913-QuinidineSulfate300MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|852877-QuinidineSulfate200MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|849515-DesmopressinAcetate0.1MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|849506-DesmopressinAcetate0.01MG/ACTUATNasalSpray|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|848943-CholestyramineResin4000MGPowderforOralSuspension|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|848176-AugmentedBetamethasone0.5MG/MLTopicalCream|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|847121-CalciumCitrate1500MG/Cholecalciferol250UNTOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|836358-IpratropiumBromide0.2MG/MLInhalationSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|835925-cyclosporine,modified50MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|835913-MefloquineHydrochloride250MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|835894-cyclosporine,modified25MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|835886-cyclosporine,modified100MG/MLOralSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|835593-ImipramineHydrochloride10MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|835568-ImipramineHydrochloride50MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|835564-ImipramineHydrochloride25MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|834127-chlorhexidinegluconate1.2MG/MLMouthwash|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|834102-PenicillinVPotassium500MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|834061-PenicillinVPotassium250MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|834046-PenicillinVPotassium25MG/MLOralSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|834040-PenicillinVPotassium50MG/MLOralSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|833528-Amiodaronehydrochloride200MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|833217-DiltiazemHydrochloride30MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|833008-DesmopressinAcetate0.2MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|832909-CalciumCarbonate1250MG/Cholecalciferol100UNTChewableTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|831261-CromolynSodium20MG/MLOralSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|831109-CromolynSodium40MG/MLOphthalmicSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|831103-DiltiazemHydrochloride60MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|831102-DiltiazemHydrochloride90MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|831054-DiltiazemHydrochloride120MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|830882-24HRDiltiazemHydrochloride300MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|828348-Cyclobenzaprinehydrochloride10MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|828320-Cyclobenzaprinehydrochloride5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|801054-POLYETHYLENEGLYCOL3350420000MG/PotassiumChloride1480MG/SodiumBicarbonate5720MG/SodiumChloride11200MGPowderforOralSolut|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|763185-{21(Prednisone10MGOralTablet)}Pack|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|763181-{21(Prednisone5MGOralTablet)}Pack|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|762675-{21(Methylprednisolone4MGOralTablet)}Pack|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|756209-Zidovudine10MG/MLOralSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|755497-Albuterol0.4MG/MLOralSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|751901-{84(EthinylEstradiol0.03MG/Levonorgestrel0.15MGOralTablet)/7(InertIngredients1MGOralTablet)}Pack|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|749860-{21(EthinylEstradiol0.035MG/norgestimate0.25MGOralTablet)/7(InertIngredients1MGOralTablet)}Pack|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|749784-{7(EthinylEstradiol0.035MG/norgestimate0.18MGOralTablet)/7(EthinylEstradiol0.035MG/norgestimate0.215MGOralTablet)/7(Et|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|749783-{6(Azithromycin250MGOralTablet)}Pack|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|749780-{3(Azithromycin500MGOralTablet)}Pack|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|749157-{7(EthinylEstradiol0.025MG/norgestimate0.18MGOralTablet)/7(EthinylEstradiol0.025MG/norgestimate0.215MGOralTablet)/7(Et|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|748961-{28(Norethindrone0.35MGOralTablet)}Pack|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|748868-{21(EthinylEstradiol0.02MG/Levonorgestrel0.1MGOralTablet)/7(InertIngredients1MGOralTablet)}Pack|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|748800-{21(drospirenone3MG/EthinylEstradiol0.03MGOralTablet)/7(InertIngredients1MGOralTablet)}Pack|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|727316-NDA0194300.3MLEpinephrine0.5MG/MLAuto-Injector|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|722137-Amlodipine5MG/valsartan320MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|722134-Amlodipine5MG/valsartan160MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|722131-Amlodipine10MG/valsartan320MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|722126-Amlodipine10MG/valsartan160MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|702519-Phenobarbital4MG/MLOralSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|702249-ferroussulfate44MG/MLOralSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|692783-Loratadine1MG/MLOralSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|686924-carvedilol3.125MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|686418-ErythromycinEthylsuccinate80MG/MLOralSuspension|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|686405-ErythromycinEthylsuccinate400MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|686400-ErythromycinEthylsuccinate40MG/MLOralSuspension|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|647121-5MLLevetiracetam100MG/MLInjection|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|646456-Nystatin100UNT/MGTopicalPowder|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|646333-Capsaicin1MG/MLTopicalCream|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|643102-Ibuprofen200MGOralTablet[Wal-Profen]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|639566-VitaminB650MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|628953-PotassiumChloride10MEQExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|617993-Amoxicillin120MG/ML/Clavulanate8.58MG/MLOralSuspension|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|617430-Amoxicillin80MG/ML/Clavulanate11.4MG/MLOralSuspension|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|617423-Amoxicillin40MG/ML/Clavulanate5.7MG/MLOralSuspension|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|617322-Amoxicillin50MG/ML/Clavulanate12.5MG/MLOralSuspension|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1014673-cetirizinehydrochloride1MG/MLOralSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|617316-Amoxicillin400MG/Clavulanate57MGChewableTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|617312-atorvastatin10MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|617311-atorvastatin40MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|617310-atorvastatin20MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|617309-Amoxicillin200MG/Clavulanate28.5MGChewableTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|617296-Amoxicillin500MG/Clavulanate125MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|598025-Amoxicillin250MGChewableTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|598006-Erythromycin250MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|597852-anagrelide1MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|596843-lansoprazole15MGDelayedReleaseOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|583170-Salsalate750MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|582926-podofilox5MG/MLTopicalSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|577040-CalciumCarbonate648MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|562704-ropinirole4MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|562524-12HRAcetazolamide500MGExtendedReleaseOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|562510-SodiumFluoride2MG/MLMouthwash|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|562508-Amoxicillin875MG/Clavulanate125MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|562251-Amoxicillin250MG/Clavulanate125MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|544455-Lactulose667MG/MLOralSolution[Generlac]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|543546-Nystatin100000UNT/MLTopicalCream|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|486152-24HRNitroglycerin0.4MG/HRTransdermalSystem|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|486148-24HRNitroglycerin0.2MG/HRTransdermalSystem|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|486146-24HRNitroglycerin0.6MG/HRTransdermalSystem|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|486131-BenzoylPeroxide0.1MG/MGTopicalGel|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|476809-Mirtazapine7.5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|476576-cefdinir50MG/MLOralSuspension|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|432402-cinacalcet30MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|432401-cinacalcet60MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|432400-cinacalcet90MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|429503-Hydrochlorothiazide12.5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|403967-zonisamide50MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|403966-zonisamide25MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|403855-Hydrochlorothiazide25MG/Olmesartanmedoxomil40MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|403854-Hydrochlorothiazide12.5MG/Olmesartanmedoxomil40MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|403853-Hydrochlorothiazide12.5MG/Olmesartanmedoxomil20MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|402698-24HRFelodipine2.5MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|402696-24HRFelodipine5MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|402695-24HRFelodipine10MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|393245-Digoxin0.05MG/MLOralSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|391937-Lactulose667MG/MLOralSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|387003-Levetiracetam1000MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|381056-IsosorbideDinitrate10MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|360110-Sirolimus2MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|359601-Guaifenesin400MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|359296-calciumacetate667MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|353538-24HRIsosorbideMononitrate60MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|351250-Escitalopram20MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|351249-Escitalopram5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|103401-Hydrocortisone0.025MG/MGTopicalOintment|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|351172-Dutasteride0.5MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|351137-Albuterol0.21MG/MLInhalationSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|351136-Albuterol0.417MG/MLInhalationSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|349420-desloratadine5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|349405-Olmesartanmedoxomil40MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|349401-Olmesartanmedoxomil20MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|349373-Olmesartanmedoxomil5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|349332-Escitalopram10MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|349208-Sirolimus1MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|348472-Theophylline600MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|343033-Dexamethasone0.75MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|328161-Methylprednisolone16MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|328160-Cyclosporine100MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|318272-Aspirin81MGChewableTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|317769-Theophylline300MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|317573-pioglitazone15MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|317173-Captopril25MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|317136-Nortriptyline25MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|317128-Misoprostol0.2MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|317110-24HRIsosorbideMononitrate30MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|315187-Prednisone1MG/MLOralSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|315183-PotassiumChloride8MEQExtendedReleaseOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|315134-Levocarnitine100MG/MLOralSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|315107-24HRGlipizide10MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|315102-SodiumFluoride1.1MG/MLOralSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|315090-Erythromycin333MGDelayedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|314277-venlafaxine50MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|314241-Theophylline450MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|314238-Tropicamide10MG/MLOphthalmicSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|314234-Sucralfate1000MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|314231-Simvastatin10MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|314208-ropinirole1MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|314203-quinapril40MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|314182-PotassiumChloride2.67MEQ/MLOralSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|314165-prednisolone10MG/MLOphthalmicSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|314131-Niacin250MGExtendedReleaseOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|314111-Mirtazapine30MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|314106-Metronidazole250MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|314077-Lisinopril20MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|314076-Lisinopril10MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|314072-latanoprost0.05MG/MLOphthalmicSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|314055-IsosorbideDinitrate5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|314006-24HRGlipizide5MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|314000-Glyburide1.5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|313989-Fluoxetine40MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|313988-Furosemide40MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|313979-fludrocortisoneacetate0.1MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|313919-salmoncalcitonin200UNT/ACTUATNasalSpray|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|103951-Tolnaftate10MG/MLTopicalCream|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|313888-Cefaclor50MG/MLOralSuspension|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|313850-Amoxicillin40MG/MLOralSuspension|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|313797-Amoxicillin25MG/MLOralSuspension|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|313786-AceticAcid20MG/ML/Hydrocortisone10MG/MLOticSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|313586-venlafaxine75MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|313585-24HRvenlafaxine75MGExtendedReleaseOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|313584-venlafaxine37.5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|313583-24HRvenlafaxine37.5MGExtendedReleaseOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|313582-venlafaxine25MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|313581-24HRvenlafaxine150MGExtendedReleaseOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|313580-venlafaxine100MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|313565-valacyclovir500MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|313564-valacyclovir1000MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|313521-Tropicamide5MG/MLOphthalmicSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|313477-Trifluridine10MG/MLOphthalmicSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|313428-Toremifene60MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|313423-Tolnaftate10MG/MLTopicalSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|313306-Theophylline5.33MG/MLOralSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|313291-Theophylline400MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|313227-terconazole8MG/MLVaginalCream|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|313226-terconazole4MG/MLVaginalCream|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|313219-Terazosin5MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|313217-Terazosin2MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|313215-Terazosin1MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|313195-Tamoxifen20MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|313190-Tacrolimus0.5MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|313142-Sulfasalazine500MGDelayedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|313134-Sulfamethoxazole40MG/ML/Trimethoprim8MG/MLOralSuspension|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|313123-Sucralfate100MG/MLOralSuspension|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|313096-Spironolactone25MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|313092-Sorbitol700MG/MLOralSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|312997-SodiumChloride9MG/MLInhalationSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|312962-Simvastatin5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|312961-Simvastatin20MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|312941-Sertraline50MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|312940-Sertraline25MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|312938-Sertraline100MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|312899-Salsalate500MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|312849-ropinirole5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|312847-ropinirole2MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|312846-ropinirole0.5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|312845-ropinirole0.25MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|312750-quinapril5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|312749-quinapril20MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|312748-quinapril10MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|312641-Progesterone200MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|312635-Prochlorperazine5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|312617-Prednisone5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|312615-Prednisone20MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|312594-Prazosin2MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|312593-Prazosin1MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|312529-PotassiumChloride8MEQExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|312515-PotassiumChloride1.33MEQ/MLOralSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|312504-PotassiumChloride10MEQExtendedReleaseOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|312441-pioglitazone45MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|312440-pioglitazone30MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|312362-Phenobarbital30MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|312357-Phenobarbital15MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|312301-Pentoxifylline400MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|312289-Naloxone0.5MG/Pentazocine50MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|312138-oxcarbazepine600MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|312137-oxcarbazepine300MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|312136-oxcarbazepine150MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|312059-Nystatin500000UNTOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|312055-Nystatin100000UNT/MLOralSuspension|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|312036-Nortriptyline2MG/MLOralSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|312013-Nitroglycerin2.5MGExtendedReleaseOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|311995-NITROFURANTOIN,MACROCRYSTALS50MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|311994-NITROFURANTOIN,MACROCRYSTALS25MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|311989-Nitrofurantoin5MG/MLOralSuspension|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|311963-Niacin750MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|311960-Niacin500MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|311955-Niacin250MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|311893-nabumetone750MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|311892-nabumetone500MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|311727-Misoprostol0.1MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|311726-Mirtazapine45MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|311725-Mirtazapine15MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|311681-Metronidazole500MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|311679-Metronidazole0.0075MG/MGTopicalGel|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|311678-Metronidazole7.5MG/MLTopicalCream|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|311668-Metoclopramide5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|311666-Metoclopramide10MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|311665-Metipranolol3MG/MLOphthalmicSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|311486-meloxicam7.5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|311376-Lorazepam2MG/MLOralSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|311372-Loratadine10MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|311354-Lisinopril5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|311353-Lisinopril2.5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|311296-Levofloxacin750MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|311290-Levetiracetam750MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|311289-Levetiracetam500MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|311288-Levetiracetam250MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|311277-lansoprazole30MGDelayedReleaseOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|311264-lamotrigine25MGChewableTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|311197-IsosorbideMononitrate20MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1049630-DiphenhydramineHydrochloride25MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|311196-24HRIsosorbideMononitrate120MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|311194-IsosorbideDinitrate40MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|311192-IsosorbideMononitrate10MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|311166-isoniazid100MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|310982-imiquimod50MG/MLTopicalCream|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|310965-Ibuprofen200MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|310964-Ibuprofen200MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|310891-Hydrocortisone25MG/MLTopicalCream|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|310818-Hydrochlorothiazide50MG/Triamterene75MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|310812-Hydrochlorothiazide25MG/Triamterene37.5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|310809-Hydrochlorothiazide25MG/quinapril20MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|310798-Hydrochlorothiazide25MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|310797-Hydrochlorothiazide12.5MG/quinapril20MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|310796-Hydrochlorothiazide12.5MG/quinapril10MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|310687-Hydrocortisone10MG/ML/Neomycin3.5MG/ML/PolymyxinB10000UNT/MLOticSuspension|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|310594-Gramicidin0.025MG/ML/Neomycin1.75MG/ML/PolymyxinB10000UNT/MLOphthalmicSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|310539-Glyburide6MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|310537-Glyburide5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|310536-Glyburide3MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|310534-Glyburide2.5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|310490-Glipizide5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|310489-24HRGlipizide2.5MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|310488-Glipizide10MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|310459-Gemfibrozil600MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|310442-Ganciclovir500MGInjection|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|310434-gabapentin800MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|310433-gabapentin600MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|310432-gabapentin400MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|310431-gabapentin300MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|310430-gabapentin100MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|310429-Furosemide20MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|310410-FolicAcid1MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|310386-Fluoxetine4MG/MLOralSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|310385-Fluoxetine20MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|310384-Fluoxetine10MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|310380-Fluorouracil50MG/MLTopicalSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|310379-Fluorouracil20MG/MLTopicalSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|310377-Fluorometholone1MG/MLOphthalmicSuspension|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|310364-Fluocinonide0.5MG/MLTopicalSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|310362-Fluocinonide0.0005MG/MGTopicalGel|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|310353-Fluconazole40MG/MLOralSuspension|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|310352-Fluconazole10MG/MLOralSuspension|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|310346-Finasteride5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|310325-ferroussulfate325MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|310324-ferroussulfate325MGDelayedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|310273-Famotidine20MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|310261-exemestane25MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|310169-Estradiol0.1MG/MLVaginalCream|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1052760-magnesiumcitrate58.2MG/MLOralSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|310157-Erythromycin500MGDelayedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|310155-Erythromycin250MGDelayedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|310154-Erythromycin250MGDelayedReleaseOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|310015-dorzolamide20MG/MLOphthalmicSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|309955-Dipyridamole75MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|309952-Dipyridamole25MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|309686-Dexamethasone0.1MG/MLOralSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|309680-Dexamethasone1MG/ML/Neomycin3.5MG/ML/PolymyxinB10000UNT/MLOphthalmicSuspension|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|309679-Dexamethasone0.001MG/MG/Neomycin0.0035MG/MG/PolymyxinB10UNT/MGOphthalmicOintment|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|309594-vitaminB121MG/MLInjectableSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|309371-Clotrimazole10MGOralLozenge|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|309370-Clotrimazole10MG/MLTopicalSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|309367-Clotrimazole10MG/MLTopicalCream|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|309362-clopidogrel75MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|309337-Clindamycin20MG/MLVaginalCream|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|309313-Citalopram2MG/MLOralSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|309291-ciclopirox80MG/MLTopicalSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|309290-ciclopirox7.7MG/MLTopicalLotion|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|309273-cholinesalicylate58.6MG/ML/MagnesiumSalicylate72.4MG/MLOralSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|309115-Cephalexin250MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|309114-Cephalexin500MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|309113-Cephalexin50MG/MLOralSuspension|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|309112-Cephalexin250MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|309110-Cephalexin25MG/MLOralSuspension|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|309098-Cefuroxime500MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|309054-cefdinir25MG/MLOralSuspension|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|309045-Cefaclor250MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|309044-Cefaclor25MG/MLOralSuspension|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|308989-Carbidopa50MG/Levodopa200MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|308988-Carbidopa25MG/Levodopa100MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|308979-Carbamazepine200MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|308976-Carbamazepine20MG/MLOralSuspension|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|308973-Carbamazepine100MGChewableTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|308964-Captopril50MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|308963-Captopril12.5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|308962-Captopril100MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|308891-CalciumCarbonate250MG/MLOralSuspension|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|308868-Calcitriol0.0005MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|308867-Calcitriol0.00025MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|308725-bexarotene75MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|308714-Betamethasone0.5MG/ML/Clotrimazole10MG/MLTopicalCream|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|308696-BenzoylPeroxide50MG/MLMedicatedLiquidSoap|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|308694-BenzoylPeroxide0.05MG/MGTopicalGel|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|308689-BenzoylPeroxide0.025MG/MGTopicalGel|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|308512-Bacitracin0.5UNT/MG/PolymyxinB10UNT/MGTopicalOintment|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|308508-Bacitracin0.5UNT/MGOphthalmicOintment|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|308493-Bacitracin0.4UNT/MG/Neomycin0.0035MG/MG/PolymyxinB10UNT/MGOphthalmicOintment|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|308459-Azithromycin20MG/MLOralSuspension|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|105583-Fluorouracil50MG/MLTopicalCream|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|308416-Aspirin81MGDelayedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|308345-apraclonidine5MG/MLOphthalmicSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|308212-Ampicillin500MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|308194-Amoxicillin875MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|308191-Amoxicillin500MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|308189-Amoxicillin80MG/MLOralSuspension|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|308182-Amoxicillin250MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|308177-Amoxicillin125MGChewableTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|308136-Amlodipine2.5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|308135-Amlodipine10MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|308078-AluminumHydroxide64MG/MLOralSuspension|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|307730-Acyclovir40MG/MLOralSuspension|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|307719-Acetylcysteine200MG/MLInhalationSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|307718-Acetylcysteine100MG/MLInhalationSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|307675-Acetaminophen32MG/MLOralSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|284988-Didanosine400MGDelayedReleaseOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|284245-Famotidine40MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|284215-Clindamycin300MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|284185-Didanosine200MGDelayedReleaseOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|284184-Didanosine250MGDelayedReleaseOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|283858-ropinirole3MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|283672-Citalopram10MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|283523-gabapentin50MG/MLOralSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|283485-Mirtazapine45MGDisintegratingOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|283433-Melatonin10MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|283406-Mirtazapine15MGDisintegratingOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|283077-prednisolone3MG/MLOralSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|282755-telmisartan20MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|282401-lamotrigine25MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|260376-Terazosin10MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|260243-Progesterone100MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|259966-Methylprednisolone4MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|259255-atorvastatin80MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|2532159-PMDDfluoxetine10MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|253059-Levocarnitine500MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|253039-Melatonin1MG/MLOralSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|252732-Melatonin5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|251322-Ethosuximide50MG/MLOralSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|251156-ferroussulfate75MG/MLOralSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|248420-mesalamine1000MGRectalSuppository|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|248109-Ribavirin200MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|245314-Albuterol5MG/MLInhalationSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|244967-PolymyxinB10000UNT/ML/Trimethoprim1MG/MLOphthalmicSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|242590-ferrousgluconate240MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|242446-Ofloxacin3MG/MLOticSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|241834-cyclosporine,modified100MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|240209-Betamethasone0.5MG/MLTopicalLotion|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|240029-Cholecalciferol0.125MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|239238-Griseofulvin25MG/MLOralSuspension|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|239191-Amoxicillin50MG/MLOralSuspension|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|238920-Betamethasone0.5MG/MLTopicalCream|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|238600-seleniumsulfide25MG/MLMedicatedShampoo|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|238154-Acetaminophen325MG/butalbital50MG/Caffeine40MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|238151-mesalamine66.7MG/MLEnema|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|238006-Estrogens,Esterified(USP)0.625MG/Methyltestosterone1.25MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|237776-vitaminB121MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|237723-Ergocalciferol0.2MG/MLOralSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|237420-CalciumCarbonate1500MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|226343-Dexamethasonephosphate1MG/MLOphthalmicSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|211365-chlorhexidinegluconate40MG/MLMedicatedLiquidSoap|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|2101899-Sodiumpolystyrenesulfonate15000MGPowderforOralSuspension|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|209890-Acetaminophen500MGOralCapsule[Mapap]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|206842-IsosorbideDinitrate20MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|205326-Lisinopril30MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|205305-telmisartan80MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|205304-telmisartan40MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|205285-leflunomide20MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|205284-leflunomide10MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|204844-Azithromycin600MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|204423-Hydrocortisone10MG/ML/Neomycin3.5MG/ML/PolymyxinB10000UNT/MLOticSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|204135-Desonide0.0005MG/MGTopicalOintment|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|200371-Citalopram20MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|200346-cefdinir300MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|200257-repaglinide0.5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|200256-repaglinide1MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|200133-12HRCarbamazepine200MGExtendedReleaseOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|200132-Acarbose25MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|200131-12HRCarbamazepine300MGExtendedReleaseOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|200064-letrozole2.5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|200060-mycophenolatemofetil500MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|200033-carvedilol25MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|200032-carvedilol12.5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|200031-carvedilol6.25MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|199903-Hydrochlorothiazide12.5MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|199890-topiramate200MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|199889-topiramate100MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|199888-topiramate25MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|199885-Levofloxacin500MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|199884-Levofloxacin250MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|199703-cabergoline0.5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|199425-Melatonin1MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|199390-Etodolac500MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|199353-trandolapril1MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|199352-trandolapril4MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|199351-trandolapril2MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|199246-glimepiride2MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1085640-TriamcinoloneAcetonide0.005MG/MGTopicalOintment|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|199245-glimepiride1MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1992303-12HRTimolol5MG/MLOphthalmicSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|199224-anastrozole1MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|199193-famciclovir250MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|199192-famciclovir125MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|199168-Phenobarbital64.8MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|199167-Phenobarbital32.4MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|199164-Phenobarbital97.2MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|199163-Melatonin3MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|199159-Tretinoin10MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|199150-Acarbose100MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|199149-Acarbose50MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|199143-Niacin250MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|199058-mycophenolatemofetil250MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|199047-Famotidine10MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|198861-SodiumBicarbonate650MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|198857-Simethicone66.7MG/MLOralSuspension|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|198760-Niacin50MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|198759-Niacin100MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|198741-MagnesiumOxide400MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|198707-Hydrocortisone5MG/MLTopicalCream|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|198630-ferrousgluconate324MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|198555-Capsaicin0.25MG/MLTopicalCream|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|198546-CalciumGluconate500MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|198509-Bisacodyl10MGRectalSuppository|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|198440-Acetaminophen500MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|198429-lamotrigine200MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|198428-lamotrigine150MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|198427-lamotrigine100MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|198382-famciclovir500MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|198380-tioconazole0.065MG/MGVaginalOintment|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|198378-Tacrolimus5MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|198377-Tacrolimus1MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|198372-torsemide5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|198371-torsemide20MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|198370-torsemide100MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|198369-torsemide10MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|198365-Prochlorperazine10MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|198352-Zidovudine100MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|198335-Sulfamethoxazole800MG/Trimethoprim160MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|198334-Sulfamethoxazole400MG/Trimethoprim80MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|198332-Trimethoprim100MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|198316-Hydrochlorothiazide25MG/Triamterene37.5MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|198293-Tolazamide500MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|198292-Tolazamide250MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|198240-Tamoxifen10MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|198239-Sulindac200MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|198238-Sulindac150MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1085745-TriamcinoloneAcetonide1MG/MLTopicalLotion|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|198232-Sulfasalazine500MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|198224-Hydrochlorothiazide25MG/Spironolactone25MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|198223-Spironolactone50MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|198222-Spironolactone100MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|198211-Simvastatin40MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|198202-Rifampin300MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|198201-Rifampin150MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|198181-Pyrazinamide500MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|198175-Propylthiouracil50MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|198165-Propantheline15MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|198153-Colchicine0.5MG/Probenecid500MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|198152-Probenecid500MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|198148-Prednisone50MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|198146-Prednisone2.5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|198145-Prednisone10MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|198144-Prednisone1MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|198141-Prazosin5MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|198116-PotassiumChloride20MEQExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|198108-Piroxicam20MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|198107-Piroxicam10MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|198105-Pindolol5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|198104-Pindolol10MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|198102-vitaminK15MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|198089-Phenobarbital60MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|198086-Phenobarbital16.2MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|198083-Phenobarbital100MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|198049-Ofloxacin300MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|198047-Nortriptyline75MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|198046-Nortriptyline50MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|198045-Nortriptyline10MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|198040-Nitroglycerin0.6MGSublingualTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|198039-Nitroglycerin0.4MGSublingualTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|198038-Nitroglycerin0.3MGSublingualTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|198033-Nifedipine20MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|198032-Nifedipine10MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|198024-Niacin500MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|198014-Naproxen500MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|198013-Naproxen250MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|198012-Naproxen375MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197987-Minoxidil2.5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197986-Minoxidil10MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197973-Methylprednisolone8MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197971-Methylprednisolone32MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197963-Hydrochlorothiazide15MG/Methyldopa250MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197960-Hydrochlorothiazide25MG/Methyldopa250MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197958-Methyldopa500MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197956-Methyldopa250MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197944-Methocarbamol750MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1095725-ClemastineFumarate1.34MGOralTablet[Dayhist-1]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197943-Methocarbamol500MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197942-Methimazole5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197941-Methimazole10MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197940-Methazolamide50MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197939-Methazolamide25MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197931-mercaptopurine50MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197919-Melphalan2MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197905-Lovastatin40MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197904-Lovastatin20MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197903-Lovastatin10MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197887-Hydrochlorothiazide25MG/Lisinopril20MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197886-Hydrochlorothiazide12.5MG/Lisinopril20MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197885-Hydrochlorothiazide12.5MG/Lisinopril10MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197884-Lisinopril40MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197863-Leucovorin5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197862-Leucovorin25MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197861-Leucovorin15MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197860-Leucovorin10MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197856-Ketoprofen75MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197855-Ketoprofen50MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197854-Ketoprofen25MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197853-Ketoconazole200MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197839-IsosorbideDinitrate30MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197832-isoniazid300MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197818-Indomethacin50MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197817-Indomethacin25MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197816-Indapamide2.5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197815-Indapamide1.25MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197807-Ibuprofen800MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197806-Ibuprofen600MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197805-Ibuprofen400MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197803-Ibuprofen20MG/MLOralSuspension|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197797-hydroxyurea500MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197787-Hydrocortisone5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197785-Hydrocortisone25MG/MLTopicalLotion|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197783-Hydrocortisone20MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197782-Hydrocortisone10MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197770-Hydrochlorothiazide50MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197746-Guanfacine2MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197745-Guanfacine1MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197741-Guaifenesin200MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197737-Glyburide1.25MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197732-Furosemide80MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197726-Flutamide125MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197701-Fluconazole50MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197700-Fluconazole200MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197699-Fluconazole150MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197698-Fluconazole100MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197686-Etodolac400MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197685-Etodolac300MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197684-Etodolac200MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197682-Ethosuximide250MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197670-Estrogens,Esterified(USP)1.25MG/Methyltestosterone2.5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197659-Estradiol2MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|Y||Preferred Generic|892646-MorphineSulfate200MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|Y|N|Y||Preferred Generic|891893-MorphineSulfate60MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197657-Estradiol0.5MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|Y||Preferred Generic|891888-MorphineSulfate30MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|Y|N|Y||Preferred Generic|891881-MorphineSulfate15MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197650-Erythromycin500MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|Y||Preferred Generic|891874-MorphineSulfate100MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|Y|N|Y||Preferred Generic|883826-TranexamicAcid650MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|Y||Preferred Generic|835809-testosteroneenanthate200MG/MLInjectableSolution|DISABLED FULL DUALS 632|2002|Y|N|Y||Preferred Generic|577033-sildenafil20MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|Y||Preferred Generic|313451-Tretinoin0.00025MG/MGTopicalGel|DISABLED FULL DUALS 632|2002|Y|N|Y||Preferred Generic|313450-Tretinoin0.0001MG/MGTopicalGel|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197626-Doxazosin2MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|Y||Preferred Generic|312084-Ondansetron24MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|Y||Preferred Generic|310140-eprosartan600MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|Y||Preferred Generic|245723-Tretinoin0.0005MG/MGTopicalGel|DISABLED FULL DUALS 632|2002|Y|N|Y||Preferred Generic|198300-Tretinoin1MG/MLTopicalCream|DISABLED FULL DUALS 632|2002|Y|N|Y||Preferred Generic|197636-dronabinol5MGOralCapsule|DISABLED FULL DUALS 632|2002|Y|N|Y||Preferred Generic|197635-dronabinol2.5MGOralCapsule|DISABLED FULL DUALS 632|2002|Y|N|Y||Preferred Generic|197634-dronabinol10MGOralCapsule|DISABLED FULL DUALS 632|2002|Y|N|Y||Preferred Generic|106303-Tretinoin0.5MG/MLTopicalCream|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197622-Dipyridamole50MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|Y||Preferred Generic|106302-Tretinoin0.25MG/MLTopicalCream|DISABLED FULL DUALS 632|2002|Y|N|Y||Preferred Brand|861821-Metforminhydrochloride500MG/sitagliptin50MGOralTablet[Janumet]|DISABLED FULL DUALS 632|2002|Y|N|Y||Preferred Brand|861771-Metforminhydrochloride1000MG/sitagliptin50MGOralTablet[Janumet]|DISABLED FULL DUALS 632|2002|Y|N|Y||Preferred Brand|804547-difluprednate0.5MG/MLOphthalmicSuspension[Durezol]|DISABLED FULL DUALS 632|2002|Y|N|Y||Preferred Brand|665044-sitagliptin50MGOralTablet[Januvia]|DISABLED FULL DUALS 632|2002|Y|N|Y||Preferred Brand|665040-sitagliptin25MGOralTablet[Januvia]|DISABLED FULL DUALS 632|2002|Y|N|Y||Preferred Brand|665036-sitagliptin100MGOralTablet[Januvia]|DISABLED FULL DUALS 632|2002|Y|N|Y||Preferred Brand|1292435-0.65MLVaricella-ZosterVirusVaccineLive(Oka-Merck)strain29800UNT/MLInjection[Zostavax]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197595-Dicloxacillin250MGOralCapsule|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|999996-Amlodipine5MG/Hydrochlorothiazide12.5MG/Olmesartanmedoxomil40MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|999991-Amlodipine10MG/Hydrochlorothiazide25MG/Olmesartanmedoxomil40MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|999986-Amlodipine10MG/Hydrochlorothiazide12.5MG/Olmesartanmedoxomil40MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|999967-Amlodipine5MG/Hydrochlorothiazide12.5MG/Olmesartanmedoxomil20MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|998189-everolimus2.5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1099563-24HRDivalproexSodium250MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|992395-gatifloxacin5MG/MLOphthalmicSolution|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|990982-2MLphysostigminesalicylate1MG/MLInjection|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|968766-PhentermineHydrochloride15MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197580-Dexamethasone1.5MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|904952-3MLibandronicacid1MG/MLPrefilledSyringe|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|903857-PyridostigmineBromide60MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|903847-PyridostigmineBromide180MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|903843-PyridostigmineBromide12MG/MLOralSolution|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|900164-24HRlamotrigine25MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|900156-24HRlamotrigine200MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|900038-PhentermineHydrochloride30MGOralCapsule|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|898715-pregabalin20MG/MLOralSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197558-Dapsone25MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|897021-12HRdalfampridine10MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|892349-24HRMorphineSulfate60MGExtendedReleaseOralCapsule|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|892342-24HRMorphineSulfate30MGExtendedReleaseOralCapsule|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|886634-ButorphanolTartrate1MG/ACTUATMeteredDoseNasalSpray|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197553-Cyclosporine25MGOralCapsule|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|881341-adefovirdipivoxil10MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|876529-Amlodipine5MG/telmisartan80MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|876524-Amlodipine5MG/telmisartan40MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|876519-Amlodipine10MG/telmisartan80MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197517-Clarithromycin500MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|876514-Amlodipine10MG/telmisartan40MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|864978-MethadoneHydrochloride40MGTabletforOralSuspension|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|864769-MethadoneHydrochloride2MG/MLOralSolution|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|864761-MethadoneHydrochloride1MG/MLOralSolution|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|864718-MethadoneHydrochloride5MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|864706-MethadoneHydrochloride10MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|864681-Atovaquone62.5MG/proguanilhydrochloride25MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|864675-Atovaquone250MG/proguanilhydrochloride100MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197454-Cephalexin500MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|863038-bepotastinebesilate15MG/MLOphthalmicSolution|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|861960-armodafinil200MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|861375-sevelamercarbonate800MGPowderforOralSuspension|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|861370-sevelamercarbonate2400MGPowderforOralSuspension|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|860901-galantaminehydrobromide4MG/MLOralSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1099648-5MLValproicAcid100MG/MLInjection|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|860715-24HRgalantaminehydrobromide8MGExtendedReleaseOralCapsule|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|860707-24HRgalantaminehydrobromide24MGExtendedReleaseOralCapsule|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|860695-24HRgalantaminehydrobromide16MGExtendedReleaseOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197444-Carbidopa25MG/Levodopa100MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|860103-KetorolacTromethamine4MG/MLOphthalmicSolution|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|857700-DiclofenacSodium15MG/MLTopicalSolution|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|857224-Sevelamerhydrochloride800MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|857216-Sevelamerhydrochloride400MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|855642-DiclofenacSodium0.03MG/MGTopicalGel|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|855626-Twice-Dailydiclofenacepolamine0.013MG/MGMedicatedPatch|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|854894-Zolpidemtartrate6.25MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|854880-Zolpidemtartrate12.5MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197409-Betamethasone0.001MG/MGTopicalOintment|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|850091-24HRlamotrigine50MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|850087-24HRlamotrigine100MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|848151-Amlodipine10MG/Hydrochlorothiazide25MG/valsartan160MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|848145-Amlodipine5MG/Hydrochlorothiazide25MG/valsartan160MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|848140-Amlodipine5MG/Hydrochlorothiazide12.5MG/valsartan160MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|848135-Amlodipine10MG/Hydrochlorothiazide25MG/valsartan320MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|848131-Amlodipine10MG/Hydrochlorothiazide12.5MG/valsartan160MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|845515-everolimus5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197392-Baclofen20MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|834241-febuxostat80MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|834235-febuxostat40MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|833234-mesalamine800MGDelayedReleaseOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|824301-rufinamide400MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197388-Azathioprine50MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|824295-rufinamide200MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|810096-{7(EthinylEstradiol0.01MGOralTablet)/84(EthinylEstradiol0.02MG/Levonorgestrel0.1MGOralTablet)}Pack|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|803353-PhentermineHydrochloride37.5MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|802749-candesartancilexetil32MG/Hydrochlorothiazide25MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197382-Atenolol100MG/Chlorthalidone25MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|794639-lubiprostone0.008MGOralCapsule|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|754508-{1(aprepitant125MGOralCapsule)/2(aprepitant80MGOralCapsule)}Pack|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|728231-12HRranolazine1000MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|727339-0.5MLSumatriptan12MG/MLPrefilledSyringe|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|725023-24HRrivastigmine0.396MG/HRTransdermalSystem|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1099870-DivalproexSodium500MGDelayedReleaseOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|725021-24HRrivastigmine0.192MG/HRTransdermalSystem|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|724863-armodafinil50MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|724861-armodafinil250MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197362-ammoniumlactate120MG/MLTopicalLotion|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|724859-armodafinil150MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|722122-ambrisentan5MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|722116-ambrisentan10MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|705824-100MLzoledronicacid0.05MG/MLInjection|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|700885-temozolomide180MGOralCapsule|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|700883-temozolomide140MGOralCapsule|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|672149-lapatinib250MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|656659-bosentan125MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197318-Albuterol4MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|644088-aprepitant40MGOralCapsule|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|642452-lanthanumcarbonate750MGChewableTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|639537-candesartancilexetil32MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|616749-12HRranolazine500MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197313-Acyclovir800MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|616578-lubiprostone0.024MGOralCapsule|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|603208-erlotinib25MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|603206-erlotinib150MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|603203-erlotinib100MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197310-Acyclovir200MGOralCapsule|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|602635-lanthanumcarbonate1000MGChewableTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|597772-deferasirox500MGTabletforOralSuspension|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|597770-deferasirox250MGTabletforOralSuspension|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|597768-deferasirox125MGTabletforOralSuspension|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|579148-Galantamine12MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|578330-candesartancilexetil32MG/Hydrochlorothiazide12.5MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|578325-candesartancilexetil16MG/Hydrochlorothiazide12.5MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|578018-bromfenac0.9MG/MLOphthalmicSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1946772-Methotrexate25MG/MLInjectableSolution|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|577776-candesartancilexetil16MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|577348-ramelteon8MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|577208-Omega-3AcidEthylEsters(USP)1000MGOralCapsule|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|577057-72HRFentanyl0.012MG/HRTransdermalSystem|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|545835-LeuprolideAcetate5MG/MLInjectableSolution|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|543218-1MLGranisetron0.1MG/MLInjection|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|485489-Temazepam22.5MGOralCapsule|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|485436-entecavir1MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1923426-SotalolHydrochloride80MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|485434-entecavir0.5MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|485423-24HRdarifenacin7.5MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|485421-24HRdarifenacin15MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|477372-solifenacinsuccinate10MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|477367-solifenacinsuccinate5MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|477347-lanthanumcarbonate500MGChewableTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|477130-Hydrochlorothiazide25MG/telmisartan80MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|465355-voriconazole40MG/MLOralSuspension|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1860100-ferroussulfate324MGDelayedReleaseOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|403930-Isotretinoin30MGOralCapsule|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|403879-imatinib400MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|403878-imatinib100MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|403818-moxifloxacin5MG/MLOphthalmicSolution|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|403811-aprepitant125MGOralCapsule|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|402506-12HRCarbamazepine400MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|402505-12HRCarbamazepine200MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|351114-5MLzoledronicacid0.8MG/MLInjection|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1806181-30/70Release24HRMethylphenidateHydrochloride10MGExtendedReleaseOralCapsule|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|349435-voriconazole50MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|349434-voriconazole200MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|349410-Treprostinil5MG/MLInjectableSolution|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|349409-Treprostinil2.5MG/MLInjectableSolution|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|349408-Treprostinil10MG/MLInjectableSolution|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|349407-Treprostinil1MG/MLInjectableSolution|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|349253-bosentan62.5MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|348719-Tobramycin60MG/MLInhalationSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1797913-TriamcinoloneAcetonide0.055MG/ACTUATMeteredDoseNasalSpray|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|317160-temozolomide100MGOralCapsule|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|313472-Trientinehydrochloride250MGOralCapsule|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|313211-temozolomide5MGOralCapsule|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|313210-temozolomide250MGOralCapsule|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|313209-temozolomide20MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1190572-AtropineSulfate0.025MG/DiphenoxylateHydrochloride2.5MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|313165-0.5MLSumatriptan12MG/MLInjection|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|312835-rivastigmine3MGOralCapsule|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|311204-Itraconazole100MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1738511-ParoxetineHydrochloride40MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|310599-Granisetron1MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|310437-Galantamine8MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|310436-Galantamine4MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|283317-Hydrochlorothiazide12.5MG/telmisartan80MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|283316-Hydrochlorothiazide12.5MG/telmisartan40MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|260218-modafinil100MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|245136-72HRFentanyl0.1MG/HRTransdermalSystem|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|245135-72HRFentanyl0.05MG/HRTransdermalSystem|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1731350-deferoxaminemesylate500MGInjection|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|245134-72HRFentanyl0.025MG/HRTransdermalSystem|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|240912-Granisetron1MG/MLInjectableSolution|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|2198370-pretomanid200MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|2123194-PulmonaryHypertensiontadalafil20MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1724481-thyroid(USP)60MGOralTablet[NPThyroid]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|205324-modafinil200MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|205316-topiramate15MGOralCapsule|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|205315-topiramate25MGOralCapsule|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|200328-capecitabine500MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1724437-thyroid(USP)90MGOralTablet[NPThyroid]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|200327-capecitabine150MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|200220-tolcapone100MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|199521-Vigabatrin500MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|199378-12HRCarbamazepine100MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1988980-24HRpregabalin82.5MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1988977-24HRpregabalin330MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1988974-24HRpregabalin165MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|198243-Temazepam7.5MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1655968-8MLMethotrexate25MG/MLInjection|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|198200-Rifabutin150MGOralCapsule|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|198071-Penicillamine250MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|198070-Penicillamine250MGOralCapsule|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|197845-Isotretinoin40MGOralCapsule|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|197844-Isotretinoin20MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1191310-FluocinoloneAcetonide0.1MG/MLTopicalSolution|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|197843-Isotretinoin10MGOralCapsule|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|197730-Furosemide10MG/MLOralSolution|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|197696-72HRFentanyl0.075MG/HRTransdermalSystem|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|152695-meloxicam15MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1923828-deferasirox180MGOralGranules|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1923826-deferasirox360MGOralGranules|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1923822-deferasirox90MGOralGranules|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1918042-abirateroneacetate500MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1874559-24HRdesvenlafaxinesuccinate50MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1874553-24HRdesvenlafaxinesuccinate100MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1860157-Abuse-Deterrent12HROxycodoneHydrochloride10MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1860154-Abuse-Deterrent12HROxycodoneHydrochloride15MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|142034-BenzoylPeroxide100MG/MLMedicatedLiquidSoap|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1860151-Abuse-Deterrent12HROxycodoneHydrochloride30MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1860148-Abuse-Deterrent12HROxycodoneHydrochloride80MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1860137-Abuse-Deterrent12HROxycodoneHydrochloride40MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1860129-Abuse-Deterrent12HROxycodoneHydrochloride20MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1860127-Abuse-Deterrent12HROxycodoneHydrochloride60MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1799212-sofosbuvir400MG/velpatasvir100MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1796690-1MLhydroxyprogesteronecaproate(USP)250MG/MLInjection|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1793916-0.5MLSumatriptan8MG/MLAuto-Injector|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1367410-Ergocalciferol1.25MGOralCapsule|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1745091-Lidocaine0.05MG/MGMedicatedPatch|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1737461-PamidronateDisodium90MGInjection|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1737459-PamidronateDisodium30MGInjection|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1734399-1MLGranisetron1MG/MLInjection|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1728055-5MLpalonosetron0.05MG/MLInjection|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1657173-0.5MLSumatriptan8MG/MLCartridge|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1657160-0.5MLSumatriptan12MG/MLCartridge|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1607990-{24(EthinylEstradiol0.025MG/Norethindrone0.8MGChewableTablet)/4(Ferrousfumarate75MGChewableTablet)}Pack|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1362712-MexiletineHydrochloride200MGOralCapsule|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1607796-deferasirox90MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1607792-deferasirox360MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1607784-deferasirox180MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1607617-24HRdesvenlafaxinesuccinate25MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1599949-60ACTUATTestosterone30MG/ACTUATTopicalSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1193362-100MLLevetiracetam5MG/MLInjection|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1597129-5000MGTestosterone0.01MG/MGTopicalGel|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1597123-2500MGTestosterone0.01MG/MGTopicalGel|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1591943-ledipasvir90MG/sofosbuvir400MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1359117-{24(EthinylEstradiol0.02MG/norethindroneacetate1MGOralTablet)/4(Ferrousfumarate75MGOralTablet)}Pack|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1547565-Isotretinoin35MGOralCapsule|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1547561-Isotretinoin25MGOralCapsule|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|153823-candesartancilexetil8MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|153822-candesartancilexetil4MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1490065-RaloxifeneHydrochloride60MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1487361-1MLglatirameracetate40MG/MLPrefilledSyringe|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1435115-28ACTUATTeriparatide0.02MG/ACTUATPenInjector|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1426600-{24(EthinylEstradiol0.02MG/norethindroneacetate1MGChewableTablet)/4(Ferrousfumarate75MGOralTablet)}Pack|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1298070-Cyclopentolatehydrochloride20MG/MLOphthalmicSolution|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1373503-{7(EthinylEstradiol0.01MGOralTablet)/42(EthinylEstradiol0.02MG/Levonorgestrel0.15MGOralTablet)/21(EthinylEstradiol0.0|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1373497-{14(dimethylfumarate120MGDelayedReleaseOralCapsule)/46(dimethylfumarate240MGDelayedReleaseOralCapsule)}Pack|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1373491-dimethylfumarate240MGDelayedReleaseOralCapsule|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1373483-dimethylfumarate120MGDelayedReleaseOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1291082-hydrocortisoneacetate25MGRectalSuppository|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1366550-24HRBudesonide9MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1360304-Budesonide0.08MG/ACTUAT/formoterolfumarate0.0045MG/ACTUATMeteredDoseInhaler|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1359861-Budesonide0.16MG/ACTUAT/formoterolfumarate0.0045MG/ACTUATMeteredDoseInhaler|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1308569-24HRrivastigmine0.554MG/HRTransdermalSystem|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1245919-Marlissa28DayPack|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1307427-sildenafil10MG/MLOralSuspension|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1304979-icosapentethyl1000MGOralCapsule|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1299917-Tiagabinehydrochloride4MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1299911-Tiagabinehydrochloride2MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1299909-Tiagabinehydrochloride16MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1299903-Tiagabinehydrochloride12MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1146690-24HRlamotrigine250MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1119400-everolimus7.5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1242787-Alyacen7/7/7Kit|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1111641-1MLglatirameracetate20MG/MLPrefilledSyringe|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1100075-abirateroneacetate250MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1242786-Alyacen1/3528-DayKit|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1098608-24HRlamotrigine300MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1095229-FlavoxateHydrochloride100MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1234571-PhenylephrineHydrochloride100MG/MLOphthalmicSolution|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1092357-rufinamide40MG/MLOralSuspension|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1243585-Flurbiprofensodium0.3MG/MLOphthalmicSolution|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1087964-hydroxyprogesteronecaproate(USP)250MG/MLInjectableSolution|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1050493-{21(drospirenone3MG/EthinylEstradiol0.03MG/levomefolatecalcium0.451MGOralTablet)/7(levomefolatecalcium0.451MGOralTabl|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1013629-{24(drospirenone3MG/EthinylEstradiol0.02MG/levomefolatecalcium0.451MGOralTablet)/4(levomefolatecalcium0.451MGOralTabl|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1193360-100MLLevetiracetam15MG/MLInjection|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1011739-aliskiren300MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1011736-aliskiren150MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1193358-100MLLevetiracetam10MG/MLInjection|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Generic|1000001-Amlodipine5MG/Hydrochlorothiazide25MG/Olmesartanmedoxomil40MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|995156-lacosamide10MG/MLOralSolution[Vimpat]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1191315-FluocinoloneAcetonide0.25MG/MLTopicalCream|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|993456-1MLdenosumab60MG/MLPrefilledSyringe[Prolia]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|979115-0.6MLMethylnaltrexonebromide20MG/MLInjection[Relistor]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|978950-Natazia28DayPack|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|903855-2MLPyridostigmineBromide5MG/MLInjection[Regonol]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1191256-FluocinoloneAcetonide0.00025MG/MGTopicalOintment|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|902626-dexlansoprazole60MGDelayedReleaseOralCapsule[Dexilant]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|902624-dexlansoprazole30MGDelayedReleaseOralCapsule[Dexilant]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1191013-Proparacainehydrochloride5MG/MLOphthalmicSolution|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|901614-Aztreonam75MG/MLInhalationSolution[Cayston]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|897126-3MLliraglutide6MG/MLPenInjector[Victoza]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1190655-AtropineSulfate10MG/MLOphthalmicSolution|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|896273-120ACTUATFluticasonepropionate0.23MG/ACTUAT/salmeterol0.021MG/ACTUATMeteredDoseInhaler[Advair]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1245468-DocusateSodium250MGOralCapsule|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|896245-120ACTUATFluticasonepropionate0.115MG/ACTUAT/salmeterol0.021MG/ACTUATMeteredDoseInhaler[Advair]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|896237-120ACTUATFluticasonepropionate0.045MG/ACTUAT/salmeterol0.021MG/ACTUATMeteredDoseInhaler[Advair]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|884619-eltrombopag75MGOralTablet[Promacta]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1190570-AtropineSulfate0.01MG/MGOphthalmicOintment|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|867506-pazopanib200MGOralTablet[Votrient]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|864820-Oxybutyninchloride0.1MG/MGTopicalGel[Gelnique]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1190568-AtropineSulfate0.005MG/ML/DiphenoxylateHydrochloride0.5MG/MLOralSolution|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|861966-Iloprost0.02MG/MLInhalationSolution[Ventavis]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|861045-1.5MLpramlintideacetate1MG/MLPenInjector[Symlin]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1150836-LevobunololHydrochloride5MG/MLOphthalmicSolution|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|861043-2.7MLpramlintideacetate1MG/MLPenInjector[Symlin]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|860898-Vigabatrin500MGPowderforOralSolution[Sabril]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1116758-chloroquinephosphate500MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|860244-interferonbeta-1b0.3MGInjection[Extavia]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|858366-KetorolacTromethamine4.5MG/MLOphthalmicSolution[Acuvail]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1116150-bacitracinzinc0.4UNT/MG/hydrocortisoneacetate0.01MG/MG/NeomycinSulfate0.0035MG/MG/PolymyxinBSulfate10UNT/MGOphthalmic|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|858044-saxagliptin2.5MGOralTablet[Onglyza]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|858040-saxagliptin5MGOralTablet[Onglyza]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1115005-DocusateSodium100MGOralCapsule|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|857799-Treprostinil0.6MG/MLInhalationSolution[Tyvaso]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|854852-lisdexamfetaminedimesylate50MGOralCapsule[Vyvanse]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1100457-PyridoxineHydrochloride25MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|854848-lisdexamfetaminedimesylate60MGOralCapsule[Vyvanse]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1250490-hydrocortisoneacetate5MG/MLTopicalCream|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|854844-lisdexamfetaminedimesylate70MGOralCapsule[Vyvanse]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|854840-lisdexamfetaminedimesylate40MGOralCapsule[Vyvanse]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|854836-lisdexamfetaminedimesylate30MGOralCapsule[Vyvanse]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1099687-ValproicAcid50MG/MLOralSolution|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|854832-lisdexamfetaminedimesylate20MGOralCapsule[Vyvanse]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|853356-1MLustekinumab90MG/MLPrefilledSyringe[Stelara]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1099681-ValproicAcid250MGOralCapsule|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|853354-0.5MLustekinumab90MG/MLPrefilledSyringe[Stelara]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|849599-1MLcertolizumabpegol200MG/MLPrefilledSyringe[Cimzia]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1099678-DivalproexSodium250MGDelayedReleaseOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|848164-0.5MLgolimumab100MG/MLPrefilledSyringe[Simponi]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|847917-60ACTUATexenatide0.005MG/ACTUATPenInjector[Byetta]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|847913-60ACTUATexenatide0.01MG/ACTUATPenInjector[Byetta]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|845512-everolimus10MGOralTablet[Afinitor]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1099625-DivalproexSodium125MGDelayedReleaseOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|836649-Zolpidemtartrate5MGSublingualTablet[Edluar]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|836645-Zolpidemtartrate10MGSublingualTablet[Edluar]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1099596-DivalproexSodium125MGDelayedReleaseOralCapsule|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|828703-1.2MLPlerixafor20MG/MLInjection[Mozobil]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|828696-Zolpidemtartrate5MG/ACTUATOralSpray[Zolpimist]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1099569-24HRDivalproexSodium500MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|828364-hydrocortisoneacetate10MG/ML/Pramoxinehydrochloride10MG/MLRectalFoam[Proctofoam-HC]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1298066-Cyclopentolatehydrochloride10MG/MLOphthalmicSolution|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|825429-eltrombopag50MGOralTablet[Promacta]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|825425-eltrombopag25MGOralTablet[Promacta]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|825170-HumiraPen40MG/0.8ML-Crohn'sDiseaseStarterPack|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1099316-DesipramineHydrochloride75MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|810079-24HRFesoterodineFumarate8MGExtendedReleaseOralTablet[Toviaz]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|810075-24HRFesoterodineFumarate4MGExtendedReleaseOralTablet[Toviaz]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1099304-DesipramineHydrochloride50MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|810002-lacosamide50MGOralTablet[Vimpat]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|809998-lacosamide200MGOralTablet[Vimpat]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1099300-DesipramineHydrochloride25MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|809994-lacosamide150MGOralTablet[Vimpat]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|809990-lacosamide100MGOralTablet[Vimpat]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1099296-DesipramineHydrochloride150MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|809159-0.5MLEtanercept50MG/MLPrefilledSyringe[Enbrel]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|802652-1MLEtanercept50MG/MLPrefilledSyringe[Enbrel]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1099292-DesipramineHydrochloride100MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|799830-dasatinib100MGOralTablet[Sprycel]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|795749-RebifTitrationPack|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1099288-DesipramineHydrochloride10MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|795085-certolizumabpegol200MGInjection[Cimzia]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|763565-0.4MLadalimumab50MG/MLPrefilledSyringe[Humira]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1098134-24HRNiacin1000MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|758032-0.5MLInterferonbeta-1a0.044MG/MLPrefilledSyringe[Rebif]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1298072-Cyclopentolatehydrochloride5MG/MLOphthalmicSolution|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|758027-0.5MLInterferonbeta-1a0.088MG/MLPrefilledSyringe[Rebif]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|753443-9HRMethylphenidate3.33MG/HRTransdermalSystem[Daytrana]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1313112-Phenytoin25MG/MLOralSuspension|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|753442-9HRMethylphenidate2.22MG/HRTransdermalSystem[Daytrana]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1094543-Briellyn28DayPack|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|753437-9HRMethylphenidate1.11MG/HRTransdermalSystem[Daytrana]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|748740-Topotecan1MGOralCapsule[Hycamtin]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1094107-Phenazopyridinehydrochloride100MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|748738-Topotecan0.25MGOralCapsule[Hycamtin]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|746609-nilotinib200MGOralCapsule[Tasigna]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1094104-Phenazopyridinehydrochloride200MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|731250-0.3MLdarbepoetinalfa0.2MG/MLPrefilledSyringe[Aranesp]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|731245-0.42MLdarbepoetinalfa0.06MG/MLPrefilledSyringe[Aranesp]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|731241-1MLdarbepoetinalfa0.5MG/MLPrefilledSyringe[Aranesp]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|731235-0.4MLdarbepoetinalfa0.5MG/MLPrefilledSyringe[Aranesp]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1085741-TriamcinoloneAcetonide0.25MG/MLTopicalLotion|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|731231-0.3MLdarbepoetinalfa0.5MG/MLPrefilledSyringe[Aranesp]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|731229-0.6MLdarbepoetinalfa0.5MG/MLPrefilledSyringe[Aranesp]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1085686-TriamcinoloneAcetonide5MG/MLTopicalCream|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|731227-0.4MLdarbepoetinalfa0.1MG/MLPrefilledSyringe[Aranesp]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|730046-0.5MLdarbepoetinalfa0.2MG/MLPrefilledSyringe[Aranesp]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1085644-TriamcinoloneAcetonide0.25MG/MLTopicalCream|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|727816-0.5MLInterferonbeta-1a0.06MG/MLPrefilledSyringe[Avonex]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1313885-Phenytoin50MGChewableTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|727714-0.67MLanakinra149MG/MLPrefilledSyringe[Kineret]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|727705-0.8MLadalimumab50MG/MLPrefilledSyringe[Humira]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|723846-orlistat60MGOralCapsule[Alli]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1085636-TriamcinoloneAcetonide0.001MG/MGTopicalOintment|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|706872-Azithromycin10MG/MLOphthalmicSolution[AzaSite]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|700418-Thalidomide150MGOralCapsule[Thalomid]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1085633-TriamcinoloneAcetonide0.00025MG/MGTopicalOintment|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|668606-Vorinostat100MGOralCapsule[Zolinza]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|643722-lenalidomide25MGOralCapsule[Revlimid]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|106387-Permethrin50MG/MLTopicalCream|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|643714-lenalidomide15MGOralCapsule[Revlimid]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|643488-Isotretinoin30MGOralCapsule[Claravis]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|106351-SilverSulfadiazine10MG/MLTopicalCream|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|643177-dasatinib70MGOralTablet[Sprycel]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|643175-dasatinib50MGOralTablet[Sprycel]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|106336-Ketoconazole20MG/MLMedicatedShampoo|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|643173-dasatinib20MGOralTablet[Sprycel]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|616292-sunitinib50MGOralCapsule[Sutent]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|106258-Hydrocortisone10MG/MLTopicalCream|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|616287-sunitinib25MGOralCapsule[Sutent]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|616283-sunitinib12.5MGOralCapsule[Sutent]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|105585-Methotrexate2.5MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|616116-lenalidomide5MGOralCapsule[Revlimid]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1359779-Fluticasonepropionate0.1MG/ACTUAT/salmeterol0.05MG/ACTUATDryPowderInhaler|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|616114-lenalidomide10MGOralCapsule[Revlimid]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|616018-abatacept250MGInjection[Orencia]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1359858-Fluticasonepropionate0.5MG/ACTUAT/salmeterol0.05MG/ACTUATDryPowderInhaler|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|615979-sorafenib200MGOralTablet[Nexavar]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1053753-Nystatin100000UNT/ML/TriamcinoloneAcetonide1MG/MLTopicalCream|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|607579-entecavir0.05MG/MLOralSolution[Baraclude]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|603978-nepafenac1MG/MLOphthalmicSuspension[Nevanac]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1053697-Nystatin100UNT/MG/TriamcinoloneAcetonide0.001MG/MGTopicalOintment|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|602862-magnesiumaminoacidchelate133MGOralTablet[MGPlusProtein]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|582595-Iloprost0.01MG/MLInhalationSolution[Ventavis]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|105292-isoniazid10MG/MLOralSolution|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|580286-mesalamine500MGExtendedReleaseOralCapsule[Pentasa]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|540181-alosetron0.5MGOralTablet[Lotronex]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|404450-Thalidomide200MGOralCapsule[Thalomid]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|404449-Thalidomide100MGOralCapsule[Thalomid]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1050077-DiphenhydramineHydrochloride20MG/MLTopicalCream|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|404065-Isotretinoin40MGOralCapsule[Claravis]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|404062-Isotretinoin20MGOralCapsule[Claravis]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1049909-DiphenhydramineHydrochloride25MGOralCapsule|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|404059-Isotretinoin10MGOralCapsule[Claravis]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|352262-1MLdarbepoetinalfa0.3MG/MLInjection[Aranesp]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1049906-DiphenhydramineHydrochloride2.5MG/MLOralSolution|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|352047-1MLdarbepoetinalfa0.1MG/MLInjection[Aranesp]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1362706-MexiletineHydrochloride150MGOralCapsule|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|352046-1MLdarbepoetinalfa0.06MG/MLInjection[Aranesp]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|352045-1MLdarbepoetinalfa0.04MG/MLInjection[Aranesp]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|352044-1MLdarbepoetinalfa0.025MG/MLInjection[Aranesp]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1049167-PseudoephedrineHydrochloride60MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|261362-alosetron1MGOralTablet[Lotronex]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|261105-Etanercept25MG/MLInjectableSolution[Enbrel]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|104884-Metoclopramide1MG/MLOralSolution|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2559707-1.14MLdupilumab175MG/MLAuto-Injector[Dupixent]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2557216-trikafta50MG/37.5MG/25MGand75MGPack|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1047905-HyoscyamineSulfate0.125MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2550713-0.5MLsecukinumab150MG/MLPrefilledSyringe[Cosentyx]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2536758-24HRviloxazine200MGExtendedReleaseOralCapsule[Qelbree]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1047895-HyoscyamineSulfate0.125MG/MLOralSolution|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2536752-24HRviloxazine150MGExtendedReleaseOralCapsule[Qelbree]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2536554-24HRviloxazine100MGExtendedReleaseOralCapsule[Qelbree]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1047881-HyoscyamineSulfate0.025MG/MLOralSolution|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2531134-HumiraPen80MG/0.8ML-StarterPackageforPediatricUlcerativeColitis(4count)|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2475860-vericiguat5MGOralTablet[Verquvo]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1046985-HyoscyamineSulfate0.125MGDisintegratingOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2475856-vericiguat2.5MGOralTablet[Verquvo]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2475852-vericiguat10MGOralTablet[Verquvo]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1043690-hydrocortisoneacetate10MG/MLTopicalCream|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2475406-voclosporin7.9MGOralCapsule[Lupkynis]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1362720-MexiletineHydrochloride250MGOralCapsule|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2473042-ponatinib10MGOralTablet[Iclusig]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2463737-epoetinalfa-epbx20000UNT/MLInjectableSolution[Retacrit]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1363309-ChlorpheniramineMaleate4MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2463733-epoetinalfa-epbx10000UNT/MLInjectableSolution[Retacrit]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|103457-Fluocinonide0.0005MG/MGTopicalOintment|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2395775-30ACTUATfluticasonefuroate0.2MG/ACTUAT/umeclidinium0.0625MG/ACTUAT/vilanterol0.025MG/ACTUATDryPowderInhaler[Trelegy]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2392142-0.5MLetanercept50MG/MLInjection[Enbrel]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|103456-Fluocinonide0.5MG/MLTopicalCream|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2387331-120ACTUATbudesonide0.16MG/ACTUAT/formoterolfumarate0.0048MG/ACTUAT/glycopyrrolate0.009MG/ACTUATMeteredDoseInhaler[Bre|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2373941-bedaquiline20MGOralTablet[Sirturo]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|103403-Hydrocortisone10MG/MLTopicalLotion|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2371768-Oriahnn28DayKit|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2359358-24HRempagliflozin5MG/linagliptin2.5MG/metforminhydrochloride1000MGExtendedReleaseOralTablet[Trijardy]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2359353-24HRempagliflozin25MG/linagliptin5MG/metforminhydrochloride1000MGExtendedReleaseOralTablet[Trijardy]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2359290-24HRempagliflozin12.5MG/linagliptin2.5MG/metforminhydrochloride1000MGExtendedReleaseOralTablet[Trijardy]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1020477-DiphenhydramineHydrochloride50MGOralCapsule|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2359285-24HRempagliflozin10MG/linagliptin5MG/metforminhydrochloride1000MGExtendedReleaseOralTablet[Trijardy]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2287905-1.5MLfremanezumab-vfrm150MG/MLAuto-Injector[Ajovy]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1014678-cetirizinehydrochloride10MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2283236-bempedoicacid180MG/ezetimibe10MGOralTablet[Nexlizet]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2282414-bempedoicacid180MGOralTablet[Nexletol]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1014676-cetirizinehydrochloride5MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2282320-Rimegepant75MGDisintegratingOralTablet[Nurtec]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1366116-bacitracinzinc0.5UNT/MGTopicalOintment|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2273115-24HRtofacitinib22MGExtendedReleaseOralTablet[Xeljanz]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|226917-orlistat120MGOralCapsule[Xenical]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2268231-ubrogepant50MGOralTablet[Ubrelvy]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1014571-12HRcetirizinehydrochloride5MG/PseudoephedrineHydrochloride120MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2268227-ubrogepant100MGOralTablet[Ubrelvy]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2265689-Voxelotor500MGOralTablet[Oxbryta]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1014314-TriamcinoloneAcetonide1MG/MLTopicalCream|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2262731-MicronizedIsotretinoin8MGOralCapsule[Absorica]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2262727-MicronizedIsotretinoin32MGOralCapsule[Absorica]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1012021-Prednisolonesodiumphosphate2.5MG/ML/SulfacetamideSodium100MG/MLOphthalmicSolution|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2262719-MicronizedIsotretinoin24MGOralCapsule[Absorica]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2262713-MicronizedIsotretinoin16MGOralCapsule[Absorica]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1011852-LidocaineHydrochloride0.02MG/MGTopicalGel|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2257013-trikafta100MG/50MG/75MGand150MGPack|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2256947-lasmiditan50MGOralTablet[Reyvow]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1010878-LidocaineHydrochloride40MG/MLMucousMembraneTopicalSolution|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2256943-lasmiditan100MGOralTablet[Reyvow]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2205634-1MLbenralizumab30MG/MLAuto-Injector[Fasenra]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1006688-SulfacetamideSodium100MG/MLTopicalLotion|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2203897-ledipasvir45MG/sofosbuvir200MGOralTablet[Harvoni]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2203893-sofosbuvir200MGOralTablet[Sovaldi]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1006120-SulfacetamideSodium100MG/MLOphthalmicSolution|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2201540-romiplostim0.125MGInjection[Nplate]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1367436-21DAYEthinylEstradiol0.000625MG/HR/Etonogestrel0.005MG/HRVaginalSystem|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2196592-120ACTUATformoterolfumarate0.005MG/ACTUAT/mometasonefuroate0.05MG/ACTUATMeteredDoseInhaler[Dulera]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2182340-1MLEtanercept50MG/MLCartridge[Enbrel]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1376336-prednisoloneacetate10MG/MLOphthalmicSuspension|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2174390-symdeko50MG/75MGand75MGPack|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1000897-PilocarpineHydrochloride40MG/MLOphthalmicSolution|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2173822-1MLmepolizumab100MG/MLPrefilledSyringe[Nucala]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2170993-1MLmepolizumab100MG/MLAuto-Injector[Nucala]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1000862-PilocarpineHydrochloride20MG/MLOphthalmicSolution|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2170613-1MLgalcanezumab-gnlm100MG/MLPrefilledSyringe[Emgality]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2166401-ivacaftor25MGOralGranules[Kalydeco]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1000673-SulfacetamideSodium0.1MG/MGOphthalmicOintment|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|213475-1MLEpoetinAlfa40000UNT/MLInjection[Procrit]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|213360-Thalidomide50MGOralCapsule[Thalomid]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2123314-Mayzent0.25MGStarterPack|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|212219-EpoetinAlfa20000UNT/MLInjectableSolution[Procrit]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1000141-medroxyprogesteroneacetate5MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|212218-EpoetinAlfa20000UNT/MLInjectableSolution[Epogen]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1245230-chlorhexidinegluconate20MG/MLMedicatedLiquidSoap|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2121100-siponimod2MGOralTablet[Mayzent]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1000135-medroxyprogesteroneacetate2.5MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2121096-siponimod0.25MGOralTablet[Mayzent]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2120195-1MLerenumab-aooe140MG/MLAuto-Injector[Aimovig]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1000114-medroxyprogesteroneacetate10MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2119391-Spravato56MGDoseKit|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|141963-Azithromycin40MG/MLOralSuspension|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2119389-Spravato84MGDoseKit|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2107355-prucalopride2MGOralTablet[Motegrity]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2107351-prucalopride1MGOralTablet[Motegrity]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1000076-DoxepinHydrochloride50MGOralCapsule|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2106362-rifamycinSV194MGDelayedReleaseOralTablet[Aemcolo]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2106075-0.9MLtocilizumab180MG/MLAuto-Injector[Actemra]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1000070-DoxepinHydrochloride25MGOralCapsule|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2102705-0.6MLpegfilgrastim-cbqv10MG/MLPrefilledSyringe[Udenyca]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|208083-sargramostim0.25MG/MLInjectableSolution[Leukine]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1000064-DoxepinHydrochloride150MGOralCapsule|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|207059-interferonbeta-1b0.3MGInjection[Betaseron]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|206791-mesalamine250MGExtendedReleaseOralCapsule[Pentasa]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1000058-DoxepinHydrochloride100MGOralCapsule|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|205924-1MLEpoetinAlfa4000UNT/MLInjection[Procrit]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|205923-1MLEpoetinAlfa4000UNT/MLInjection[Epogen]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1000054-DoxepinHydrochloride10MG/MLOralSolution|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|205922-1MLEpoetinAlfa3000UNT/MLInjection[Procrit]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|205921-1MLEpoetinAlfa3000UNT/MLInjection[Epogen]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1000048-DoxepinHydrochloride10MGOralCapsule|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2059189-amikacinliposomal70.3MG/MLInhalationSuspension[Arikayce]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|205918-1MLEpoetinAlfa2000UNT/MLInjection[Procrit]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|993804-Gianvi28-DayPack|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|205917-1MLEpoetinAlfa2000UNT/MLInjection[Epogen]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1437702-Albuterol0.833MG/ML/IpratropiumBromide0.167MG/MLInhalationSolution|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|205913-EpoetinAlfa10000UNT/MLInjectableSolution[Procrit]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|205912-EpoetinAlfa10000UNT/MLInjectableSolution[Epogen]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1440184-hydrocortisoneacetate0.01MG/MGTopicalOintment|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2058950-0.5MLomalizumab150MG/MLPrefilledSyringe[Xolair]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|992481-PromethazineHydrochloride50MGRectalSuppository[Promethegan]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2058946-1MLomalizumab150MG/MLPrefilledSyringe[Xolair]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2058906-cannabidiol100MG/MLOralSolution[Epidiolex]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|991233-bexarotene0.01MG/MGTopicalGel[Targretin]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2058887-1MLgalcanezumab-gnlm120MG/MLPrefilledSyringe[Emgality]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2058877-1MLgalcanezumab-gnlm120MG/MLAuto-Injector[Emgality]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|967012-POLYETHYLENEGLYCOL3350236000MG/PotassiumChloride2970MG/SodiumBicarbonate6740MG/SodiumChloride5860MG/sodiumsulfate22740|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2057216-0.8MLfilgrastim-aafi0.6MG/MLPrefilledSyringe[Nivestym]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2057205-0.5MLfilgrastim-aafi0.6MG/MLPrefilledSyringe[Nivestym]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2056700-1.5MLfremanezumab-vfrm150MG/MLPrefilledSyringe[Ajovy]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2056670-AimovigAutoinjector2-Pack(140MGDose)|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|896031-28ACTUATFluticasonepropionate0.1MG/ACTUATDryPowderInhaler[Flovent]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|205532-DornaseAlfa1MG/MLInhalationSolution[Pulmozyme]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2054995-lusutrombopag3MGOralTablet[Mulpleta]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|896019-60ACTUATFluticasonepropionate0.05MG/ACTUATDryPowderInhaler[Flovent]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2053519-ivacaftor188MG/lumacaftor150MGOralGranules[ORKAMBI]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2053512-ivacaftor125MG/lumacaftor100MGOralGranules[ORKAMBI]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|896006-120ACTUATFluticasonepropionate0.22MG/ACTUATMeteredDoseInhaler[Flovent]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2048568-tofacitinib10MGOralTablet[Xeljanz]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|151226-topiramate50MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2048025-0.6MLpegfilgrastim-jmdb10MG/MLPrefilledSyringe[Fulphila]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2047623-1MLepoetinalfa-epbx40000UNT/MLInjection[Retacrit]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2047614-1MLepoetinalfa-epbx4000UNT/MLInjection[Retacrit]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|895996-120ACTUATFluticasonepropionate0.044MG/ACTUATMeteredDoseInhaler[Flovent]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2047608-1MLepoetinalfa-epbx3000UNT/MLInjection[Retacrit]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2047602-1MLepoetinalfa-epbx2000UNT/MLInjection[Retacrit]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|890786-Butoconazolenitrate20MG/MLVaginalCream[Gynazole-1]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2047596-1MLepoetinalfa-epbx10000UNT/MLInjection[Retacrit]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2045961-Doptelet60MGDailyDoseCartonPack|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|866049-60ACTUATsalmeterol0.05MG/ACTUATDryPowderInhaler[Serevent]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2045959-Doptelet40MGDailyDoseCartonPack|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2045638-1MLerenumab-aooe70MG/MLAuto-Injector[Aimovig]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|864010-ammoniumlactate120MG/MLTopicalLotion[Geri-Hydrolac]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2003767-1.14MLsarilumab175MG/MLAuto-Injector[Kevzara]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2003757-1.14MLsarilumab132MG/MLAuto-Injector[Kevzara]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|863841-amylase60000UNT/lipase12000UNT/protease38000UNTDelayedReleaseOralCapsule[Creon]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2001321-Roflumilast0.25MGOralTablet[Daliresp]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|2000013-1.1MLhydroxyprogesteronecaproate(USP)250MG/MLAuto-Injector[Makena]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|863836-amylase30000UNT/lipase6000UNT/protease19000UNTDelayedReleaseOralCapsule[Creon]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1999389-symdeko100MG/150MGand150MGPack|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1990869-0.85MLexenatide2.35MG/MLAuto-Injector[Bydureon]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|863829-amylase120000UNT/lipase24000UNT/protease76000UNTDelayedReleaseOralCapsule[Creon]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1989109-1MLbenralizumab30MG/MLPrefilledSyringe[Fasenra]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1547771-Tetracainehydrochloride5MG/MLOphthalmicSolution|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1989085-bosentan32MGTabletforOralSuspension[Tracleer]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1946522-4-Month1.5MLLeuprolideAcetate20MG/MLPrefilledSyringe[Lupron]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1648755-NITROFURANTOIN,MACROCRYSTALS25MG/Nitrofurantoin,Monohydrate75MGOralCapsule|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1946520-3-Month1.5MLLeuprolideAcetate20MG/MLPrefilledSyringe[Lupron]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|856467-Tri-Lo-Sprintec28DayPack|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1945048-30ACTUATfluticasonefuroate0.1MG/ACTUAT/umeclidinium0.0625MG/ACTUAT/vilanterol0.025MG/ACTUATDryPowderInhaler[Trelegy]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1927290-infliximab-abda100MGInjection[Renflexis]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|855871-Phenytoinsodium30MGExtendedReleaseOralCapsule[Dilantin]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1925257-0.7MLabatacept125MG/MLPrefilledSyringe[Orencia]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1925255-0.4MLabatacept125MG/MLPrefilledSyringe[Orencia]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|855205-docosanol100MG/MLTopicalCream[Abreva]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1923347-1.14MLsarilumab175MG/MLPrefilledSyringe[Kevzara]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1923338-1.14MLsarilumab132MG/MLPrefilledSyringe[Kevzara]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1921468-HumiraPen80MG/0.8MLand40MG/0.4ML-Psoriasis/UveitisStarterPackage(3count)|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1921245-HumiraPen80MG/0.8ML-StarterPackageforCrohn'sDisease,UlcerativeColitisorHidradenitisSuppurativa(3count)|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|854918-BisoprololFumarate2.5MG/Hydrochlorothiazide6.25MGOralTablet[Ziac]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1921240-0.8MLadalimumab100MG/MLAuto-Injector[Humira]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1921081-1.56MLabaloparatide2MG/MLPenInjector[Tymlos]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|854910-BisoprololFumarate10MG/Hydrochlorothiazide6.25MGOralTablet[Ziac]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1921017-0.2MLadalimumab100MG/MLPrefilledSyringe[Humira]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1921010-0.1MLadalimumab100MG/MLPrefilledSyringe[Humira]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|845305-Nonoxynol-90.04MG/MGVaginalGel[Conceptrol]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1876609-naldemedine0.2MGOralTablet[Symproic]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1648759-NITROFURANTOIN,MACROCRYSTALS100MGOralCapsule|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1873765-plecanatide3MGOralTablet[Trulance]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1873704-Mibelas24FeChewable28DayPack|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1873087-HumiraPrefilledSyringe80MG/0.8MLStarterPack-PediatricCrohn'sDisease(3count)|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|830470-1MLrabiesvirusvaccinewistarstrainPM-1503-3M(Human),Inactivated2.5UNT/MLInjection[Imovax]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1872980-0.4MLadalimumab100MG/MLAuto-Injector[Humira]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1871469-lisdexamfetaminedimesylate50MGChewableTablet[Vyvanse]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|830463-1MLrabiesvirusvaccineflury-lepstrain2.5UNT/MLInjection[RabAvert]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1871467-lisdexamfetaminedimesylate60MGChewableTablet[Vyvanse]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1871465-lisdexamfetaminedimesylate10MGChewableTablet[Vyvanse]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|827713-MineralOil0.03MG/MG/Petrolatum0.94MG/MGOphthalmicOintment[SystaneNighttime]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1871463-lisdexamfetaminedimesylate20MGChewableTablet[Vyvanse]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1871461-lisdexamfetaminedimesylate30MGChewableTablet[Vyvanse]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|808118-prednisolone5MGOralTablet[MILLIPRED]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1871459-lisdexamfetaminedimesylate40MGChewableTablet[Vyvanse]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1870968-deflazacort22.75MG/MLOralSuspension[Emflaza]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|797023-DexPakTaperPak13DayPack|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1870960-deflazacort36MGOralTablet[Emflaza]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1870956-deflazacort18MGOralTablet[Emflaza]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|762663-Jolessa91DayPack|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1870952-deflazacort30MGOralTablet[Emflaza]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1870950-deflazacort6MGOralTablet[Emflaza]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|762334-Velivet28DayPack|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1868020-pirfenidone801MGOralTablet[Esbriet]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1659263-1MLheparinsodium,porcine5000UNT/MLInjection|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1868016-pirfenidone267MGOralTablet[Esbriet]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1858833-12HRTreprostinil5MGExtendedReleaseOralTablet[Orenitram]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1665050-Cefazolin1000MGInjection|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1855527-HumiraPediatricCrohn'sDiseaseStarterPackage(2count)|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|762001-Kariva28DayPack|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1813112-Rajani28DayPack|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1812470-ivacaftor125MG/lumacaftor100MGOralTablet[ORKAMBI]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|759473-20ACTUATZanamivir5MG/ACTUATDryPowderInhaler[Relenza]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1811182-icosapentethyl500MGOralCapsule[Vascepa]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1806942-carfilzomib60MGInjection[Kyprolis]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|759469-Quasense91DayPack|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1801519-Methylnaltrexonebromide150MGOralTablet[Relistor]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1801322-3.5MLevolocumab120MG/MLCartridge[Repatha]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1801278-HumiraPsoriasisStarterPack40MG/0.8MLPen(4count)|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1799230-1MLabatacept125MG/MLAuto-Injector[Orencia]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|753543-Reclipsen28DayPack|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1796096-24HRLinagliptin5MG/Metforminhydrochloride1000MGExtendedReleaseOralTablet[Jentadueto]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1796091-24HRLinagliptin2.5MG/Metforminhydrochloride1000MGExtendedReleaseOralTablet[Jentadueto]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|753482-Apri28DayPack|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1790546-infliximab-dyyb100MGInjection[Inflectra]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1747194-0.4MLMethotrexate56.3MG/MLAuto-Injector[Otrexup]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|751890-Portia28DayPack|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1747187-0.4MLMethotrexate43.8MG/MLAuto-Injector[Otrexup]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1665188-1MLLorazepam2MG/MLInjection|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1747181-0.4MLMethotrexate31.3MG/MLAuto-Injector[Otrexup]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1746898-10MLreslizumab10MG/MLInjection[Cinqair]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1745114-1MLixekizumab80MG/MLPrefilledSyringe[Taltz]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|751875-Necon0.5/3528DayPack|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1745108-1MLixekizumab80MG/MLAuto-Injector[Taltz]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1741049-24HRtofacitinib11MGExtendedReleaseOralTablet[Xeljanz]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|751871-Nortrel1/3521DayPack|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1734642-elbasvir50MG/grazoprevir100MGOralTablet[Zepatier]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1732165-incobotulinumtoxinA200UNTInjection[Xeomin]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|751870-Nortrel1/3528DayPack|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1732161-incobotulinumtoxinA100UNTInjection[Xeomin]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1732157-incobotulinumtoxinA50UNTInjection[Xeomin]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|750839-erythromycinstearate250MGOralTablet[ErythrocinStearate]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1729076-UptraviTitrationPack|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1729065-selexipag0.8MGOralTablet[Uptravi]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|750264-Necon7/7/728DayPack|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1729061-selexipag0.6MGOralTablet[Uptravi]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1729057-selexipag0.4MGOralTablet[Uptravi]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|750244-Low-Ogestrel28DayPack|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1729053-selexipag0.2MGOralTablet[Uptravi]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1729047-selexipag1.6MGOralTablet[Uptravi]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|750243-Ogestrel28DayPack|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1729033-selexipag1.4MGOralTablet[Uptravi]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1724439-thyroid(USP)30MGOralTablet[NPThyroid]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1729029-selexipag1.2MGOralTablet[Uptravi]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1729013-selexipag1MGOralTablet[Uptravi]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1728099-romiplostim0.5MGInjection[Nplate]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|748865-Trivora28DayPack|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1728095-romiplostim0.25MGInjection[Nplate]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1726846-0.4MLadalimumab100MG/MLPrefilledSyringe[Humira]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|748859-Zovia1/35E28DayPack|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1726639-ponatinib30MGOralTablet[Iclusig]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1721690-1MLEpoetinAlfa10000UNT/MLInjection[Procrit]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|707333-SodiumChloride0.111MEQ/MLNasalSolution[AyrSalineNasal]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1721685-1MLEpoetinAlfa10000UNT/MLInjection[Epogen]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1720606-mepolizumab100MGInjection[Nucala]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1666334-Ticagrelor60MGOralTablet[Brilinta]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1665906-1MLevolocumab140MG/MLPrefilledSyringe[Repatha]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|692694-thyroid(USP)65MGOralTablet[Westhroid]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1665900-1MLevolocumab140MG/MLAuto-Injector[Repatha]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1663728-Isotretinoin30MGOralCapsule[Myorisan]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|688242-Estrogens,Conjugated(USP)0.625MG/MLVaginalCream[Premarin]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1661567-TOBIPodhalerDailyKit,8|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1660938-60ACTUATformoterolfumarate0.005MG/ACTUAT/mometasonefuroate0.2MG/ACTUATMeteredDoseInhaler[Dulera]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|644304-Tamoxifen2MG/MLOralSolution[Soltamox]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1660934-60ACTUATformoterolfumarate0.005MG/ACTUAT/mometasonefuroate0.1MG/ACTUATMeteredDoseInhaler[Dulera]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1731345-deferoxaminemesylate2000MGInjection|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1657982-20MLtocilizumab20MG/MLInjection[Actemra]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1657980-10MLtocilizumab20MG/MLInjection[Actemra]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1657976-4MLtocilizumab20MG/MLInjection[Actemra]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|617333-Amoxicillin25MG/ML/Clavulanate6.25MG/MLOralSuspension[Augmentin]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1657212-omalizumab150MGInjection[Xolair]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1655934-ivacaftor125MG/lumacaftor200MGOralTablet[ORKAMBI]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|616450-MycophenolicAcid180MGDelayedReleaseOralTablet[Myfortic]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1654955-1MLdarbepoetinalfa0.2MG/MLInjection[Aranesp]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1654630-1MLglatirameracetate20MG/MLPrefilledSyringe[Glatopa]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|616449-MycophenolicAcid360MGDelayedReleaseOralTablet[Myfortic]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1654079-0.5MLustekinumab90MG/MLInjection[Stelara]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1653243-1MLsecukinumab150MG/MLAuto-Injector[Cosentyx]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|616444-mycophenolatemofetil200MG/MLOralSuspension[Cellcept]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1653225-1MLEtanercept50MG/MLAuto-Injector[Enbrel]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1653166-1MLgolimumab100MG/MLAuto-Injector[Simponi]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|544597-PotassiumIodide1000MG/MLOralSolution[SSKIbrandofPotassiumIodide]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1653144-0.5MLgolimumab100MG/MLAuto-Injector[Simponi]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1650901-0.5MLInterferonbeta-1a0.06MG/MLAuto-Injector[Avonex]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|542059-Didanosine10MG/MLOralSolution[Videx]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1650282-RebifRebidoseTitrationPack|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1650004-0.5MLInterferonbeta-1a0.088MG/MLAuto-Injector[Rebif]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|404550-Estrogens,Conjugated(USP)0.45MGOralTablet[Premarin]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1649996-0.5MLInterferonbeta-1a0.044MG/MLAuto-Injector[Rebif]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1738483-ParoxetineHydrochloride10MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1649605-PlegridyPenStarterPack|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1649593-0.5MLpeginterferonbeta-1a0.25MG/MLAuto-Injector[Plegridy]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1738495-ParoxetineHydrochloride20MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1649495-ivabradine7.5MGOralTablet[Corlanor]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|404492-5MLLaronidase0.58MG/MLInjection[Aldurazyme]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1649491-ivabradine5MGOralTablet[Corlanor]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1648789-30ACTUATfluticasonefuroate0.2MG/ACTUAT/vilanterol0.025MG/ACTUATDryPowderInhaler[Breo]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|404476-Azathioprine100MGOralTablet[Azasan]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1606870-ivacaftor75MGOralGranules[Kalydeco]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1606866-ivacaftor50MGOralGranules[Kalydeco]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|404475-Azathioprine75MGOralTablet[Azasan]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1605455-Otezla28-DayStarterPack|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1605172-0.4MLdarbepoetinalfa0.025MG/MLPrefilledSyringe[Aranesp]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|352210-Mesna400MGOralTablet[Mesnex]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1605075-0.8MLFILGRASTIM-SNDZ0.6MG/MLPrefilledSyringe[Zarxio]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1605071-0.5MLFILGRASTIM-SNDZ0.6MG/MLPrefilledSyringe[Zarxio]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|351901-Sirolimus1MG/MLOralSolution[Rapamune]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1601373-naloxegol25MGOralTablet[Movantik]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1599797-1MLsecukinumab150MG/MLPrefilledSyringe[Cosentyx]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|351750-podofilox0.005MG/MGTopicalGel[Condylox]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1596778-14ACTUATBudesonide2MG/ACTUATRectalFoam[Uceris]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1596023-ferriccitrate1000MGOralTablet[Auryxia]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|351487-thyroid(USP)130MGOralTablet[Westhroid]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1594358-HumiraPediatricCrohn'sDiseaseStarterPackage(3count)|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1738503-ParoxetineHydrochloride30MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1593858-lisdexamfetaminedimesylate10MGOralCapsule[Vyvanse]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|312020-Nitroglycerin9MGExtendedReleaseOralCapsule|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1593835-24HRdapagliflozin10MG/Metforminhydrochloride500MGExtendedReleaseOralTablet[Xigduo]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1593833-24HRdapagliflozin5MG/Metforminhydrochloride1000MGExtendedReleaseOralTablet[Xigduo]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|312018-Nitroglycerin6.5MGExtendedReleaseOralCapsule|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1593831-24HRdapagliflozin5MG/Metforminhydrochloride500MGExtendedReleaseOralTablet[Xigduo]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1593775-24HRdapagliflozin10MG/Metforminhydrochloride1000MGExtendedReleaseOralTablet[Xigduo]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|284551-nilutamide150MGOralTablet[Nilandron]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1592752-nintedanib150MGOralCapsule[Ofev]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1592748-nintedanib100MGOralCapsule[Ofev]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|261353-Trimethoprim10MG/MLOralSolution[Primsol]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1592285-pirfenidone267MGOralCapsule[Esbriet]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1551923-naloxegol12.5MGOralTablet[Movantik]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|260409-prednisolone1MG/MLOralSolution[Pediapred]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1551888-0.2MLadalimumab50MG/MLPrefilledSyringe[Humira]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1551886-lanthanumcarbonate750MGOralPowder[Fosrenol]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|2564406-influenzaAvirusA/Tasmania/503/2020(H3N2)antigen158000000UNT/ML/influenzaAvirusA/Victoria/1/2020(H1N1)antigen158000000|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1546198-PlegridyStarterPack|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1546189-0.5MLpeginterferonbeta-1a0.25MG/MLPrefilledSyringe[Plegridy]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|2564038-influenzaAvirusA/Cambodia/e0826360/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.03MG/|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1545174-hydrocortisoneacetate100MG/MLRectalFoam[Cortifoam]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1544918-0.65MLexenatide3.08MG/MLPenInjector[Bydureon]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|2564021-0.5MLinfluenzaAvirusA/Cambodia/e0826360/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1544404-0.15MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1797851-CromolynSodium5.2MG/ACTUATMeteredDoseNasalSpray|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1544402-0.6MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|2563039-0.5MLinfluenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.03MG/|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1544398-0.5MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1797867-Azelastinehydrochloride0.137MG/ACTUATMeteredDoseNasalSpray|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1544396-0.45MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|2563032-0.5MLinfluenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.03MG/|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1544394-0.4MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1544390-0.35MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|2563031-influenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.03MG/ML/in|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1544388-0.3MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1544386-0.25MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|2563020-influenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Washington/19/2020(H1N1)antigen0.03MG/ML/in|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1544383-0.2MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1541928-sunitinib37.5MGOralCapsule[Sutent]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|2563004-0.7MLinfluenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.0857MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.085|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1539893-30ACTUATfluticasonefuroate0.1MG/ACTUAT/vilanterol0.025MG/ACTUATDryPowderInhaler[Breo]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|153324-Interferonbeta-1a0.03MGInjection[Avonex]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|2563002-0.5MLinfluenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.09MG/ML/influenzaAvirusA/Wisconsin/588/2019(H1N1)antigen0.09MG/|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1492746-apremilast30MGOralTablet[Otezla]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1488679-12HRTreprostinil2.5MGExtendedReleaseOralTablet[Orenitram]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|2562996-0.5MLinfluenzaAvirusA/Cambodia/e0826360/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1488675-12HRTreprostinil1MGExtendedReleaseOralTablet[Orenitram]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|404509-CalciumCarbonate1000MG/Simethicone60MGChewableTablet[MaaloxMaxQuickDissolve]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1488671-12HRTreprostinil0.25MGExtendedReleaseOralTablet[Orenitram]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|2562995-0.5MLinfluenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Washington/19/2020(H1N1)antigen0.03MG/|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1488667-12HRTreprostinil0.125MGExtendedReleaseOralTablet[Orenitram]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1797907-Fluticasonepropionate0.05MG/ACTUATMeteredDoseNasalSpray|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1487076-DiclofenacSodium20MG/MLTopicalSolution[Pennsaid]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|2561275-0.5MLinfluenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.03MG/|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1486981-dapagliflozin5MGOralTablet[Farxiga]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1486977-dapagliflozin10MGOralTablet[Farxiga]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|2561270-0.5MLinfluenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.03MG/|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1484296-sucroferricoxyhydroxide500MGChewableTablet[Velphoro]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1482814-1MLgolimumab100MG/MLPrefilledSyringe[Simponi]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|2178792-0.3MLEpinephrine0.5MG/MLPrefilledSyringe[Symjepi]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1482513-eslicarbazepineacetate200MGOralTablet[Aptiom]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1442143-Macitentan10MGOralTablet[Opsumit]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|2173508-Nonoxynol-91000MGVaginalSponge[TodaySponge]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1441530-0.9MLtocilizumab180MG/MLPrefilledSyringe[Actemra]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1441424-0.4MLMethotrexate62.5MG/MLAuto-Injector[Otrexup]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|213621-Bacitracin0.5UNT/MG/PolymyxinB10UNT/MGOphthalmicOintment[Polycin]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1441418-0.4MLMethotrexate50MG/MLAuto-Injector[Otrexup]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1441413-0.4MLMethotrexate37.5MG/MLAuto-Injector[Otrexup]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|213510-Auranofin3MGOralCapsule[Ridaura]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1441407-0.4MLMethotrexate25MG/MLAuto-Injector[Otrexup]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1439903-riociguat2.5MGOralTablet[Adempas]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|213291-ParoxetineHydrochloride2MG/MLOralSuspension[Paxil]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1439901-riociguat2MGOralTablet[Adempas]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1439899-riociguat1.5MGOralTablet[Adempas]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|213284-hydroxyurea400MGOralCapsule[Droxia]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1439896-riociguat1MGOralTablet[Adempas]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1801289-SmokingCessation12HRBupropionHydrochloride150MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1439894-riociguat0.5MGOralTablet[Adempas]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|213283-hydroxyurea300MGOralCapsule[Droxia]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1431647-4MLgolimumab12.5MG/MLInjection[Simponi]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1801294-MicroencapsulatedPotassiumChloride20MEQExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1429367-lenalidomide20MGOralCapsule[Revlimid]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|213282-hydroxyurea200MGOralCapsule[Droxia]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1429284-NeostigmineMethylsulfate1MG/MLInjectableSolution[Bloxiverz]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1429282-NeostigmineMethylsulfate0.5MG/MLInjectableSolution[Bloxiverz]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|212373-Estrogens,Esterified(USP)1.25MGOralTablet[Menest]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1375922-bromfenac0.7MG/MLOphthalmicSolution[Prolensa]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1374574-TOBIPodhalerKit,224|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|212232-Estrogens,Esterified(USP)0.625MGOralTablet[Menest]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1373337-Isotretinoin40MGOralCapsule[Zenatane]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1373335-Isotretinoin20MGOralCapsule[Zenatane]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|212039-Estrogens,Esterified(USP)0.3MGOralTablet[Menest]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1373333-Isotretinoin10MGOralCapsule[Zenatane]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1365866-nepafenac3MG/MLOphthalmicSuspension[Ilevro]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|211633-AluminumHydroxide200MG/MagnesiumHydroxide200MG/Simethicone25MGChewableTablet[Gelusil]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1364515-Bedaquiline100MGOralTablet[Sirturo]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1364477-teduglutide5MGInjection[Gattex]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|2110516-60ACTUATFluticasonepropionate0.5MG/ACTUAT/salmeterol0.05MG/ACTUATDryPowderInhaler[Wixela]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1364362-ponatinib45MGOralTablet[Iclusig]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1364358-ponatinib15MGOralTablet[Iclusig]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|2110513-60ACTUATFluticasonepropionate0.25MG/ACTUAT/salmeterol0.05MG/ACTUATDryPowderInhaler[Wixela]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1357547-tofacitinib5MGOralTablet[Xeljanz]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1801298-MicroencapsulatedPotassiumChloride10MEQExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1313061-24HRPhentermine11.25MG/topiramate69MGExtendedReleaseOralCapsule[Qsymia]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|2110510-60ACTUATFluticasonepropionate0.1MG/ACTUAT/salmeterol0.05MG/ACTUATDryPowderInhaler[Wixela]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1310535-teriflunomide7MGOralTablet[Aubagio]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1310531-teriflunomide14MGOralTablet[Aubagio]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|210000-AluminumHydroxide80MG/ML/MagnesiumHydroxide80MG/ML/Simethicone8MG/MLOralSuspension[Almacone]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1310147-everolimus5MGTabletforOralSuspension[Afinitor]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1310144-everolimus3MGTabletforOralSuspension[Afinitor]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|209531-Acetaminophen80MGRectalSuppository[Feverall]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1310138-everolimus2MGTabletforOralSuspension[Afinitor]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1307635-bosutinib500MGOralTablet[Bosulif]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|209360-Acetaminophen325MGRectalSuppository[Acephen]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1307630-bosutinib100MGOralTablet[Bosulif]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1302856-24HRPhentermine15MG/topiramate92MGExtendedReleaseOralCapsule[Qsymia]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|209002-prednisolone1.2MG/MLOphthalmicSuspension[PredMild]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1302845-24HRPhentermine3.75MG/topiramate23MGExtendedReleaseOralCapsule[Qsymia]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1302833-24HRPhentermine7.5MG/topiramate46MGExtendedReleaseOralCapsule[Qsymia]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|208949-Estrogens,Conjugated(USP)0.9MGOralTablet[Premarin]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1300803-24HRmirabegron50MGExtendedReleaseOralTablet[Myrbetriq]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1300797-24HRmirabegron25MGExtendedReleaseOralTablet[Myrbetriq]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|208551-thyroid(USP)300MGOralTablet[ArmourThyroid]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1291092-hydrocortisoneacetate30MGRectalSuppository[Proctocort]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1245003-eltrombopag12.5MGOralTablet[Promacta]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|208549-thyroid(USP)240MGOralTablet[ArmourThyroid]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1244632-AmethiaLo91DayPack|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1806187-30/70Release24HRMethylphenidateHydrochloride20MGExtendedReleaseOralCapsule|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1244064-0.4MLMethylnaltrexonebromide20MG/MLPrefilledSyringe[Relistor]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|208547-thyroid(USP)180MGOralTablet[ArmourThyroid]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1244062-0.6MLMethylnaltrexonebromide20MG/MLPrefilledSyringe[Relistor]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1806189-30/70Release24HRMethylphenidateHydrochloride30MGExtendedReleaseOralCapsule|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1243848-24HRMetforminhydrochloride500MG/sitagliptin50MGExtendedReleaseOralTablet[Janumet]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|208513-Estrogens,Conjugated(USP)0.3MGOralTablet[Premarin]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1243843-24HRMetforminhydrochloride1000MG/sitagliptin50MGExtendedReleaseOralTablet[Janumet]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1243833-24HRMetforminhydrochloride1000MG/sitagliptin100MGExtendedReleaseOralTablet[Janumet]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|207949-Succimer100MGOralCapsule[Chemet]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1243052-ivacaftor150MGOralTablet[Kalydeco]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1243040-Linagliptin2.5MG/Metforminhydrochloride850MGOralTablet[Jentadueto]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|207864-crotamiton100MG/MLTopicalCream[Eurax]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1243033-Linagliptin2.5MG/Metforminhydrochloride500MGOralTablet[Jentadueto]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1243026-Linagliptin2.5MG/Metforminhydrochloride1000MGOralTablet[Jentadueto]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|207588-Procarbazine50MGOralCapsule[Matulane]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1242968-exenatide2MGInjection[Bydureon]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1242615-Isotretinoin40MGOralCapsule[Myorisan]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|207478-Primidone50MGOralTablet[Mysoline]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1242613-Isotretinoin20MGOralCapsule[Myorisan]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1242611-Isotretinoin10MGOralCapsule[Myorisan]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|207373-Mitotane500MGOralTablet[Lysodren]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1242233-lenalidomide2.5MGOralCapsule[Revlimid]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|630475-SodiumFluoride5.56MG/MLOralSolution[FluoraDay]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1235267-CamreseLo91DayPack|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|207273-Nitroglycerin0.02MG/MGTopicalOintment[Nitro-Bid]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1235157-azilsartanmedoxomil40MG/Chlorthalidone25MGOralTablet[Edarbyclor]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1855086-thyroid(USP)15MGOralTablet[NPThyroid]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1235150-azilsartanmedoxomil40MG/Chlorthalidone12.5MGOralTablet[Edarbyclor]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|207136-Methylprednisolone2MGOralTablet[Medrol]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1232204-Zolpidemtartrate3.5MGSublingualTablet[Intermezzo]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1232200-Zolpidemtartrate1.75MGSublingualTablet[Intermezzo]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|206978-Ketoconazole20MG/MLMedicatedShampoo[Nizoral]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1232190-asparaginaseErwiniachrysanthemi10000UNTInjection[Erwinaze]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1191128-EdrophoniumChloride10MG/MLInjectableSolution[Enlon]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|206961-Nadolol20MGOralTablet[Corgard]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1149667-Camrese91DayPack|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1149617-COLLAGENASE0.25UNT/MGTopicalOintment[Santyl]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|206314-Hydrocortisone0.01MG/MGTopicalOintment[Cortizone]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1148506-crizotinib250MGOralCapsule[Xalkori]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1148502-crizotinib200MGOralCapsule[Xalkori]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|206216-2MLIron-DextranComplex50MG/MLInjection[InFed]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1145932-1MLabatacept125MG/MLPrefilledSyringe[Orencia]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1116639-Ticagrelor90MGOralTablet[Brilinta]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|206208-aluminumchloride200MG/MLTopicalSolution[Drysol]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1115473-1.5MLLeuprolideAcetate7.5MG/MLPrefilledSyringe[Lupron]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1115468-1.5MLLeuprolideAcetate15MG/MLPrefilledSyringe[Lupron]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|205669-Dexamethasone1MG/MLOphthalmicSuspension[Maxidex]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1115464-1MLLeuprolideAcetate7.5MG/MLPrefilledSyringe[Lupron]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1115459-1MLLeuprolideAcetate3.75MG/MLPrefilledSyringe[Lupron]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|205562-Estramustine140MGOralCapsule[Emcyt]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1115456-1MLLeuprolideAcetate15MG/MLPrefilledSyringe[Lupron]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1870230-NDA0208000.3MLEpinephrine1MG/MLAuto-Injector|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1115449-1MLLeuprolideAcetate11.25MG/MLPrefilledSyringe[Lupron]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|2045958-avatrombopag20MGOralTablet[Doptelet]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1115259-1.5MLLeuprolideAcetate30MG/MLPrefilledSyringe[Lupron]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1923422-SotalolHydrochloride120MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1114096-Vandetanib300MGOralTablet[Caprelsa]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|202301-Estrogens,Conjugated(USP)1.25MGOralTablet[Premarin]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1114074-Vandetanib100MGOralTablet[Caprelsa]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1112687-Amethia91DayPack|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|201747-Primidone250MGOralTablet[Mysoline]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1100706-Linagliptin5MGOralTablet[Tradjenta]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1091843-Roflumilast0.5MGOralTablet[Daliresp]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|201338-Nadolol80MGOralTablet[Corgard]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1091654-azilsartanmedoxomil80MGOralTablet[Edarbi]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1091650-azilsartanmedoxomil40MGOralTablet[Edarbi]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|201337-Nadolol40MGOralTablet[Corgard]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1046402-1.7MLdenosumab70MG/MLInjection[Xgeva]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1045408-dasatinib80MGOralTablet[Sprycel]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|1998774-Breath-Actuated120ACTUATBeclomethasoneDipropionate0.04MG/ACTUATMeteredDoseInhaler[Qvar]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1045404-dasatinib140MGOralTablet[Sprycel]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1043582-24HRMetforminhydrochloride500MG/saxagliptin5MGExtendedReleaseOralTablet[Kombiglyze]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|1998772-Breath-Actuated120ACTUATBeclomethasoneDipropionate0.08MG/ACTUATMeteredDoseInhaler[Qvar]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1043574-24HRMetforminhydrochloride1000MG/saxagliptin5MGExtendedReleaseOralTablet[Kombiglyze]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|705008-Cefixime40MG/MLOralSuspension[Suprax]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1043567-24HRMetforminhydrochloride1000MG/saxagliptin2.5MGExtendedReleaseOralTablet[Kombiglyze]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|1995479-amylase168000UNT/lipase40000UNT/protease126000UNTDelayedReleaseOralCapsule[Zenpep]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1040058-DextromethorphanHydrobromide20MG/QuinidineSulfate10MGOralCapsule[Nuedexta]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1923424-SotalolHydrochloride160MGOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1037185-LoLoestrinFe28DayPack|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|1989117-0.3MLEpinephrine1MG/MLPrefilledSyringe[Symjepi]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1012899-fingolimod0.5MGOralCapsule[Gilenya]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1011755-aliskiren300MG/Hydrochlorothiazide25MGOralTablet[TekturnaHCT]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|198467-Aspirin325MGDelayedReleaseOralTablet|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1011752-aliskiren300MG/Hydrochlorothiazide12.5MGOralTablet[TekturnaHCT]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1011715-aliskiren150MG/Hydrochlorothiazide25MGOralTablet[TekturnaHCT]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|1797880-Nafarelin0.2MG/ACTUATMeteredDoseNasalSpray[Synarel]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1011712-aliskiren150MG/Hydrochlorothiazide12.5MGOralTablet[TekturnaHCT]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1002300-nilotinib150MGOralCapsule[Tasigna]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|1667916-5MLIsoproterenolHydrochloride0.2MG/MLInjection[Isuprel]|DISABLED FULL DUALS 632|2002|Y|N|N||Preferred Brand|1000089-alcaftadine2.5MG/MLOphthalmicSolution[Lastacaft]|DISABLED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|998679-168HRClonidine0.0125MG/HRTransdermalSystem|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|1595478-amylase84000UNT/lipase20000UNT/protease63000UNTDelayedReleaseOralCapsule[Zenpep]|DISABLED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|998675-168HRClonidine0.00833MG/HRTransdermalSystem|DISABLED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|998671-168HRClonidine0.00417MG/HRTransdermalSystem|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|1595473-amylase63000UNT/lipase15000UNT/protease47000UNTDelayedReleaseOralCapsule[Zenpep]|DISABLED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|860654-epinastinehydrochloride0.5MG/MLOphthalmicSolution|DISABLED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|856569-24HRPropranololHydrochloride80MGExtendedReleaseOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|1595462-amylase42000UNT/lipase10000UNT/protease32000UNTDelayedReleaseOralCapsule[Zenpep]|DISABLED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|856535-24HRPropranololHydrochloride60MGExtendedReleaseOralCapsule|DISABLED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|856481-24HRPropranololHydrochloride160MGExtendedReleaseOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|1595457-amylase24000UNT/lipase5000UNT/protease17000UNTDelayedReleaseOralCapsule[Zenpep]|DISABLED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|856460-24HRPropranololHydrochloride120MGExtendedReleaseOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1923428-Timolol2.5MG/MLOphthalmicSolution|DISABLED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|854868-Rabeprazolesodium20MGDelayedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|1595292-amylase14000UNT/lipase3000UNT/protease10000UNTDelayedReleaseOralCapsule[Zenpep]|DISABLED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|798133-Erythromycin20MG/MLMedicatedPad[Ery]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1923432-dorzolamide20MG/ML/Timolol5MG/MLOphthalmicSolution|DISABLED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|797274-Clindamycin10MG/MLMedicatedPad|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|1594673-amylase105000UNT/lipase25000UNT/protease79000UNTDelayedReleaseOralCapsule[Zenpep]|DISABLED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|606726-Esomeprazole20MGDelayedReleaseOralCapsule|DISABLED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|577127-pregabalin225MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|1536586-168HREthinylEstradiol0.00146MG/HR/norelgestromin0.00625MG/HRTransdermalSystem[Xulane]|DISABLED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|483450-pregabalin75MGOralCapsule|DISABLED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|483448-pregabalin50MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|153473-Altretamine50MGOralCapsule[Hexalen]|DISABLED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|483446-pregabalin200MGOralCapsule|DISABLED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|483444-pregabalin300MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|153183-adapalene0.001MG/MGTopicalGel[Differin]|DISABLED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|483442-pregabalin25MGOralCapsule|DISABLED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|483440-pregabalin150MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|152854-Itraconazole10MG/MLOralSolution[Sporanox]|DISABLED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|483438-pregabalin100MGOralCapsule|DISABLED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|351134-zolmitriptan5MGDisintegratingOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|150840-Estrogens,Conjugated(USP)0.625MGOralTablet[Premarin]|DISABLED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|314266-Tacrolimus0.001MG/MGTopicalOintment|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|749151-Tri-Norinyl28DayPack|DISABLED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|314227-Sumatriptan20MG/ACTUATNasalSpray|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|1440936-Hydrocortisone25MG/MLTopicalCream[ProctozoneHC]|DISABLED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|313189-Tacrolimus0.0003MG/MGTopicalOintment|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1923809-thyroid(USP)120MGOralTablet[NPThyroid]|DISABLED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|313159-Sumatriptan5MG/ACTUATNasalSpray|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|1426881-Levonorgestrel1.5MGOralTablet[MyWay]|DISABLED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|311671-Metolazone5MGOralTablet|DISABLED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|309333-Clindamycin10MG/MLTopicalSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|1422081-Enskyce28DayPack|DISABLED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|309332-Clindamycin0.01MG/MGTopicalGel|DISABLED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|284201-zolmitriptan2.5MGDisintegratingOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|1373327-amylase180000UNT/lipase36000UNT/protease114000UNTDelayedReleaseOralCapsule[Creon]|DISABLED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|244374-BenzoylPeroxide0.05MG/MG/Erythromycin0.03MG/MGTopicalGel|DISABLED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|200194-zolmitriptan5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|1359135-Tri-LegestFe28DayPack|DISABLED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|200193-zolmitriptan2.5MGOralTablet|DISABLED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|2001568-BXRating24HRMethylphenidateHydrochloride54MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|1359134-TiliaFe28DayPack|DISABLED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|2001566-BXRating24HRMethylphenidateHydrochloride36MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|2001565-BXRating24HRMethylphenidateHydrochloride27MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|1359032-Microgestin1.5/3021DayPack|DISABLED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|2001564-BXRating24HRMethylphenidateHydrochloride18MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|197979-Metolazone2.5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|1359030-Junel1.5/3021DayPack|DISABLED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|197978-Metolazone10MGOralTablet|DISABLED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|197519-Clindamycin10MG/MLTopicalLotion|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|1359027-MicrogestinFe1.5/3028DayPack|DISABLED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|1806195-50/50Release24HRMethylphenidateHydrochloride10MGExtendedReleaseOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197303-Acetazolamide125MGOralTablet|DISABLED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|1806185-50/50Release24HRMethylphenidateHydrochloride60MGExtendedReleaseOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|1359025-JunelFe28DayPack|DISABLED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|1797865-mometasonefuroate0.05MG/ACTUATMeteredDoseNasalSpray|DISABLED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|1111343-olopatadine2MG/MLOphthalmicSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|1359020-Microgestin1/2021DayPack|DISABLED FULL DUALS 632|2002|N|Y|Y||Preferred Generic|1111339-olopatadine1MG/MLOphthalmicSolution|DISABLED FULL DUALS 632|2002|N|Y|Y||Preferred Brand|2200658-semaglutide7MGOralTablet[Rybelsus]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|1358780-Junel1/2021DayPack|DISABLED FULL DUALS 632|2002|N|Y|Y||Preferred Brand|2200654-semaglutide3MGOralTablet[Rybelsus]|DISABLED FULL DUALS 632|2002|N|Y|Y||Preferred Brand|2200650-semaglutide14MGOralTablet[Rybelsus]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|1358775-MicrogestinFe1/2028DayPack|DISABLED FULL DUALS 632|2002|N|Y|Y||Preferred Brand|1716223-patiromer25200MGPowderforOralSuspension[Veltassa]|DISABLED FULL DUALS 632|2002|N|Y|Y||Preferred Brand|1716219-patiromer16800MGPowderforOralSuspension[Veltassa]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|1358765-JunelFe1/2028DayPack|DISABLED FULL DUALS 632|2002|N|Y|Y||Preferred Brand|1716215-patiromer8400MGPowderforOralSuspension[Veltassa]|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Generic|997406-12HRFexofenadinehydrochloride60MG/PseudoephedrineHydrochloride120MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|1293864-ErgotamineTartrate2MGSublingualTablet[Ergomar]|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Generic|996615-24HRMemantinehydrochloride7MGExtendedReleaseOralCapsule|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Generic|996609-24HRMemantinehydrochloride28MGExtendedReleaseOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|1293639-Caffeine100MG/ErgotamineTartrate2MGRectalSuppository[Migergot]|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Generic|996603-24HRMemantinehydrochloride21MGExtendedReleaseOralCapsule|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Generic|996594-24HRMemantinehydrochloride14MGExtendedReleaseOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|1250090-Nonoxynol-90.03MG/MGVaginalGel[GynolII]|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Generic|857564-24HRtrospiumchloride60MGExtendedReleaseOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197305-AceticAcid20MG/MLOticSolution|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Generic|857560-trospiumchloride20MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|1233850-Vestura28DayPack|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Generic|855194-tolterodinetartrate2MGOralTablet|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Generic|855189-24HRtolterodinetartrate4MGExtendedReleaseOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|1190225-120ACTUATAlbuterol0.1MG/ACTUAT/IpratropiumBromide0.02MG/ACTUATInhalationSpray[Combivent]|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Generic|855182-24HRtolterodinetartrate2MGExtendedReleaseOralCapsule|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Generic|855178-tolterodinetartrate1MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|1148646-28ACTUATFluticasonepropionate0.25MG/ACTUATDryPowderInhaler[Flovent]|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Generic|825130-24HRmesalamine375MGExtendedReleaseOralCapsule|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Generic|810090-Carbidopa18.75MG/entacapone200MG/Levodopa75MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|1114135-amylase16000UNT/lipase3000UNT/protease10000UNTDelayedReleaseOralCapsule[Zenpep]|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Generic|810083-Carbidopa31.25MG/entacapone200MG/Levodopa125MGOralTablet|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Generic|749206-sevelamercarbonate800MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|1114041-DextromethorphanHydrobromide1MG/MLOralSolution[DayQuilCough]|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Generic|745791-200ACTUATLevalbuterol0.045MG/ACTUATMeteredDoseInhaler|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Generic|730988-Carbidopa50MG/entacapone200MG/Levodopa200MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|1113046-amylase15000UNT/lipase3000UNT/protease9500UNTDelayedReleaseOralCapsule[Creon]|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Generic|686429-mesalamine1200MGDelayedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Generic|606730-Esomeprazole40MGDelayedReleaseOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|1112715-Amethyst28DayPack|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Generic|562806-Pimecrolimus10MG/MLTopicalCream|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Generic|403852-Carbidopa37.5MG/entacapone200MG/Levodopa150MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|1101778-Monobasicpotassiumphosphate0.0408MEQ/MLOralSolution[K-Phos]|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Generic|403851-Carbidopa25MG/entacapone200MG/Levodopa100MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197311-Acyclovir400MGOralTablet|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Generic|403850-Carbidopa12.5MG/entacapone200MG/Levodopa50MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|1099026-Loryna28DayPack|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Generic|349590-Levalbuterol0.103MG/MLInhalationSolution|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Generic|349556-ezetimibe10MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|1098924-SodiumFluoride11MG/MLOralSolution[Flura-Drops]|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Generic|317094-entacapone200MGOralTablet|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Generic|313921-calcipotriene0.05MG/MLTopicalCream|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|1095362-Balziva28DayPack|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Generic|311787-moxifloxacin400MGOralTablet|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Generic|311347-linezolid600MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|1087012-thyroid(USP)32.5MGOralTablet[Westhroid]|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Generic|311345-linezolid20MG/MLOralSuspension|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Generic|311286-Levalbuterol0.21MG/MLInhalationSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|105590-Thioguanine40MGOralTablet[Tabloid]|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Generic|310600-Griseofulvin500MGOralTablet|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Generic|308865-calcipotriene0.05MG/MLTopicalSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|105553-Chlorambucil2MGOralTablet[Leukeran]|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Generic|284008-travoprost0.04MG/MLOphthalmicSolution|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Generic|242831-Griseofulvin125MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|105551-Busulfan2MGOralTablet[Myleran]|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Generic|242754-Levalbuterol0.417MG/MLInhalationSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|751884-Lutera28DayPack|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Generic|239239-Griseofulvin250MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|1048452-ColestipolHydrochloride5000MGGranulesforOralSuspension[Colestid]|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Generic|204119-Malathion5MG/MLTopicalLotion|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197316-Albuterol2MGOralTablet|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Generic|198373-calcipotriene0.00005MG/MGTopicalOintment|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|1046771-12HRHyoscyamineSulfate0.375MGExtendedReleaseOralTablet[Levbid]|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Generic|197984-Minocycline100MGOralCapsule|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Generic|197551-Cycloserine250MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|1039273-Hydrocortisone10MG/MLTopicalSolution[ScalpicinItchRelief]|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Generic|197508-Cimetidine800MGOralTablet|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Generic|197507-Cimetidine400MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|102250-Hydrocortisone1.67MG/MLEnema[Cortenema]|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Generic|197506-Cimetidine300MGOralTablet|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Generic|197505-Cimetidine200MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|1020155-Introvale91DayPack|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Generic|197419-Bumetanide2MGOralTablet|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Generic|197418-Bumetanide1MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|1005928-ulipristalacetate30MGOralTablet[Ella]|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Generic|197417-Bumetanide0.5MGOralTablet|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Generic|1855389-Levalbuterol2.5MG/MLInhalationSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|1000500-Prempro0.625/528DayPack|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Generic|1797863-flunisolide0.025MG/ACTUATMeteredDoseNasalSpray|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Generic|1368954-mesalamine400MGDelayedReleaseOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|1000499-Prempro0.625/2.528DayPack|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Generic|1368438-alogliptin25MG/pioglitazone45MGOralTablet|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Generic|1368431-alogliptin25MG/pioglitazone30MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|1000497-Prempro0.45/1.528DayPack|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Generic|1368424-alogliptin25MG/pioglitazone15MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197319-Allopurinol100MGOralTablet|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Generic|1368417-alogliptin12.5MG/pioglitazone45MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|1000491-Prempro0.3/1.528DayPack|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Generic|1368410-alogliptin12.5MG/pioglitazone30MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197320-Allopurinol300MGOralTablet|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Generic|1368403-alogliptin12.5MG/pioglitazone15MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|1000487-Premphase28DayPack|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Generic|1368392-alogliptin12.5MG/Metforminhydrochloride500MGOralTablet|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Generic|1368385-alogliptin12.5MG/Metforminhydrochloride1000MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|1000158-0.65MLmedroxyprogesteroneacetate160MG/MLPrefilledSyringe[depo-subQprovera]|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Generic|1368034-alogliptin12.5MGOralTablet|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Generic|1368018-alogliptin6.25MGOralTablet|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Generic|1368006-alogliptin25MGOralTablet|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Generic|1246673-Ivermectin5MG/MLTopicalLotion|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Generic|1085816-spinosad9MG/MLMedicatedShampoo|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Brand|996633-NamendaXR28DayTitrationPack|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Brand|856666-rifaximin550MGOralTablet[XIFAXAN]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197361-Amlodipine5MGOralTablet|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Brand|835721-Ethionamide250MGOralTablet[Trecator]|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Brand|833151-Savella4-WeekTitrationPack|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Brand|833149-Milnacipranhydrochloride25MGOralTablet[Savella]|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Brand|833146-Milnacipranhydrochloride50MGOralTablet[Savella]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|754766-Metronidazole0.0075MG/MGVaginalGel[MetroGel]|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Brand|833143-Milnacipranhydrochloride12.5MGOralTablet[Savella]|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Brand|833139-Milnacipranhydrochloride100MGOralTablet[Savella]|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Brand|539789-rifaximin200MGOralTablet[XIFAXAN]|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Brand|402092-Cyclosporine0.5MG/MLOphthalmicSuspension[Restasis]|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Brand|2398842-3MLsemaglutide1.34MG/MLPenInjector[Ozempic]|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Brand|2395785-0.5MLdulaglutide9MG/MLAuto-Injector[Trulicity]|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Brand|2395779-0.5MLdulaglutide6MG/MLAuto-Injector[Trulicity]|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Brand|213307-Ciprofloxacin0.003MG/MGOphthalmicOintment[Ciloxan]|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Brand|212381-aminosalicylicacid4000MGOralGranules[PaserD/R]|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Brand|1992821-ertugliflozin15MGOralTablet[Steglatro]|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Brand|1992816-ertugliflozin5MGOralTablet[Steglatro]|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Brand|1992703-ertugliflozin7.5MG/Metforminhydrochloride500MGOralTablet[Segluromet]|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Brand|1992700-ertugliflozin7.5MG/Metforminhydrochloride1000MGOralTablet[Segluromet]|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Brand|1992695-ertugliflozin2.5MG/Metforminhydrochloride500MGOralTablet[Segluromet]|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Brand|1992691-ertugliflozin2.5MG/Metforminhydrochloride1000MGOralTablet[Segluromet]|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Brand|1991317-1MGDose1.5MLsemaglutide1.34MG/MLPenInjector[Ozempic]|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Brand|1991311-0.25MG,0.5MGDose1.5MLsemaglutide1.34MG/MLPenInjector[Ozempic]|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Brand|1801840-lifitegrast50MG/MLOphthalmicSolution[Xiidra]|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Brand|1551306-0.5MLdulaglutide3MG/MLAuto-Injector[Trulicity]|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Brand|1551300-0.5MLdulaglutide1.5MG/MLAuto-Injector[Trulicity]|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Brand|1356673-BenzylAlcohol0.05ML/MLTopicalLotion[Ulesfia]|DISABLED FULL DUALS 632|2002|N|Y|N||Preferred Brand|1190334-24HRFexofenadinehydrochloride180MG/PseudoephedrineHydrochloride240MGExtendedReleaseOralTablet[Wal-FexD]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|996757-CodeinePhosphate2MG/ML/PhenylephrineHydrochloride1MG/ML/PromethazineHydrochloride1.25MG/MLOralSolution|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|995868-CodeinePhosphate2MG/ML/Guaifenesin20MG/MLOralSolution|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|993890-Acetaminophen300MG/CodeinePhosphate60MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197379-Atenolol100MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|993781-Acetaminophen300MG/CodeinePhosphate30MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|993770-Acetaminophen300MG/CodeinePhosphate15MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|993755-Acetaminophen24MG/ML/CodeinePhosphate2.4MG/MLOralSolution|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|993470-midodrinehydrochloride5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|993466-midodrinehydrochloride2.5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|993462-midodrinehydrochloride10MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|992668-homatropinemethylbromide0.3MG/ML/HydrocodoneBitartrate1MG/MLOralSolution|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|991528-DextromethorphanHydrobromide3MG/ML/PromethazineHydrochloride1.25MG/MLOralSolution|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|991486-CodeinePhosphate2MG/ML/PromethazineHydrochloride1.25MG/MLOralSolution|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|977880-AmilorideHydrochloride5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197380-Atenolol25MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|905516-ChlordiazepoxideHydrochloride5MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|762007-Nortrel7/7/728DayPack|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|905495-ChlordiazepoxideHydrochloride25MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|905369-ChlordiazepoxideHydrochloride10MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|904589-SotalolHydrochloride240MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|904447-Alendronicacid0.933MG/MLOralSolution|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|904419-Alendronicacid10MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|904405-Alendronicacid40MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|899557-dexmethylphenidatehydrochloride2.5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|899548-dexmethylphenidatehydrochloride10MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197381-Atenolol50MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|899518-dexmethylphenidatehydrochloride5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|897749-HydromorphoneHydrochloride3MGRectalSuppository|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|897710-HydromorphoneHydrochloride8MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|897702-HydromorphoneHydrochloride4MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|897696-HydromorphoneHydrochloride2MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|897659-Verapamilhydrochloride120MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|897640-Verapamilhydrochloride180MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|897630-24HRVerapamilhydrochloride360MGExtendedReleaseOralCapsule|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|897618-24HRVerapamilhydrochloride180MGExtendedReleaseOralCapsule|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|897612-24HRVerapamilhydrochloride120MGExtendedReleaseOralCapsule|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|894780-MorphineSulfate4MG/MLOralSolution|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|892672-MorphineSulfate30MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|892625-MorphineSulfate20MG/MLOralSolution|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|892589-MorphineSulfate2MG/MLOralSolution|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|892582-MorphineSulfate15MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|884386-DextroamphetamineSulfate5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|884385-DextroamphetamineSulfate10MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|866042-NeomycinSulfate500MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|863559-valganciclovir50MG/MLOralSolution|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|862025-24HRGuanfacine4MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|862019-24HRGuanfacine3MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|862013-24HRGuanfacine2MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|862006-24HRGuanfacine1MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|861237-24HRAmphetamineaspartate1.25MG/AmphetamineSulfate1.25MG/Dextroamphetaminesaccharate1.25MG/DextroamphetamineSulfate1.25|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|861232-24HRAmphetamineaspartate7.5MG/AmphetamineSulfate7.5MG/Dextroamphetaminesaccharate7.5MG/DextroamphetamineSulfate7.5MGEx|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|861227-24HRAmphetamineaspartate6.25MG/AmphetamineSulfate6.25MG/Dextroamphetaminesaccharate6.25MG/DextroamphetamineSulfate6.25|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|861225-24HRAmphetamineaspartate5MG/AmphetamineSulfate5MG/Dextroamphetaminesaccharate5MG/DextroamphetamineSulfate5MGExtendedRe|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|861223-24HRAmphetamineaspartate3.75MG/AmphetamineSulfate3.75MG/Dextroamphetaminesaccharate3.75MG/DextroamphetamineSulfate3.75|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|861221-24HRAmphetamineaspartate2.5MG/AmphetamineSulfate2.5MG/Dextroamphetaminesaccharate2.5MG/DextroamphetamineSulfate2.5MGEx|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197383-Atenolol50MG/Chlorthalidone25MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|857366-EconazoleNitrate10MG/MLTopicalCream|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|857005-Acetaminophen325MG/HydrocodoneBitartrate7.5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|857002-Acetaminophen325MG/HydrocodoneBitartrate5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|856999-Acetaminophen325MG/HydrocodoneBitartrate10MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|856940-Acetaminophen21.7MG/ML/HydrocodoneBitartrate0.5MG/MLOralSolution|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|855633-DiclofenacSodium0.01MG/MGTopicalGel|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|854876-Zolpidemtartrate5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|854873-Zolpidemtartrate10MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|854252-1MLEnoxaparinsodium150MG/MLPrefilledSyringe|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|854248-1MLEnoxaparinsodium100MG/MLPrefilledSyringe|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|854245-0.8MLEnoxaparinsodium150MG/MLPrefilledSyringe|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|854241-0.8MLEnoxaparinsodium100MG/MLPrefilledSyringe|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|854238-0.6MLEnoxaparinsodium100MG/MLPrefilledSyringe|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|854235-0.4MLEnoxaparinsodium100MG/MLPrefilledSyringe|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|854228-0.3MLEnoxaparinsodium100MG/MLPrefilledSyringe|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|847252-3MLInsulinLispro25UNT/ML/insulinlisproprotamine,human75UNT/MLPenInjector|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|847191-3MLinsulinaspartprotamine,human70UNT/ML/insulinaspart,human30UNT/MLPenInjector|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|846378-24HRLevetiracetam750MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|845488-Ramipril1.25MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|835829-testosteronecypionate100MG/MLInjectableSolution|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|835603-tramadolhydrochloride50MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|834022-KetorolacTromethamine10MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197304-Acetazolamide250MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|830861-24HRDiltiazemHydrochloride120MGExtendedReleaseOralCapsule|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|830845-24HRDiltiazemHydrochloride180MGExtendedReleaseOralCapsule|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|830837-24HRDiltiazemHydrochloride240MGExtendedReleaseOralCapsule|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|830801-24HRDiltiazemHydrochloride300MGExtendedReleaseOralCapsule|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|807832-24HRLevetiracetam500MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|801966-4MLDiazepam5MG/MLRectalGel|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|801961-2MLDiazepam5MG/MLRectalGel|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|801957-0.5MLDiazepam5MG/MLRectalGel|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|728113-Oseltamivir45MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|728109-Oseltamivir30MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|687043-Amphetamineaspartate3.125MG/AmphetamineSulfate3.125MG/Dextroamphetaminesaccharate3.125MG/DextroamphetamineSulfate3.125|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|686379-celecoxib50MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|636045-Hydrochlorothiazide25MG/valsartan320MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|636042-Hydrochlorothiazide12.5MG/valsartan320MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|608143-atomoxetine80MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|608139-atomoxetine100MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|596934-duloxetine60MGDelayedReleaseOralCapsule|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|596930-duloxetine30MGDelayedReleaseOralCapsule|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|596926-duloxetine20MGDelayedReleaseOralCapsule|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|577961-Amphetamineaspartate5MG/AmphetamineSulfate5MG/Dextroamphetaminesaccharate5MG/DextroamphetamineSulfate5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|577957-Amphetamineaspartate3.75MG/AmphetamineSulfate3.75MG/Dextroamphetaminesaccharate3.75MG/DextroamphetamineSulfate3.75MGOr|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|541892-Amphetamineaspartate2.5MG/AmphetamineSulfate2.5MG/Dextroamphetaminesaccharate2.5MG/DextroamphetamineSulfate2.5MGOralTa|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|541878-Amphetamineaspartate1.25MG/AmphetamineSulfate1.25MG/Dextroamphetaminesaccharate1.25MG/DextroamphetamineSulfate1.25MGOr|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|541363-Amphetamineaspartate7.5MG/AmphetamineSulfate7.5MG/Dextroamphetaminesaccharate7.5MG/DextroamphetamineSulfate7.5MGOralTa|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|485486-tizanidine2MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|485485-tizanidine4MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197405-Betamethasone0.0005MG/MGTopicalOintment|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|485484-tizanidine6MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|485465-Eszopiclone3MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|485442-Eszopiclone2MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|485440-Eszopiclone1MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|477562-Fenofibrate48MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|477560-Fenofibrate145MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|403923-168HREstradiol0.0025MG/HRTransdermalSystem|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|403922-168HREstradiol0.00156MG/HRTransdermalSystem|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|403884-Levetiracetam100MG/MLOralSolution|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|359818-Nicotine4MGOralLozenge|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197407-Betamethasone1MG/MLTopicalCream|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|359817-Nicotine2MGOralLozenge|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|836368-200ACTUATIpratropiumBromide0.017MG/ACTUATMeteredDoseInhaler[Atrovent]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|351297-insulinaspartprotamine,human70UNT/ML/insulinaspart,human30UNT/MLInjectableSuspension|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|351246-montelukast4MGOralGranules|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|351133-Fenofibrate54MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197391-Baclofen10MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|351109-Budesonide0.25MG/MLInhalationSuspension|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|349595-atomoxetine60MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|349594-atomoxetine40MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|349593-atomoxetine25MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|349592-atomoxetine18MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197408-Betamethasone1MG/MLTopicalLotion|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|349591-atomoxetine10MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|349514-celecoxib400MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|349483-valsartan40MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|349353-Hydrochlorothiazide25MG/valsartan160MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|349287-Fenofibrate160MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|349201-valsartan160MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|349200-valsartan320MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|349199-valsartan80MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|349198-Clonazepam0.5MGDisintegratingOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|349197-Clonazepam2MGDisintegratingOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|349196-Clonazepam1MGDisintegratingOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|349195-Clonazepam0.25MGDisintegratingOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|349194-Clonazepam0.125MGDisintegratingOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|349094-Budesonide0.125MG/MLInhalationSuspension|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|318202-Erythromycin20MG/MLTopicalSolution|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|315223-Sumatriptan25MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|314285-zonisamide100MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|314209-rizatriptan10MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|314200-pantoprazole40MGDelayedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|314135-naratriptan2.5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|313762-zaleplon5MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|313761-zaleplon10MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|313571-Vancomycin250MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|313570-Vancomycin125MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|313566-valganciclovir450MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|313415-Tobramycin3MG/MLOphthalmicSolution|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|313413-tizanidine4MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|313412-tizanidine2MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|313222-terbinafine250MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197411-Bromocriptine2.5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|313161-Sumatriptan50MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|313160-Sumatriptan100MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|312840-rizatriptan5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|312087-Ondansetron8MGDisintegratingOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|312086-Ondansetron8MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|312075-Ofloxacin3MG/MLOphthalmicSolution|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|311975-Nicotine4MGChewingGum|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|311918-naratriptan1MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|311759-montelukast4MGChewableTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|311265-lamotrigine5MGChewableTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|311237-Ketotifen0.25MG/MLOphthalmicSolution|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|311207-Ivermectin3MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|310793-Hydrochlorothiazide12.5MG/irbesartan300MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|310792-Hydrochlorothiazide12.5MG/irbesartan150MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|310467-Gentamicin3MG/MLOphthalmicSolution|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|310465-Gentamicin0.001MG/MGTopicalOintment|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|310289-Fenofibrate200MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|310288-Fenofibrate134MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|310191-estradiolvalerate40MG/MLInjectableSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197443-Carbidopa10MG/Levodopa100MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|310190-estradiolvalerate20MG/MLInjectableSolution|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|310152-Erythromycin0.02MG/MGTopicalGel|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|310149-Erythromycin0.005MG/MGOphthalmicOintment|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|309314-Citalopram40MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|854921-BisoprololFumarate5MG/Hydrochlorothiazide6.25MGOralTablet[Ziac]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|309309-Ciprofloxacin500MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|309307-Ciprofloxacin3MG/MLOphthalmicSolution|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|283407-Mirtazapine30MGDisintegratingOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|261962-Ramipril10MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|259081-12HRAspirin25MG/Dipyridamole200MGExtendedReleaseOralCapsule|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|252559-Budesonide0.5MG/MLInhalationSuspension|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|251872-pantoprazole20MGDelayedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|248478-84HREstradiol0.00104MG/HRTransdermalSystem|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|242892-84HREstradiol0.00417MG/HRTransdermalSystem|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|242891-84HREstradiol0.00208MG/HRTransdermalSystem|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|242462-cilostazol50MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|242461-cilostazol100MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|242438-montelukast5MGChewableTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|242333-168HREstradiol0.00104MG/HRTransdermalSystem|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|241946-84HREstradiol0.00156MG/HRTransdermalSystem|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|241527-168HREstradiol0.00312MG/HRTransdermalSystem|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|238004-168HREstradiol0.00417MG/HRTransdermalSystem|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|238003-168HREstradiol0.00208MG/HRTransdermalSystem|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|2123111-NDA020503200ACTUATAlbuterol0.09MG/ACTUATMeteredDoseInhaler|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|205323-celecoxib200MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|205322-celecoxib100MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|2047882-1MLtestosteronecypionate200MG/MLInjection|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|203088-Ketoconazole20MG/MLTopicalCream|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|200345-Simvastatin80MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|200329-Omeprazole40MGDelayedReleaseOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197445-Carbidopa25MG/Levodopa250MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|200311-Fenofibrate67MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|200285-Hydrochlorothiazide12.5MG/valsartan160MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|200284-Hydrochlorothiazide12.5MG/valsartan80MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|200224-montelukast10MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|200096-irbesartan300MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|200095-irbesartan150MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|200094-irbesartan75MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|199381-potassiumcitrate10MEQExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|199376-potassiumcitrate5MEQExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|199370-Ciprofloxacin100MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197448-Levocarnitine330MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|199206-Riluzole50MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|861834-amylase82000UNT/lipase15000UNT/protease51000UNTDelayedReleaseOralCapsule[Zenpep]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|198342-Urea400MG/MLTopicalCream|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|198318-Triazolam0.25MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|198317-Triazolam0.125MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|198252-tetracyclinehydrochloride500MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|198250-tetracyclinehydrochloride250MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|198242-Temazepam30MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|198241-Temazepam15MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|198189-Ramipril5MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197449-Cefaclor500MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|198188-Ramipril2.5MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|198052-Ondansetron4MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|198051-Omeprazole20MGDelayedReleaseOralCapsule|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|198036-24HRNifedipine90MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|198035-24HRNifedipine60MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|198034-24HRNifedipine30MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|197902-Lorazepam2MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|197900-Lorazepam0.5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|197877-Lidocaine25MG/ML/Prilocaine25MG/MLTopicalCream|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|197739-Glycopyrrolate2MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|197738-Glycopyrrolate1MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|197735-Gentamicin1MG/MLTopicalCream|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|197591-Diazepam5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|197590-Diazepam2MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|197589-Diazepam10MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|197541-Colchicine0.6MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|197529-Clonazepam2MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|197528-Clonazepam1MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|197527-Clonazepam0.5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|197512-Ciprofloxacin750MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|197511-Ciprofloxacin250MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|1926331-0.5UNTDoses3MLInsulinLispro100UNT/MLPenInjector|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|1918209-60ACTUATfluticasonepropionate0.055MG/ACTUAT/salmeterol0.014MG/ACTUATDryPowderInhaler|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|1918203-60ACTUATfluticasonepropionate0.232MG/ACTUAT/salmeterol0.014MG/ACTUATDryPowderInhaler|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|1918194-60ACTUATfluticasonepropionate0.113MG/ACTUAT/salmeterol0.014MG/ACTUATDryPowderInhaler|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|1812015-Osmotic24HRNifedipine90MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|1812013-Osmotic24HRNifedipine60MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|1812011-Osmotic24HRNifedipine30MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197433-calciumacetate667MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|1806197-30/70Release24HRMethylphenidateHydrochloride60MGExtendedReleaseOralCapsule|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|1806193-30/70Release24HRMethylphenidateHydrochloride50MGExtendedReleaseOralCapsule|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|1806191-30/70Release24HRMethylphenidateHydrochloride40MGExtendedReleaseOralCapsule|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|1650142-DoxycyclineMonohydrate100MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|1649990-DoxycyclineMonohydrate100MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|1649401-DoxycyclineMonohydrate50MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|1596780-60ACTUATTestosterone12.5MG/ACTUATTopicalGel|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|1550940-Colchicine0.6MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|1543069-Lidocaine0.05MG/MGTopicalOintment|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|1298091-FlurazepamHydrochloride30MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|1298088-FlurazepamHydrochloride15MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197500-Chlorthalidone50MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|1244214-Budesonide3MGDelayedReleaseOralCapsule|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|1149632-84HREstradiol0.00313MG/HRTransdermalSystem|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|1115698-Oseltamivir6MG/MLOralSuspension|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|1091497-MethylphenidateHydrochloride5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|1091392-MethylphenidateHydrochloride20MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|1091225-8HRMethylphenidateHydrochloride20MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|1091150-MethylphenidateHydrochloride10MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|1091145-8HRMethylphenidateHydrochloride10MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|106346-Mupirocin0.02MG/MGTopicalOintment|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197516-Clarithromycin250MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|1049225-Acetaminophen325MG/OxycodoneHydrochloride7.5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|1049221-Acetaminophen325MG/OxycodoneHydrochloride5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|1049214-Acetaminophen325MG/OxycodoneHydrochloride10MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|104894-Ondansetron4MGDisintegratingOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|1009145-Amphetamineaspartate1.875MG/AmphetamineSulfate1.875MG/Dextroamphetaminesaccharate1.875MG/DextroamphetamineSulfate1.87|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|1000153-1MLmedroxyprogesteroneacetate150MG/MLPrefilledSyringe|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Generic|1000126-1MLmedroxyprogesteroneacetate150MG/MLInjection|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|999965-Glycopyrrolate0.2MG/MLOralSolution[Cuvposa]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|998666-carboxymethylcellulosesodium0.01MG/MGOphthalmicGel[TheraTears]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|901644-0.5MLStreptococcuspneumoniaeserotype1capsularantigendiphtheriaCRM197proteinconjugatevaccine0.0044MG/ML/Streptococcuspn|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|901518-0.5MLNeisseriameningitidisserogroupAoligosaccharidediphtheriaCRM197proteinconjugatevaccine0.02MG/ML/Neisseriameningiti|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|895756-PolyethyleneGlycol4000.004MG/MG/Propyleneglycol0.003MG/MGOphthalmicGel[Systane]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|864650-Ganciclovir0.0015MG/MGOphthalmicGel[Zirgan]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|847213-3MLInsulinLispro50UNT/ML/insulinlisproprotamine,human50UNT/MLPenInjector[HumalogMix]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|847199-3MLinsulinisophane,human100UNT/MLPenInjector[HumulinN]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|847189-3MLinsulinisophane,human70UNT/ML/insulin,regular,human30UNT/MLPenInjector[Humulin]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|836634-1MLhepatitisAvirusstrainCR326Fantigen,inactivated50UNT/MLPrefilledSyringe[Vaqta]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|830263-1MLHepatitisBSurfaceAntigenVaccine0.04MG/MLInjection[Recombivax]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|830253-0.5MLHepatitisBSurfaceAntigenVaccine0.01MG/MLPrefilledSyringe[Recombivax]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|830245-1MLHepatitisBSurfaceAntigenVaccine0.01MG/MLPrefilledSyringe[Recombivax]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|804186-0.5MLMeaslesVirusVaccineLive,Enders'attenuatedEdmonstonstrain2000UNT/ML/MumpsVirusVaccineLive,JerylLynnStrain25000UNT/|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|803371-1MLHepatitisAVaccine(Inactivated)StrainHM175720UNT/ML/HepatitisBSurfaceAntigenVaccine0.02MG/MLPrefilledSyringe[Twinrix|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|798482-0.5MLHepatitisAVaccine(Inactivated)StrainHM1751440UNT/MLPrefilledSyringe[Havrix]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|798479-1MLHepatitisAVaccine(Inactivated)StrainHM1751440UNT/MLPrefilledSyringe[Havrix]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|798428-1MLHepatitisBSurfaceAntigenVaccine0.02MG/MLPrefilledSyringe[Engerix-B]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|797641-0.5MLNeisseriameningitidisserogroupAcapsularpolysaccharidediphtheriatoxoidproteinconjugatevaccine0.104MG/ML/Neisseriam|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|795737-ChantixStartingMonthPAK|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|795735-ChantixContinuingMonthsOfTherapy1MGPack|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|762602-SalmonellatyphiTy21aliveantigen2000000000UNTDelayedReleaseOralCapsule[Vivotif]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197518-Clindamycin150MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|752388-InsulinLispro25UNT/ML/insulinlisproprotamine,human75UNT/MLInjectableSuspension[HumalogMix]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|731281-InsulinLispro50UNT/ML/insulinlisproprotamine,human50UNT/MLInjectableSuspension[HumalogMix]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|707566-PolyethyleneGlycol4004MG/ML/Propyleneglycol3MG/MLOphthalmicSolution[Systane]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|637190-varenicline1MGOralTablet[Chantix]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|637188-varenicline0.5MGOralTablet[Chantix]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|630981-PolyvinylAlcohol27MG/ML/Povidone20MG/MLOphthalmicSolution[Freshkote]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|404448-84HRoxybutynin0.162MG/HRTransdermalSystem[Oxytrol]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|351859-insulin,regular,human500UNT/MLInjectableSolution[HumulinR]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|351433-24HRNicotine0.292MG/HRTransdermalSystem[NicodermC-Q]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|351429-24HRNicotine0.875MG/HRTransdermalSystem[NicodermC-Q]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|351427-24HRNicotine0.583MG/HRTransdermalSystem[NicodermC-Q]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|896001-120ACTUATFluticasonepropionate0.11MG/ACTUATMeteredDoseInhaler[Flovent]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|311036-insulin,regular,human100UNT/MLInjectableSolution[HumulinR]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|311033-insulin,regular,human100UNT/MLInjectableSolution[NovolinR]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|311027-insulinisophane,human100UNT/MLInjectableSuspension[NovolinN]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|311026-insulinisophane,human100UNT/MLInjectableSuspension[HumulinN]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|261315-Oseltamivir75MGOralCapsule[Tamiflu]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|2360588-0.5MLNeisseriameningitidisserogroupAcapsularpolysaccharidetetanustoxoidproteinconjugatevaccine0.02MG/ML/Neisseriameni|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|2166928-10ACTUATolodaterol0.0025MG/ACTUAT/tiotropium0.0025MG/ACTUATInhalationSpray[Stiolto]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|2166204-10ACTUATtiotropium0.0025MG/ACTUATInhalationSpray[Spiriva]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197557-Dapsone100MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|213442-insulinisophane,human70UNT/ML/insulin,regular,human30UNT/MLInjectableSuspension[Novolin]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|211947-Atovaquone150MG/MLOralSuspension[Mepron]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|211609-hypromellose5MG/MLOphthalmicSolution[IsoptoAlkaline]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|211140-PentosanPolysulfate100MGOralCapsule[Elmiron]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|2106334-0.5MLdiphtheriatoxoidvaccine,inactivated4UNT/ML/tetanustoxoidvaccine,inactivated4UNT/MLInjection[Tdvax]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|208821-Dexamethasone0.001MG/MG/Tobramycin0.003MG/MGOphthalmicOintment[Tobradex]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|2059017-rivaroxaban2.5MGOralTablet[Xarelto]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|2053927-sodiumzirconiumcyclosilicate10000MGPowderforOralSuspension[Lokelma]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|2050059-0.5MLHepatitisBSurfaceAntigenVaccine0.04MG/MLPrefilledSyringe[Heplisav-B]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|2047639-sodiumzirconiumcyclosilicate5000MGPowderforOralSuspension[Lokelma]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|2045382-30ACTUATfluticasonefuroate0.05MG/ACTUATDryPowderInhaler[Arnuity]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|2000136-Vancomycin50MG/MLOralSolution[Firvanq]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|2000133-Vancomycin25MG/MLOralSolution[Firvanq]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1994352-0.5MLHepatitisBSurfaceAntigenVaccine0.04MG/MLInjection[Heplisav-B]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1992428-Eliquis30-DayStarterPack|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1992171-3MLInsulinLispro100UNT/MLPenInjector[Admelog]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1992169-InsulinLispro100UNT/MLInjectableSolution[Admelog]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1986830-0.5MLVaricellazostervirusglycoproteinE,recombinant0.1MG/MLInjection[Shingrix]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1797888-Nicotine0.5MG/ACTUATMeteredDoseNasalSpray[Nicotrol]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1736863-3MLInsulinGlargine100UNT/MLPenInjector[Basaglar]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1731317-3MLinsulin,regular,human500UNT/MLPenInjector[HumulinR]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1723478-dabigatranetexilate110MGOralCapsule[Pradaxa]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1667882-60ACTUATtiotropium0.00125MG/ACTUATInhalationSpray[Spiriva]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1658472-0.5MLStreptococcuspneumoniaetype1capsularpolysaccharideantigen0.05MG/ML/Streptococcuspneumoniaetype10Acapsularpolysac|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1658157-1MLHepatitisBSurfaceAntigenVaccine0.02MG/MLInjection[Engerix-B]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1658155-0.5MLHepatitisBSurfaceAntigenVaccine0.01MG/MLInjection[Recombivax]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1658150-1MLHepatitisBSurfaceAntigenVaccine0.01MG/MLInjection[Recombivax]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1658106-0.5MLhepatitisAvirusstrainCR326Fantigen,inactivated50UNT/MLInjection[Vaqta]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1658102-1MLhepatitisAvirusstrainCR326Fantigen,inactivated50UNT/MLInjection[Vaqta]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197575-Desoximetasone0.0025MG/MGTopicalOintment|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1658060-1MLHepatitisAVaccine(Inactivated)StrainHM1751440UNT/MLInjection[Havrix]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1656356-sacubitril97MG/valsartan103MGOralTablet[Entresto]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1656351-sacubitril49MG/valsartan51MGOralTablet[Entresto]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1656346-sacubitril24MG/valsartan26MGOralTablet[Entresto]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1601407-0.5MLmeningococcalgroupBvaccine0.1MG/ML/NeisseriameningitidisserogroupBrecombinantFHBPfusionproteinantigen0.1MG/ML/Ne|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1597103-0.5MLL1protein,Humanpapillomavirustype11Vaccine0.08MG/ML/L1protein,Humanpapillomavirustype16Vaccine0.12MG/ML/L1protei|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1597099-0.5MLL1protein,Humanpapillomavirustype11Vaccine0.08MG/ML/L1protein,Humanpapillomavirustype16Vaccine0.12MG/ML/L1protei|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1596445-7ACTUATumeclidinium0.0625MG/ACTUATDryPowderInhaler[Incruse]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1593140-0.5MLNeisseriameningitidisserogroupBrecombinantLP2086A05proteinvariantantigen0.12MG/ML/Neisseriameningitidisserogroup|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1549683-Xarelto30-DayStarterPackKit|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197577-Dexamethasone0.5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1547950-CarboxymethylcelluloseSodium2.5MG/MLOphthalmicSolution[TheraTears]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1547672-30ACTUATfluticasonefuroate0.2MG/ACTUATDryPowderInhaler[Arnuity]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1547664-14ACTUATfluticasonefuroate0.1MG/ACTUATDryPowderInhaler[Arnuity]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1547582-0.5MLStreptococcuspneumoniaetype1capsularpolysaccharideantigen0.05MG/ML/Streptococcuspneumoniaetype10Acapsularpolysac|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1364447-apixaban5MGOralTablet[Eliquis]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1364441-apixaban2.5MGOralTablet[Eliquis]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1363484-hypromellose0.003MG/MGOphthalmicGel[SystaneOvernightTherapy]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1300468-0.5MLHaemophilusinfluenzaetypebstrain1482,capsularpolysaccharideinactivatedtetanustoxoidconjugatevaccine0.068MG/MLInj|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1300378-0.5MLBordetellapertussisfilamentoushemagglutininvaccine,inactivated0.016MG/ML/Bordetellapertussispertactinvaccine,ina|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197579-Dexamethasone1MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1300370-0.5MLBordetellapertussisfilamentoushemagglutininvaccine,inactivated0.016MG/ML/Bordetellapertussispertactinvaccine,ina|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1300206-0.5MLBordetellapertussisfilamentoushemagglutininvaccine,inactivated0.01MG/ML/Bordetellapertussisfimbriae2/3vaccine,in|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1292459-0.5MLVaricella-ZosterVirusVaccineLive(Oka-Merck)strain2700UNT/MLInjection[Varivax]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1190919-0.5MLdiphtheriatoxoidvaccine,inactivated4UNT/ML/tetanustoxoidvaccine,inactivated10UNT/MLPrefilledSyringe[Tenivac]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|905379-HydralazineHydrochloride37.5MG/IsosorbideDinitrate20MGOralTablet[Bidil]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1190916-0.5MLdiphtheriatoxoidvaccine,inactivated4UNT/ML/tetanustoxoidvaccine,inactivated10UNT/MLInjection[Tenivac]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1115892-MineralOil0.15MG/MG/Petrolatum0.85MG/MGOphthalmicOintment[Puralube]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|106892-insulinisophane,human70UNT/ML/insulin,regular,human30UNT/MLInjectableSuspension[Humulin]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1049216-Acetaminophen325MG/OxycodoneHydrochloride10MGOralTablet[Endocet]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1046920-Nicotine4MGInhalationSolution[Nicotrol]|DISABLED FULL DUALS 632|2002|N|N|Y||Preferred Brand|1037181-dabigatranetexilate75MGOralCapsule[Pradaxa]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|999613-SulfacetamideSodium100MG/ML/Sulfur50MG/MLMedicatedLiquidSoap|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|997501-Fexofenadinehydrochloride60MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|997491-Fexofenadinehydrochloride6MG/MLOralSuspension|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|997420-Fexofenadinehydrochloride180MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|997229-Donepezilhydrochloride5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|997226-Donepezilhydrochloride5MGDisintegratingOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|997223-Donepezilhydrochloride10MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|997220-Donepezilhydrochloride10MGDisintegratingOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|996824-MethylergonovineMaleate0.2MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|996572-{21(Memantinehydrochloride10MGOralTablet)/28(Memantinehydrochloride5MGOralTablet)}Pack|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|996571-Memantinehydrochloride5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|996561-Memantinehydrochloride10MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|996520-DextromethorphanHydrobromide2MG/ML/Guaifenesin20MG/MLOralSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|995666-MeclizineHydrochloride25MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|995632-MeclizineHydrochloride25MGChewableTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|995624-MeclizineHydrochloride12.5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|995607-EthambutolHydrochloride400MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|995599-EthambutolHydrochloride100MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|995281-HydroxyzineHydrochloride50MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197581-Dexamethasone2MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|995278-HydroxyzinePamoate50MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|995258-HydroxyzineHydrochloride25MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|995253-HydroxyzinePamoate25MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|995241-HydroxyzineHydrochloride2MG/MLOralSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|995232-HydroxyzinePamoate100MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|995218-HydroxyzineHydrochloride10MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|993943-Acetaminophen325MG/butalbital50MG/Caffeine40MG/CodeinePhosphate30MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|993691-BupropionHydrochloride75MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|993687-BupropionHydrochloride100MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|993557-24HRBupropionHydrochloride300MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197582-Dexamethasone4MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|993541-24HRBupropionHydrochloride150MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Brand|992759-Homatropinehydrobromide50MG/MLOphthalmicSolution[Homatropaire]|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|993536-12HRBupropionHydrochloride200MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|993518-12HRBupropionHydrochloride150MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|993503-12HRBupropionHydrochloride100MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|992780-MiconazoleNitrate100MGVaginalInsert|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|992775-{1(MiconazoleNitrate1200MGVaginalInsert)/1(9000MG)(MiconazoleNitrate20MG/MLVaginalCream)}Pack|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|992528-Terbinafinehydrochloride10MG/MLTopicalCream|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|992475-PromethazineHydrochloride50MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|992454-PromethazineHydrochloride25MGRectalSuppository|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197583-Dexamethasone6MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|992447-PromethazineHydrochloride25MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|992441-PromethazineHydrochloride12.5MGRectalSuppository|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|992438-PromethazineHydrochloride12.5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|992432-PromethazineHydrochloride1.25MG/MLOralSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|992184-methenaminemandelate500MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|992153-methenaminemandelate1000MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|991086-DicyclomineHydrochloride20MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197499-Chlorthalidone25MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|991061-DicyclomineHydrochloride10MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|979492-LosartanPotassium50MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|979485-LosartanPotassium25MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|979480-LosartanPotassium100MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|979475-MetaproterenolSulfate20MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|979471-Hydrochlorothiazide25MG/LosartanPotassium100MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|979468-Hydrochlorothiazide12.5MG/LosartanPotassium50MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|979464-Hydrochlorothiazide12.5MG/LosartanPotassium100MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|979444-MetaproterenolSulfate2MG/MLOralSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|979409-MetaproterenolSulfate10MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|979092-HydroxychloroquineSulfate200MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|978006-LoperamideHydrochloride2MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|966920-POLYETHYLENEGLYCOL3350236000MG/PotassiumChloride2970MG/SodiumBicarbonate6740MG/SodiumChloride5860MG/sodiumsulfate22740|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|966914-POLYETHYLENEGLYCOL3350240000MG/PotassiumChloride2980MG/SodiumBicarbonate6720MG/SodiumChloride5840MG/sodiumsulfate22720|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|966270-LevothyroxineSodium0.137MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|966253-LevothyroxineSodium0.088MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|966249-LevothyroxineSodium0.175MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|966248-LevothyroxineSodium0.112MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|966225-LevothyroxineSodium0.15MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|966224-LevothyroxineSodium0.125MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|966222-LevothyroxineSodium0.075MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|966221-LevothyroxineSodium0.05MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197596-Dicloxacillin500MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|966220-LevothyroxineSodium0.025MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|905395-HydralazineHydrochloride50MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|905225-HydralazineHydrochloride25MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|905222-HydralazineHydrochloride100MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|905199-HydralazineHydrochloride10MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|905158-Sirolimus0.5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|904932-ibandronicacid150MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|904481-PravastatinSodium80MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|904475-PravastatinSodium40MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|904467-PravastatinSodium20MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197604-Digoxin0.125MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|904458-PravastatinSodium10MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|904431-Alendronicacid70MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|904396-Alendronicacid35MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|904170-PrimaquinePhosphate26.3MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|903891-FluvoxamineMaleate50MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|903887-FluvoxamineMaleate25MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|903884-FluvoxamineMaleate100MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|903703-liothyroninesodium0.05MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|903697-liothyroninesodium0.025MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|903456-liothyroninesodium0.005MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|898723-Benazeprilhydrochloride5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|898690-Benazeprilhydrochloride20MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|898687-Benazeprilhydrochloride10MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|898378-Benazeprilhydrochloride5MG/Hydrochlorothiazide6.25MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|898372-Benazeprilhydrochloride20MG/Hydrochlorothiazide25MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|898367-Benazeprilhydrochloride20MG/Hydrochlorothiazide12.5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|898359-Amlodipine5MG/Benazeprilhydrochloride40MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|898356-Amlodipine5MG/Benazeprilhydrochloride20MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|898353-Amlodipine5MG/Benazeprilhydrochloride10MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|898350-Amlodipine2.5MG/Benazeprilhydrochloride10MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|898346-Amlodipine10MG/Benazeprilhydrochloride40MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|898342-Amlodipine10MG/Benazeprilhydrochloride20MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|897722-Verapamilhydrochloride40MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|897683-Verapamilhydrochloride80MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|897666-Verapamilhydrochloride120MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|897649-Verapamilhydrochloride240MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|897624-24HRVerapamilhydrochloride240MGExtendedReleaseOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|897596-24HRVerapamilhydrochloride300MGExtendedReleaseOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|897590-24HRVerapamilhydrochloride200MGExtendedReleaseOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|897584-24HRVerapamilhydrochloride100MGExtendedReleaseOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|896766-Labetalolhydrochloride300MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|896762-Labetalolhydrochloride200MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|896758-Labetalolhydrochloride100MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|896209-60ACTUATFluticasonepropionate0.25MG/ACTUAT/salmeterol0.05MG/ACTUATDryPowderInhaler|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|895987-Fluticasonepropionate0.5MG/MLTopicalCream|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|895487-Fluticasonepropionate0.00005MG/MGTopicalOintment|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|892255-LevothyroxineSodium0.3MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|892251-LevothyroxineSodium0.2MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197623-Disulfiram250MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|892246-LevothyroxineSodium0.1MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|886671-FlecainideAcetate150MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|886666-FlecainideAcetate100MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|886662-FlecainideAcetate50MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|885857-Balsalazidedisodium750MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|884707-Estradiol0.01MGVaginalInsert|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|884308-Nystatin100UNT/MGTopicalOintment|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|884189-ClonidineHydrochloride0.3MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|884185-ClonidineHydrochloride0.2MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|884173-ClonidineHydrochloride0.1MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197624-Disulfiram500MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|876193-POLYETHYLENEGLYCOL335017000MGPowderforOralSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1000097-DoxepinHydrochloride75MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|866924-MetoprololTartrate25MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|866514-MetoprololTartrate50MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|866511-MetoprololTartrate100MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197606-Digoxin0.25MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|866436-24HRmetoprololsuccinate50MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|866427-24HRmetoprololsuccinate25MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|866419-24HRmetoprololsuccinate200MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|866412-24HRmetoprololsuccinate100MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|866144-Cyproheptadinehydrochloride4MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197625-Doxazosin1MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|866111-buspironehydrochloride7.5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|866094-buspironehydrochloride5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|866090-buspironehydrochloride30MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|866083-buspironehydrochloride10MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|866018-buspironehydrochloride15MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|863669-Tamsulosinhydrochloride0.4MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|863664-Oxybutyninchloride5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|863636-24HROxybutyninchloride5MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|863628-24HROxybutyninchloride15MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|863619-24HROxybutyninchloride10MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|861753-Glyburide5MG/Metforminhydrochloride500MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|861748-Glyburide2.5MG/Metforminhydrochloride500MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|861743-Glyburide1.25MG/Metforminhydrochloride250MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|861657-24HRNitroglycerin0.1MG/HRTransdermalSystem|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|861495-ClobetasolPropionate0.5MG/MLTopicalCream|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|861487-ClobetasolPropionate0.5MG/MLTopicalSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|861448-ClobetasolPropionate0.0005MG/MGTopicalOintment|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|861430-PropafenoneHydrochloride300MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|861427-PropafenoneHydrochloride225MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|861424-PropafenoneHydrochloride150MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|861416-Azithromycin1000MGPowderforOralSuspension|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|861200-Brimonidinetartrate2MG/MLOphthalmicSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|861171-12HRPropafenoneHydrochloride425MGExtendedReleaseOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|861164-12HRPropafenoneHydrochloride325MGExtendedReleaseOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|861156-12HRPropafenoneHydrochloride225MGExtendedReleaseOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|861132-24HRAlfuzosinhydrochloride10MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|861064-Sertraline20MG/MLOralSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|861010-Metforminhydrochloride850MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|861007-Metforminhydrochloride500MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197627-Doxazosin4MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|861004-Metforminhydrochloride1000MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|860981-24HRMetforminhydrochloride750MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|860975-24HRMetforminhydrochloride500MGExtendedReleaseOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|860805-Azelastinehydrochloride0.5MG/MLOphthalmicSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|860225-MegestrolAcetate40MG/MLOralSuspension|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|860221-MegestrolAcetate40MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|860215-MegestrolAcetate20MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|860107-KetorolacTromethamine5MG/MLOphthalmicSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|859751-Rosuvastatincalcium20MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|859747-Rosuvastatincalcium10MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197628-Doxazosin8MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|859424-Rosuvastatincalcium5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|859419-Rosuvastatincalcium40MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|859193-selegilinehydrochloride5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|859186-selegilinehydrochloride5MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|859052-Pramipexoledihydrochloride1MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|859048-Pramipexoledihydrochloride1.5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|859044-Pramipexoledihydrochloride0.5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|859040-Pramipexoledihydrochloride0.25MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|859033-Pramipexoledihydrochloride0.125MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|858828-EnalaprilMaleate10MG/Hydrochlorothiazide25MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|858824-EnalaprilMaleate5MG/Hydrochlorothiazide12.5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|858817-EnalaprilMaleate10MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|858813-EnalaprilMaleate5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|1000647-PilocarpineHydrochloride10MG/MLOphthalmicSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|858810-EnalaprilMaleate20MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|858804-EnalaprilMaleate2.5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|858747-Ursodiol300MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|858625-Pramipexoledihydrochloride0.75MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|858616-Nicardipinehydrochloride30MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|858613-Nicardipinehydrochloride20MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|857683-TerbutalineSulfate5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|857677-TerbutalineSulfate2.5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|857461-ClemastineFumarate2.68MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|857340-BethanecholChloride50MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|857336-BethanecholChloride5MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|857328-BethanecholChloride25MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|857321-BethanecholChloride10MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|857305-ClomipramineHydrochloride75MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|857301-ClomipramineHydrochloride50MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|857297-ClomipramineHydrochloride25MGOralCapsule|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|857187-FosinoprilSodium40MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|857183-FosinoprilSodium20MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|857169-FosinoprilSodium10MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|856853-AmitriptylineHydrochloride75MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|856845-AmitriptylineHydrochloride50MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|856840-AmitriptylineHydrochloride50MG/Perphenazine4MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|856834-AmitriptylineHydrochloride25MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|856825-AmitriptylineHydrochloride25MG/Perphenazine4MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|856797-AmitriptylineHydrochloride25MG/Perphenazine2MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|197658-Estradiol1MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|856783-AmitriptylineHydrochloride10MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|856773-AmitriptylineHydrochloride150MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|856762-AmitriptylineHydrochloride100MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|856733-PropranololHydrochloride8MG/MLOralSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|856724-PropranololHydrochloride4MG/MLOralSolution|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|856720-AmitriptylineHydrochloride10MG/Perphenazine4MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|856706-AmitriptylineHydrochloride10MG/Perphenazine2MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|856578-PropranololHydrochloride80MGOralTablet|DISABLED FULL DUALS 632|2002|N|N|N||Preferred Generic|856556-PropranololHydrochloride60MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|856519-PropranololHydrochloride40MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|856457-PropranololHydrochloride20MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|856448-PropranololHydrochloride10MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|856429-Hydrochlorothiazide25MG/PropranololHydrochloride80MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|856422-Hydrochlorothiazide25MG/PropranololHydrochloride40MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|856377-TrazodoneHydrochloride50MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|856373-TrazodoneHydrochloride100MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|856364-TrazodoneHydrochloride150MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|855926-DiclofenacSodium75MGDelayedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|855911-2MLPhenytoinsodium50MG/MLCartridge|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|855906-DiclofenacSodium50MGDelayedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|855873-Phenytoinsodium300MGExtendedReleaseOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|855861-Phenytoinsodium200MGExtendedReleaseOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|855818-prasugrel5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|855812-prasugrel10MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|855671-Phenytoinsodium100MGExtendedReleaseOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|855664-DiclofenacSodium25MGDelayedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|855480-alclometasonedipropionate0.0005MG/MGTopicalOintment|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|855474-alclometasonedipropionate0.5MG/MLTopicalCream|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|855344-WarfarinSodium7.5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|855338-WarfarinSodium6MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|855332-WarfarinSodium5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|855324-WarfarinSodium4MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|855318-WarfarinSodium3MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|855312-WarfarinSodium2.5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|855302-WarfarinSodium2MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|855296-WarfarinSodium10MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|855288-WarfarinSodium1MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|855172-levocetirizinedihydrochloride5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|855168-levocetirizinedihydrochloride0.5MG/MLOralSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|854905-BisoprololFumarate5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|854901-BisoprololFumarate10MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|854801-DiclofenacSodium1MG/MLOphthalmicSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|852913-QuinidineSulfate300MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|852877-QuinidineSulfate200MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|849515-DesmopressinAcetate0.1MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|849506-DesmopressinAcetate0.01MG/ACTUATNasalSpray|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|848943-CholestyramineResin4000MGPowderforOralSuspension|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|848176-AugmentedBetamethasone0.5MG/MLTopicalCream|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|847121-CalciumCitrate1500MG/Cholecalciferol250UNTOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|836358-IpratropiumBromide0.2MG/MLInhalationSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|835925-cyclosporine,modified50MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|835913-MefloquineHydrochloride250MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|835894-cyclosporine,modified25MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|835886-cyclosporine,modified100MG/MLOralSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|835593-ImipramineHydrochloride10MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|835568-ImipramineHydrochloride50MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|835564-ImipramineHydrochloride25MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|834127-chlorhexidinegluconate1.2MG/MLMouthwash|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|834102-PenicillinVPotassium500MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|834061-PenicillinVPotassium250MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|834046-PenicillinVPotassium25MG/MLOralSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|834040-PenicillinVPotassium50MG/MLOralSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|833528-Amiodaronehydrochloride200MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|833217-DiltiazemHydrochloride30MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|833008-DesmopressinAcetate0.2MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|832909-CalciumCarbonate1250MG/Cholecalciferol100UNTChewableTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|831261-CromolynSodium20MG/MLOralSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|831109-CromolynSodium40MG/MLOphthalmicSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|831103-DiltiazemHydrochloride60MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|831102-DiltiazemHydrochloride90MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|831054-DiltiazemHydrochloride120MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|830882-24HRDiltiazemHydrochloride300MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|828348-Cyclobenzaprinehydrochloride10MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|828320-Cyclobenzaprinehydrochloride5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|801054-POLYETHYLENEGLYCOL3350420000MG/PotassiumChloride1480MG/SodiumBicarbonate5720MG/SodiumChloride11200MGPowderforOralSolut|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|763185-{21(Prednisone10MGOralTablet)}Pack|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|763181-{21(Prednisone5MGOralTablet)}Pack|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|762675-{21(Methylprednisolone4MGOralTablet)}Pack|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|756209-Zidovudine10MG/MLOralSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|755497-Albuterol0.4MG/MLOralSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|751901-{84(EthinylEstradiol0.03MG/Levonorgestrel0.15MGOralTablet)/7(InertIngredients1MGOralTablet)}Pack|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|749860-{21(EthinylEstradiol0.035MG/norgestimate0.25MGOralTablet)/7(InertIngredients1MGOralTablet)}Pack|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|749784-{7(EthinylEstradiol0.035MG/norgestimate0.18MGOralTablet)/7(EthinylEstradiol0.035MG/norgestimate0.215MGOralTablet)/7(Et|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|749783-{6(Azithromycin250MGOralTablet)}Pack|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|749780-{3(Azithromycin500MGOralTablet)}Pack|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|749157-{7(EthinylEstradiol0.025MG/norgestimate0.18MGOralTablet)/7(EthinylEstradiol0.025MG/norgestimate0.215MGOralTablet)/7(Et|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|748961-{28(Norethindrone0.35MGOralTablet)}Pack|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|748868-{21(EthinylEstradiol0.02MG/Levonorgestrel0.1MGOralTablet)/7(InertIngredients1MGOralTablet)}Pack|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|748800-{21(drospirenone3MG/EthinylEstradiol0.03MGOralTablet)/7(InertIngredients1MGOralTablet)}Pack|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|727316-NDA0194300.3MLEpinephrine0.5MG/MLAuto-Injector|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|722137-Amlodipine5MG/valsartan320MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|722134-Amlodipine5MG/valsartan160MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|722131-Amlodipine10MG/valsartan320MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|722126-Amlodipine10MG/valsartan160MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|702519-Phenobarbital4MG/MLOralSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|702249-ferroussulfate44MG/MLOralSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|692783-Loratadine1MG/MLOralSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|686924-carvedilol3.125MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|686418-ErythromycinEthylsuccinate80MG/MLOralSuspension|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|686405-ErythromycinEthylsuccinate400MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|686400-ErythromycinEthylsuccinate40MG/MLOralSuspension|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|647121-5MLLevetiracetam100MG/MLInjection|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|646456-Nystatin100UNT/MGTopicalPowder|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|646333-Capsaicin1MG/MLTopicalCream|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|643102-Ibuprofen200MGOralTablet[Wal-Profen]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|639566-VitaminB650MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|628953-PotassiumChloride10MEQExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|617993-Amoxicillin120MG/ML/Clavulanate8.58MG/MLOralSuspension|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|617430-Amoxicillin80MG/ML/Clavulanate11.4MG/MLOralSuspension|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|617423-Amoxicillin40MG/ML/Clavulanate5.7MG/MLOralSuspension|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|617322-Amoxicillin50MG/ML/Clavulanate12.5MG/MLOralSuspension|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|617316-Amoxicillin400MG/Clavulanate57MGChewableTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|617312-atorvastatin10MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|617311-atorvastatin40MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|617310-atorvastatin20MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|617309-Amoxicillin200MG/Clavulanate28.5MGChewableTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|617296-Amoxicillin500MG/Clavulanate125MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|598025-Amoxicillin250MGChewableTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|598006-Erythromycin250MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|597852-anagrelide1MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|596843-lansoprazole15MGDelayedReleaseOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|583170-Salsalate750MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|582926-podofilox5MG/MLTopicalSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|577040-CalciumCarbonate648MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|562704-ropinirole4MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|562524-12HRAcetazolamide500MGExtendedReleaseOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|562510-SodiumFluoride2MG/MLMouthwash|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|562508-Amoxicillin875MG/Clavulanate125MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|562251-Amoxicillin250MG/Clavulanate125MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|544455-Lactulose667MG/MLOralSolution[Generlac]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|543546-Nystatin100000UNT/MLTopicalCream|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|486152-24HRNitroglycerin0.4MG/HRTransdermalSystem|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|486148-24HRNitroglycerin0.2MG/HRTransdermalSystem|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|486146-24HRNitroglycerin0.6MG/HRTransdermalSystem|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|486131-BenzoylPeroxide0.1MG/MGTopicalGel|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|476809-Mirtazapine7.5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|476576-cefdinir50MG/MLOralSuspension|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|432402-cinacalcet30MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|432401-cinacalcet60MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|432400-cinacalcet90MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|429503-Hydrochlorothiazide12.5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|403967-zonisamide50MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|403966-zonisamide25MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|403855-Hydrochlorothiazide25MG/Olmesartanmedoxomil40MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|403854-Hydrochlorothiazide12.5MG/Olmesartanmedoxomil40MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|403853-Hydrochlorothiazide12.5MG/Olmesartanmedoxomil20MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|402698-24HRFelodipine2.5MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|402696-24HRFelodipine5MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|402695-24HRFelodipine10MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|393245-Digoxin0.05MG/MLOralSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|391937-Lactulose667MG/MLOralSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|387003-Levetiracetam1000MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|381056-IsosorbideDinitrate10MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|360110-Sirolimus2MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|359601-Guaifenesin400MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|359296-calciumacetate667MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|353538-24HRIsosorbideMononitrate60MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|351250-Escitalopram20MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|351249-Escitalopram5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|351172-Dutasteride0.5MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|351137-Albuterol0.21MG/MLInhalationSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|351136-Albuterol0.417MG/MLInhalationSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|349420-desloratadine5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|349405-Olmesartanmedoxomil40MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|349401-Olmesartanmedoxomil20MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|349373-Olmesartanmedoxomil5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|349332-Escitalopram10MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|349208-Sirolimus1MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|348472-Theophylline600MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|343033-Dexamethasone0.75MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|328161-Methylprednisolone16MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|328160-Cyclosporine100MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|318272-Aspirin81MGChewableTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|317769-Theophylline300MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|317573-pioglitazone15MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|317173-Captopril25MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|317136-Nortriptyline25MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|317128-Misoprostol0.2MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|317110-24HRIsosorbideMononitrate30MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|315187-Prednisone1MG/MLOralSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|315183-PotassiumChloride8MEQExtendedReleaseOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|315134-Levocarnitine100MG/MLOralSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|315107-24HRGlipizide10MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|315102-SodiumFluoride1.1MG/MLOralSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|315090-Erythromycin333MGDelayedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|314277-venlafaxine50MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|314241-Theophylline450MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|314238-Tropicamide10MG/MLOphthalmicSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|314234-Sucralfate1000MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|314231-Simvastatin10MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|314208-ropinirole1MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|314203-quinapril40MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|314182-PotassiumChloride2.67MEQ/MLOralSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|314165-prednisolone10MG/MLOphthalmicSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|314131-Niacin250MGExtendedReleaseOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|314111-Mirtazapine30MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|314106-Metronidazole250MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|314077-Lisinopril20MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|314076-Lisinopril10MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|314072-latanoprost0.05MG/MLOphthalmicSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|314055-IsosorbideDinitrate5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|314006-24HRGlipizide5MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|314000-Glyburide1.5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|313989-Fluoxetine40MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|313988-Furosemide40MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|313979-fludrocortisoneacetate0.1MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|313919-salmoncalcitonin200UNT/ACTUATNasalSpray|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|313888-Cefaclor50MG/MLOralSuspension|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|313850-Amoxicillin40MG/MLOralSuspension|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|313797-Amoxicillin25MG/MLOralSuspension|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|313786-AceticAcid20MG/ML/Hydrocortisone10MG/MLOticSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|313586-venlafaxine75MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|313585-24HRvenlafaxine75MGExtendedReleaseOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|313584-venlafaxine37.5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|313583-24HRvenlafaxine37.5MGExtendedReleaseOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|313582-venlafaxine25MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|313581-24HRvenlafaxine150MGExtendedReleaseOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|313580-venlafaxine100MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|313565-valacyclovir500MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|313564-valacyclovir1000MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|313521-Tropicamide5MG/MLOphthalmicSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|313477-Trifluridine10MG/MLOphthalmicSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|313428-Toremifene60MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|313423-Tolnaftate10MG/MLTopicalSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|313306-Theophylline5.33MG/MLOralSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|313291-Theophylline400MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|313227-terconazole8MG/MLVaginalCream|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|313226-terconazole4MG/MLVaginalCream|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|313219-Terazosin5MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|313217-Terazosin2MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|313215-Terazosin1MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|313195-Tamoxifen20MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|313190-Tacrolimus0.5MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|313142-Sulfasalazine500MGDelayedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|313134-Sulfamethoxazole40MG/ML/Trimethoprim8MG/MLOralSuspension|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|313123-Sucralfate100MG/MLOralSuspension|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|313096-Spironolactone25MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|313092-Sorbitol700MG/MLOralSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|312997-SodiumChloride9MG/MLInhalationSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|312962-Simvastatin5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|312961-Simvastatin20MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|312941-Sertraline50MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|312940-Sertraline25MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|312938-Sertraline100MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|312899-Salsalate500MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|312849-ropinirole5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|312847-ropinirole2MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|312846-ropinirole0.5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|312845-ropinirole0.25MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|312750-quinapril5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|312749-quinapril20MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|312748-quinapril10MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|312641-Progesterone200MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|312635-Prochlorperazine5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|312617-Prednisone5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|312615-Prednisone20MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|312594-Prazosin2MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|312593-Prazosin1MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|312529-PotassiumChloride8MEQExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|312515-PotassiumChloride1.33MEQ/MLOralSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|312504-PotassiumChloride10MEQExtendedReleaseOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|312441-pioglitazone45MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|312440-pioglitazone30MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|312362-Phenobarbital30MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|312357-Phenobarbital15MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|312301-Pentoxifylline400MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|312289-Naloxone0.5MG/Pentazocine50MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|312138-oxcarbazepine600MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|312137-oxcarbazepine300MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|312136-oxcarbazepine150MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|312059-Nystatin500000UNTOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|312055-Nystatin100000UNT/MLOralSuspension|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|312036-Nortriptyline2MG/MLOralSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|312013-Nitroglycerin2.5MGExtendedReleaseOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|311995-NITROFURANTOIN,MACROCRYSTALS50MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|311994-NITROFURANTOIN,MACROCRYSTALS25MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|311989-Nitrofurantoin5MG/MLOralSuspension|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|311963-Niacin750MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|311960-Niacin500MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|311955-Niacin250MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|311893-nabumetone750MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|311892-nabumetone500MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|311727-Misoprostol0.1MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|311726-Mirtazapine45MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|311725-Mirtazapine15MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|311681-Metronidazole500MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|311679-Metronidazole0.0075MG/MGTopicalGel|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|311678-Metronidazole7.5MG/MLTopicalCream|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|311668-Metoclopramide5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|311666-Metoclopramide10MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|311665-Metipranolol3MG/MLOphthalmicSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|311486-meloxicam7.5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|311376-Lorazepam2MG/MLOralSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|311372-Loratadine10MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|311354-Lisinopril5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|311353-Lisinopril2.5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|311296-Levofloxacin750MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|311290-Levetiracetam750MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|311289-Levetiracetam500MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|311288-Levetiracetam250MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|311277-lansoprazole30MGDelayedReleaseOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|311264-lamotrigine25MGChewableTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|311197-IsosorbideMononitrate20MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|311196-24HRIsosorbideMononitrate120MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|311194-IsosorbideDinitrate40MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|311192-IsosorbideMononitrate10MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|311166-isoniazid100MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|310982-imiquimod50MG/MLTopicalCream|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|310965-Ibuprofen200MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|310964-Ibuprofen200MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|310891-Hydrocortisone25MG/MLTopicalCream|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|310818-Hydrochlorothiazide50MG/Triamterene75MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|310812-Hydrochlorothiazide25MG/Triamterene37.5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|310809-Hydrochlorothiazide25MG/quinapril20MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|310798-Hydrochlorothiazide25MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|310797-Hydrochlorothiazide12.5MG/quinapril20MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|310796-Hydrochlorothiazide12.5MG/quinapril10MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|310687-Hydrocortisone10MG/ML/Neomycin3.5MG/ML/PolymyxinB10000UNT/MLOticSuspension|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|310594-Gramicidin0.025MG/ML/Neomycin1.75MG/ML/PolymyxinB10000UNT/MLOphthalmicSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|310539-Glyburide6MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|310537-Glyburide5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|310536-Glyburide3MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|310534-Glyburide2.5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|310490-Glipizide5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|310489-24HRGlipizide2.5MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|310488-Glipizide10MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|310459-Gemfibrozil600MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|310442-Ganciclovir500MGInjection|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|310434-gabapentin800MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|310433-gabapentin600MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|310432-gabapentin400MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|310431-gabapentin300MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|310430-gabapentin100MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|310429-Furosemide20MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|310410-FolicAcid1MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|310386-Fluoxetine4MG/MLOralSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|310385-Fluoxetine20MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|310384-Fluoxetine10MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|310380-Fluorouracil50MG/MLTopicalSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|310379-Fluorouracil20MG/MLTopicalSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|310377-Fluorometholone1MG/MLOphthalmicSuspension|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|310364-Fluocinonide0.5MG/MLTopicalSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|310362-Fluocinonide0.0005MG/MGTopicalGel|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|310353-Fluconazole40MG/MLOralSuspension|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|310352-Fluconazole10MG/MLOralSuspension|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|310346-Finasteride5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|310325-ferroussulfate325MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|310324-ferroussulfate325MGDelayedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|310273-Famotidine20MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|310261-exemestane25MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|310169-Estradiol0.1MG/MLVaginalCream|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|310157-Erythromycin500MGDelayedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|310155-Erythromycin250MGDelayedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|310154-Erythromycin250MGDelayedReleaseOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|310015-dorzolamide20MG/MLOphthalmicSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|309955-Dipyridamole75MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|309952-Dipyridamole25MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|309686-Dexamethasone0.1MG/MLOralSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|309680-Dexamethasone1MG/ML/Neomycin3.5MG/ML/PolymyxinB10000UNT/MLOphthalmicSuspension|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|309679-Dexamethasone0.001MG/MG/Neomycin0.0035MG/MG/PolymyxinB10UNT/MGOphthalmicOintment|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|309594-vitaminB121MG/MLInjectableSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|309371-Clotrimazole10MGOralLozenge|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|309370-Clotrimazole10MG/MLTopicalSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|309367-Clotrimazole10MG/MLTopicalCream|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|309362-clopidogrel75MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|309337-Clindamycin20MG/MLVaginalCream|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|309313-Citalopram2MG/MLOralSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|309291-ciclopirox80MG/MLTopicalSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|309290-ciclopirox7.7MG/MLTopicalLotion|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|309273-cholinesalicylate58.6MG/ML/MagnesiumSalicylate72.4MG/MLOralSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|309115-Cephalexin250MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|309114-Cephalexin500MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|309113-Cephalexin50MG/MLOralSuspension|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|309112-Cephalexin250MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|309110-Cephalexin25MG/MLOralSuspension|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|309098-Cefuroxime500MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|309054-cefdinir25MG/MLOralSuspension|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|309045-Cefaclor250MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|309044-Cefaclor25MG/MLOralSuspension|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|308989-Carbidopa50MG/Levodopa200MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|308988-Carbidopa25MG/Levodopa100MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|308979-Carbamazepine200MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|308976-Carbamazepine20MG/MLOralSuspension|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|308973-Carbamazepine100MGChewableTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|308964-Captopril50MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|308963-Captopril12.5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|308962-Captopril100MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|308891-CalciumCarbonate250MG/MLOralSuspension|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|308868-Calcitriol0.0005MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|308867-Calcitriol0.00025MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|308725-bexarotene75MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|308714-Betamethasone0.5MG/ML/Clotrimazole10MG/MLTopicalCream|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|308696-BenzoylPeroxide50MG/MLMedicatedLiquidSoap|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|308694-BenzoylPeroxide0.05MG/MGTopicalGel|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|308689-BenzoylPeroxide0.025MG/MGTopicalGel|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|308512-Bacitracin0.5UNT/MG/PolymyxinB10UNT/MGTopicalOintment|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|308508-Bacitracin0.5UNT/MGOphthalmicOintment|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|308493-Bacitracin0.4UNT/MG/Neomycin0.0035MG/MG/PolymyxinB10UNT/MGOphthalmicOintment|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|308459-Azithromycin20MG/MLOralSuspension|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|308416-Aspirin81MGDelayedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|308345-apraclonidine5MG/MLOphthalmicSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|308212-Ampicillin500MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|308194-Amoxicillin875MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|308191-Amoxicillin500MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|308189-Amoxicillin80MG/MLOralSuspension|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|308182-Amoxicillin250MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|308177-Amoxicillin125MGChewableTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|308136-Amlodipine2.5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|308135-Amlodipine10MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|308078-AluminumHydroxide64MG/MLOralSuspension|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|307730-Acyclovir40MG/MLOralSuspension|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|307719-Acetylcysteine200MG/MLInhalationSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|307718-Acetylcysteine100MG/MLInhalationSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|307675-Acetaminophen32MG/MLOralSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|284988-Didanosine400MGDelayedReleaseOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|284245-Famotidine40MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|284215-Clindamycin300MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|284185-Didanosine200MGDelayedReleaseOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|284184-Didanosine250MGDelayedReleaseOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|283858-ropinirole3MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|283672-Citalopram10MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|283523-gabapentin50MG/MLOralSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|283485-Mirtazapine45MGDisintegratingOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|283433-Melatonin10MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|283406-Mirtazapine15MGDisintegratingOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|283077-prednisolone3MG/MLOralSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|282755-telmisartan20MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|282401-lamotrigine25MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|260376-Terazosin10MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|260243-Progesterone100MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|259966-Methylprednisolone4MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|259255-atorvastatin80MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|2532159-PMDDfluoxetine10MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|253059-Levocarnitine500MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|253039-Melatonin1MG/MLOralSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|252732-Melatonin5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|251322-Ethosuximide50MG/MLOralSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|251156-ferroussulfate75MG/MLOralSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|248420-mesalamine1000MGRectalSuppository|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|248109-Ribavirin200MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|245314-Albuterol5MG/MLInhalationSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|244967-PolymyxinB10000UNT/ML/Trimethoprim1MG/MLOphthalmicSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|242590-ferrousgluconate240MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|242446-Ofloxacin3MG/MLOticSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|241834-cyclosporine,modified100MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|240209-Betamethasone0.5MG/MLTopicalLotion|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|240029-Cholecalciferol0.125MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|239238-Griseofulvin25MG/MLOralSuspension|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|239191-Amoxicillin50MG/MLOralSuspension|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|238920-Betamethasone0.5MG/MLTopicalCream|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|238600-seleniumsulfide25MG/MLMedicatedShampoo|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|238154-Acetaminophen325MG/butalbital50MG/Caffeine40MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|238151-mesalamine66.7MG/MLEnema|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|238006-Estrogens,Esterified(USP)0.625MG/Methyltestosterone1.25MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|237776-vitaminB121MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|237723-Ergocalciferol0.2MG/MLOralSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|237420-CalciumCarbonate1500MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|226343-Dexamethasonephosphate1MG/MLOphthalmicSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|211365-chlorhexidinegluconate40MG/MLMedicatedLiquidSoap|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|2101899-Sodiumpolystyrenesulfonate15000MGPowderforOralSuspension|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|209890-Acetaminophen500MGOralCapsule[Mapap]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|206842-IsosorbideDinitrate20MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|205326-Lisinopril30MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|205305-telmisartan80MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|205304-telmisartan40MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|205285-leflunomide20MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|205284-leflunomide10MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|204844-Azithromycin600MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|204423-Hydrocortisone10MG/ML/Neomycin3.5MG/ML/PolymyxinB10000UNT/MLOticSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|204135-Desonide0.0005MG/MGTopicalOintment|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|200371-Citalopram20MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|200346-cefdinir300MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|200257-repaglinide0.5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|200256-repaglinide1MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|200133-12HRCarbamazepine200MGExtendedReleaseOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|200132-Acarbose25MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|200131-12HRCarbamazepine300MGExtendedReleaseOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|200064-letrozole2.5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|200060-mycophenolatemofetil500MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|200033-carvedilol25MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|200032-carvedilol12.5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|200031-carvedilol6.25MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|199903-Hydrochlorothiazide12.5MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|199890-topiramate200MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|199889-topiramate100MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|199888-topiramate25MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|199885-Levofloxacin500MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|199884-Levofloxacin250MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|199703-cabergoline0.5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|199425-Melatonin1MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|199390-Etodolac500MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|199353-trandolapril1MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|199352-trandolapril4MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|199351-trandolapril2MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|199246-glimepiride2MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|199245-glimepiride1MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1992303-12HRTimolol5MG/MLOphthalmicSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|199224-anastrozole1MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|199193-famciclovir250MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|199192-famciclovir125MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|199168-Phenobarbital64.8MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|199167-Phenobarbital32.4MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|199164-Phenobarbital97.2MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|199163-Melatonin3MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|199159-Tretinoin10MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|199150-Acarbose100MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|199149-Acarbose50MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|199143-Niacin250MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|199058-mycophenolatemofetil250MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|199047-Famotidine10MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|198861-SodiumBicarbonate650MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|198857-Simethicone66.7MG/MLOralSuspension|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|198760-Niacin50MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|198759-Niacin100MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|198741-MagnesiumOxide400MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|198707-Hydrocortisone5MG/MLTopicalCream|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|198630-ferrousgluconate324MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|198555-Capsaicin0.25MG/MLTopicalCream|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|198546-CalciumGluconate500MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|198509-Bisacodyl10MGRectalSuppository|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|198440-Acetaminophen500MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|198429-lamotrigine200MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|198428-lamotrigine150MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|198427-lamotrigine100MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|198382-famciclovir500MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|198380-tioconazole0.065MG/MGVaginalOintment|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|198378-Tacrolimus5MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|198377-Tacrolimus1MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|198372-torsemide5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|198371-torsemide20MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|198370-torsemide100MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|198369-torsemide10MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|198365-Prochlorperazine10MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|198352-Zidovudine100MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|198335-Sulfamethoxazole800MG/Trimethoprim160MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|198334-Sulfamethoxazole400MG/Trimethoprim80MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|198332-Trimethoprim100MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|198316-Hydrochlorothiazide25MG/Triamterene37.5MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|198293-Tolazamide500MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|198292-Tolazamide250MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|198240-Tamoxifen10MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|198239-Sulindac200MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|198238-Sulindac150MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|198232-Sulfasalazine500MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|198224-Hydrochlorothiazide25MG/Spironolactone25MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|198223-Spironolactone50MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|198222-Spironolactone100MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|198211-Simvastatin40MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|198202-Rifampin300MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|198201-Rifampin150MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|198181-Pyrazinamide500MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|198175-Propylthiouracil50MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|198165-Propantheline15MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|198153-Colchicine0.5MG/Probenecid500MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|198152-Probenecid500MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|198148-Prednisone50MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|198146-Prednisone2.5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|198145-Prednisone10MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|198144-Prednisone1MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|198141-Prazosin5MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|198116-PotassiumChloride20MEQExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|198108-Piroxicam20MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|198107-Piroxicam10MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|198105-Pindolol5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|198104-Pindolol10MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|198102-vitaminK15MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|198089-Phenobarbital60MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|198086-Phenobarbital16.2MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|198083-Phenobarbital100MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|198049-Ofloxacin300MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|198047-Nortriptyline75MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|198046-Nortriptyline50MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|198045-Nortriptyline10MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|198040-Nitroglycerin0.6MGSublingualTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|198039-Nitroglycerin0.4MGSublingualTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|198038-Nitroglycerin0.3MGSublingualTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|198033-Nifedipine20MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|198032-Nifedipine10MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|198024-Niacin500MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|198014-Naproxen500MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|198013-Naproxen250MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|198012-Naproxen375MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197987-Minoxidil2.5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197986-Minoxidil10MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197973-Methylprednisolone8MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197971-Methylprednisolone32MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197963-Hydrochlorothiazide15MG/Methyldopa250MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197960-Hydrochlorothiazide25MG/Methyldopa250MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197958-Methyldopa500MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197956-Methyldopa250MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197944-Methocarbamol750MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197943-Methocarbamol500MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197942-Methimazole5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197941-Methimazole10MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197940-Methazolamide50MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197939-Methazolamide25MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197931-mercaptopurine50MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197919-Melphalan2MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197905-Lovastatin40MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197904-Lovastatin20MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197903-Lovastatin10MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197887-Hydrochlorothiazide25MG/Lisinopril20MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197886-Hydrochlorothiazide12.5MG/Lisinopril20MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197885-Hydrochlorothiazide12.5MG/Lisinopril10MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197884-Lisinopril40MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197863-Leucovorin5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197862-Leucovorin25MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197861-Leucovorin15MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197860-Leucovorin10MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197856-Ketoprofen75MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197855-Ketoprofen50MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197854-Ketoprofen25MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197853-Ketoconazole200MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197839-IsosorbideDinitrate30MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197832-isoniazid300MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197818-Indomethacin50MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197817-Indomethacin25MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197816-Indapamide2.5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197815-Indapamide1.25MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197807-Ibuprofen800MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197806-Ibuprofen600MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197805-Ibuprofen400MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197803-Ibuprofen20MG/MLOralSuspension|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197797-hydroxyurea500MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197787-Hydrocortisone5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197785-Hydrocortisone25MG/MLTopicalLotion|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197783-Hydrocortisone20MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197782-Hydrocortisone10MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197770-Hydrochlorothiazide50MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197746-Guanfacine2MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197745-Guanfacine1MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197741-Guaifenesin200MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197737-Glyburide1.25MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197732-Furosemide80MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197726-Flutamide125MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197701-Fluconazole50MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197700-Fluconazole200MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197699-Fluconazole150MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197698-Fluconazole100MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197686-Etodolac400MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197685-Etodolac300MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197684-Etodolac200MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197682-Ethosuximide250MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197670-Estrogens,Esterified(USP)1.25MG/Methyltestosterone2.5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197659-Estradiol2MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197658-Estradiol1MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|Y||Preferred Generic|892646-MorphineSulfate200MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197657-Estradiol0.5MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|Y||Preferred Generic|891888-MorphineSulfate30MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|Y||Preferred Generic|891881-MorphineSulfate15MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197650-Erythromycin500MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|Y||Preferred Generic|891874-MorphineSulfate100MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|Y||Preferred Generic|883826-TranexamicAcid650MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197628-Doxazosin8MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|Y||Preferred Generic|835809-testosteroneenanthate200MG/MLInjectableSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197627-Doxazosin4MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|Y||Preferred Generic|313451-Tretinoin0.00025MG/MGTopicalGel|EXPANSION FULL DUALS 632|2002|Y|N|Y||Preferred Generic|313450-Tretinoin0.0001MG/MGTopicalGel|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197626-Doxazosin2MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|Y||Preferred Generic|312084-Ondansetron24MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197625-Doxazosin1MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|Y||Preferred Generic|245723-Tretinoin0.0005MG/MGTopicalGel|EXPANSION FULL DUALS 632|2002|Y|N|Y||Preferred Generic|198300-Tretinoin1MG/MLTopicalCream|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197624-Disulfiram500MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|Y||Preferred Generic|197636-dronabinol5MGOralCapsule|EXPANSION FULL DUALS 632|2002|Y|N|Y||Preferred Generic|197635-dronabinol2.5MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197623-Disulfiram250MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|Y||Preferred Generic|197634-dronabinol10MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197622-Dipyridamole50MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|Y||Preferred Generic|106302-Tretinoin0.25MG/MLTopicalCream|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197606-Digoxin0.25MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|Y||Preferred Brand|861771-Metforminhydrochloride1000MG/sitagliptin50MGOralTablet[Janumet]|EXPANSION FULL DUALS 632|2002|Y|N|Y||Preferred Brand|804547-difluprednate0.5MG/MLOphthalmicSuspension[Durezol]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197604-Digoxin0.125MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|Y||Preferred Brand|665044-sitagliptin50MGOralTablet[Januvia]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197596-Dicloxacillin500MGOralCapsule|EXPANSION FULL DUALS 632|2002|Y|N|Y||Preferred Brand|665036-sitagliptin100MGOralTablet[Januvia]|EXPANSION FULL DUALS 632|2002|Y|N|Y||Preferred Brand|1292435-0.65MLVaricella-ZosterVirusVaccineLive(Oka-Merck)strain29800UNT/MLInjection[Zostavax]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197595-Dicloxacillin250MGOralCapsule|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|999996-Amlodipine5MG/Hydrochlorothiazide12.5MG/Olmesartanmedoxomil40MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197583-Dexamethasone6MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|999986-Amlodipine10MG/Hydrochlorothiazide12.5MG/Olmesartanmedoxomil40MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|999967-Amlodipine5MG/Hydrochlorothiazide12.5MG/Olmesartanmedoxomil20MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197582-Dexamethasone4MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|998189-everolimus2.5MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|992395-gatifloxacin5MG/MLOphthalmicSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197581-Dexamethasone2MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|990982-2MLphysostigminesalicylate1MG/MLInjection|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197580-Dexamethasone1.5MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|904952-3MLibandronicacid1MG/MLPrefilledSyringe|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197579-Dexamethasone1MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|903847-PyridostigmineBromide180MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|903843-PyridostigmineBromide12MG/MLOralSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197577-Dexamethasone0.5MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|900164-24HRlamotrigine25MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197575-Desoximetasone0.0025MG/MGTopicalOintment|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|900038-PhentermineHydrochloride30MGOralCapsule|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|898715-pregabalin20MG/MLOralSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197558-Dapsone25MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|897021-12HRdalfampridine10MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197557-Dapsone100MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|892342-24HRMorphineSulfate30MGExtendedReleaseOralCapsule|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|886634-ButorphanolTartrate1MG/ACTUATMeteredDoseNasalSpray|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197553-Cyclosporine25MGOralCapsule|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|881341-adefovirdipivoxil10MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|876529-Amlodipine5MG/telmisartan80MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197518-Clindamycin150MGOralCapsule|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|876524-Amlodipine5MG/telmisartan40MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197517-Clarithromycin500MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|876514-Amlodipine10MG/telmisartan40MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197516-Clarithromycin250MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|864769-MethadoneHydrochloride2MG/MLOralSolution|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|864761-MethadoneHydrochloride1MG/MLOralSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197500-Chlorthalidone50MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|864718-MethadoneHydrochloride5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197499-Chlorthalidone25MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|864681-Atovaquone62.5MG/proguanilhydrochloride25MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|864675-Atovaquone250MG/proguanilhydrochloride100MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197454-Cephalexin500MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|863038-bepotastinebesilate15MG/MLOphthalmicSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197449-Cefaclor500MGOralCapsule|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|861375-sevelamercarbonate800MGPowderforOralSuspension|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|861370-sevelamercarbonate2400MGPowderforOralSuspension|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197448-Levocarnitine330MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|860901-galantaminehydrobromide4MG/MLOralSolution|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|860715-24HRgalantaminehydrobromide8MGExtendedReleaseOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197445-Carbidopa25MG/Levodopa250MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|860707-24HRgalantaminehydrobromide24MGExtendedReleaseOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197444-Carbidopa25MG/Levodopa100MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|860103-KetorolacTromethamine4MG/MLOphthalmicSolution|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|857700-DiclofenacSodium15MG/MLTopicalSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197443-Carbidopa10MG/Levodopa100MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|857224-Sevelamerhydrochloride800MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|857216-Sevelamerhydrochloride400MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197433-calciumacetate667MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|855642-DiclofenacSodium0.03MG/MGTopicalGel|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197411-Bromocriptine2.5MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|854894-Zolpidemtartrate6.25MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|854880-Zolpidemtartrate12.5MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197409-Betamethasone0.001MG/MGTopicalOintment|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|850091-24HRlamotrigine50MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197408-Betamethasone1MG/MLTopicalLotion|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|848151-Amlodipine10MG/Hydrochlorothiazide25MG/valsartan160MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|848145-Amlodipine5MG/Hydrochlorothiazide25MG/valsartan160MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197407-Betamethasone1MG/MLTopicalCream|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|848140-Amlodipine5MG/Hydrochlorothiazide12.5MG/valsartan160MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|848135-Amlodipine10MG/Hydrochlorothiazide25MG/valsartan320MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197405-Betamethasone0.0005MG/MGTopicalOintment|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|848131-Amlodipine10MG/Hydrochlorothiazide12.5MG/valsartan160MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197392-Baclofen20MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|834241-febuxostat80MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197391-Baclofen10MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|833234-mesalamine800MGDelayedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|824301-rufinamide400MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197388-Azathioprine50MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|824295-rufinamide200MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|810096-{7(EthinylEstradiol0.01MGOralTablet)/84(EthinylEstradiol0.02MG/Levonorgestrel0.1MGOralTablet)}Pack|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197383-Atenolol50MG/Chlorthalidone25MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|803353-PhentermineHydrochloride37.5MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|802749-candesartancilexetil32MG/Hydrochlorothiazide25MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197382-Atenolol100MG/Chlorthalidone25MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|794639-lubiprostone0.008MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197381-Atenolol50MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|728231-12HRranolazine1000MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|727339-0.5MLSumatriptan12MG/MLPrefilledSyringe|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197380-Atenolol25MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|725023-24HRrivastigmine0.396MG/HRTransdermalSystem|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|725021-24HRrivastigmine0.192MG/HRTransdermalSystem|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197379-Atenolol100MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|724863-armodafinil50MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197362-ammoniumlactate120MG/MLTopicalLotion|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|724859-armodafinil150MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197361-Amlodipine5MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|722116-ambrisentan10MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|705824-100MLzoledronicacid0.05MG/MLInjection|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197320-Allopurinol300MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|700885-temozolomide180MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197319-Allopurinol100MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|672149-lapatinib250MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|656659-bosentan125MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197318-Albuterol4MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|644088-aprepitant40MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197316-Albuterol2MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|639537-candesartancilexetil32MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|616749-12HRranolazine500MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197313-Acyclovir800MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|616578-lubiprostone0.024MGOralCapsule|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|603208-erlotinib25MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197311-Acyclovir400MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|603206-erlotinib150MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197310-Acyclovir200MGOralCapsule|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|602635-lanthanumcarbonate1000MGChewableTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197305-AceticAcid20MG/MLOticSolution|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|597770-deferasirox250MGTabletforOralSuspension|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|597768-deferasirox125MGTabletforOralSuspension|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197304-Acetazolamide250MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|579148-Galantamine12MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|197303-Acetazolamide125MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|578325-candesartancilexetil16MG/Hydrochlorothiazide12.5MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|578018-bromfenac0.9MG/MLOphthalmicSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1946772-Methotrexate25MG/MLInjectableSolution|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|577776-candesartancilexetil16MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1923809-thyroid(USP)120MGOralTablet[NPThyroid]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|577208-Omega-3AcidEthylEsters(USP)1000MGOralCapsule|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|577057-72HRFentanyl0.012MG/HRTransdermalSystem|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1923432-dorzolamide20MG/ML/Timolol5MG/MLOphthalmicSolution|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|545835-LeuprolideAcetate5MG/MLInjectableSolution|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|543218-1MLGranisetron0.1MG/MLInjection|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1923428-Timolol2.5MG/MLOphthalmicSolution|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|485489-Temazepam22.5MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1923426-SotalolHydrochloride80MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|485434-entecavir0.5MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|485423-24HRdarifenacin7.5MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1923424-SotalolHydrochloride160MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|485421-24HRdarifenacin15MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|477372-solifenacinsuccinate10MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1923422-SotalolHydrochloride120MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|477367-solifenacinsuccinate5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1870230-NDA0208000.3MLEpinephrine1MG/MLAuto-Injector|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|477130-Hydrochlorothiazide25MG/telmisartan80MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|465355-voriconazole40MG/MLOralSuspension|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1860100-ferroussulfate324MGDelayedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|403930-Isotretinoin30MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1855086-thyroid(USP)15MGOralTablet[NPThyroid]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|403878-imatinib100MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|403818-moxifloxacin5MG/MLOphthalmicSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1806189-30/70Release24HRMethylphenidateHydrochloride30MGExtendedReleaseOralCapsule|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|403811-aprepitant125MGOralCapsule|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|402506-12HRCarbamazepine400MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1806187-30/70Release24HRMethylphenidateHydrochloride20MGExtendedReleaseOralCapsule|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|402505-12HRCarbamazepine200MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1806181-30/70Release24HRMethylphenidateHydrochloride10MGExtendedReleaseOralCapsule|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|349435-voriconazole50MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1801298-MicroencapsulatedPotassiumChloride10MEQExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|349410-Treprostinil5MG/MLInjectableSolution|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|349409-Treprostinil2.5MG/MLInjectableSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1801294-MicroencapsulatedPotassiumChloride20MEQExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|349408-Treprostinil10MG/MLInjectableSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1801289-SmokingCessation12HRBupropionHydrochloride150MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|349253-bosentan62.5MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|348719-Tobramycin60MG/MLInhalationSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1797913-TriamcinoloneAcetonide0.055MG/ACTUATMeteredDoseNasalSpray|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|317160-temozolomide100MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1797907-Fluticasonepropionate0.05MG/ACTUATMeteredDoseNasalSpray|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|313211-temozolomide5MGOralCapsule|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|313210-temozolomide250MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1797867-Azelastinehydrochloride0.137MG/ACTUATMeteredDoseNasalSpray|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|313209-temozolomide20MGOralCapsule|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|313165-0.5MLSumatriptan12MG/MLInjection|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1797851-CromolynSodium5.2MG/ACTUATMeteredDoseNasalSpray|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|312835-rivastigmine3MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1738511-ParoxetineHydrochloride40MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|310599-Granisetron1MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1738503-ParoxetineHydrochloride30MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|310436-Galantamine4MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|283317-Hydrochlorothiazide12.5MG/telmisartan80MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1738495-ParoxetineHydrochloride20MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|283316-Hydrochlorothiazide12.5MG/telmisartan40MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1738483-ParoxetineHydrochloride10MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|245136-72HRFentanyl0.1MG/HRTransdermalSystem|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|245135-72HRFentanyl0.05MG/HRTransdermalSystem|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1731350-deferoxaminemesylate500MGInjection|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|245134-72HRFentanyl0.025MG/HRTransdermalSystem|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1731345-deferoxaminemesylate2000MGInjection|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|2198370-pretomanid200MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|2123194-PulmonaryHypertensiontadalafil20MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1724481-thyroid(USP)60MGOralTablet[NPThyroid]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|205324-modafinil200MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|205316-topiramate15MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1724439-thyroid(USP)30MGOralTablet[NPThyroid]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|205315-topiramate25MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1724437-thyroid(USP)90MGOralTablet[NPThyroid]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|200327-capecitabine150MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1665188-1MLLorazepam2MG/MLInjection|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|199521-Vigabatrin500MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|199378-12HRCarbamazepine100MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1665050-Cefazolin1000MGInjection|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|1988980-24HRpregabalin82.5MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1659263-1MLheparinsodium,porcine5000UNT/MLInjection|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|1988974-24HRpregabalin165MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|198243-Temazepam7.5MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1655968-8MLMethotrexate25MG/MLInjection|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|198200-Rifabutin150MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1648759-NITROFURANTOIN,MACROCRYSTALS100MGOralCapsule|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|198070-Penicillamine250MGOralCapsule|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|197845-Isotretinoin40MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1648755-NITROFURANTOIN,MACROCRYSTALS25MG/Nitrofurantoin,Monohydrate75MGOralCapsule|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|197844-Isotretinoin20MGOralCapsule|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|197843-Isotretinoin10MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1547771-Tetracainehydrochloride5MG/MLOphthalmicSolution|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|197730-Furosemide10MG/MLOralSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|152695-meloxicam15MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|1923828-deferasirox180MGOralGranules|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|1923826-deferasirox360MGOralGranules|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|151226-topiramate50MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|1923822-deferasirox90MGOralGranules|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|1918042-abirateroneacetate500MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1440184-hydrocortisoneacetate0.01MG/MGTopicalOintment|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|1874559-24HRdesvenlafaxinesuccinate50MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1437702-Albuterol0.833MG/ML/IpratropiumBromide0.167MG/MLInhalationSolution|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|1860157-Abuse-Deterrent12HROxycodoneHydrochloride10MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|1860154-Abuse-Deterrent12HROxycodoneHydrochloride15MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|142034-BenzoylPeroxide100MG/MLMedicatedLiquidSoap|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|1860151-Abuse-Deterrent12HROxycodoneHydrochloride30MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|141963-Azithromycin40MG/MLOralSuspension|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|1860137-Abuse-Deterrent12HROxycodoneHydrochloride40MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|1860129-Abuse-Deterrent12HROxycodoneHydrochloride20MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1376336-prednisoloneacetate10MG/MLOphthalmicSuspension|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|1860127-Abuse-Deterrent12HROxycodoneHydrochloride60MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|1799212-sofosbuvir400MG/velpatasvir100MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1367436-21DAYEthinylEstradiol0.000625MG/HR/Etonogestrel0.005MG/HRVaginalSystem|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|1796690-1MLhydroxyprogesteronecaproate(USP)250MG/MLInjection|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1367410-Ergocalciferol1.25MGOralCapsule|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|1745091-Lidocaine0.05MG/MGMedicatedPatch|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1366116-bacitracinzinc0.5UNT/MGTopicalOintment|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|1737459-PamidronateDisodium30MGInjection|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|1734399-1MLGranisetron1MG/MLInjection|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1363309-ChlorpheniramineMaleate4MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|1728055-5MLpalonosetron0.05MG/MLInjection|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|1657173-0.5MLSumatriptan8MG/MLCartridge|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1362720-MexiletineHydrochloride250MGOralCapsule|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|1657160-0.5MLSumatriptan12MG/MLCartridge|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|1607990-{24(EthinylEstradiol0.025MG/Norethindrone0.8MGChewableTablet)/4(Ferrousfumarate75MGChewableTablet)}Pack|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1362712-MexiletineHydrochloride200MGOralCapsule|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|1607796-deferasirox90MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1362706-MexiletineHydrochloride150MGOralCapsule|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|1607784-deferasirox180MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|1607617-24HRdesvenlafaxinesuccinate25MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1359858-Fluticasonepropionate0.5MG/ACTUAT/salmeterol0.05MG/ACTUATDryPowderInhaler|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|1599949-60ACTUATTestosterone30MG/ACTUATTopicalSolution|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|1597129-5000MGTestosterone0.01MG/MGTopicalGel|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1359779-Fluticasonepropionate0.1MG/ACTUAT/salmeterol0.05MG/ACTUATDryPowderInhaler|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|1597123-2500MGTestosterone0.01MG/MGTopicalGel|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1359117-{24(EthinylEstradiol0.02MG/norethindroneacetate1MGOralTablet)/4(Ferrousfumarate75MGOralTablet)}Pack|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|1547565-Isotretinoin35MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1313885-Phenytoin50MGChewableTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|153823-candesartancilexetil8MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|153822-candesartancilexetil4MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1313112-Phenytoin25MG/MLOralSuspension|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|1490065-RaloxifeneHydrochloride60MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1298072-Cyclopentolatehydrochloride5MG/MLOphthalmicSolution|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|1435115-28ACTUATTeriparatide0.02MG/ACTUATPenInjector|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|1426600-{24(EthinylEstradiol0.02MG/norethindroneacetate1MGChewableTablet)/4(Ferrousfumarate75MGOralTablet)}Pack|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1298070-Cyclopentolatehydrochloride20MG/MLOphthalmicSolution|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|1373503-{7(EthinylEstradiol0.01MGOralTablet)/42(EthinylEstradiol0.02MG/Levonorgestrel0.15MGOralTablet)/21(EthinylEstradiol0.0|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1298066-Cyclopentolatehydrochloride10MG/MLOphthalmicSolution|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|1373491-dimethylfumarate240MGDelayedReleaseOralCapsule|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|1373483-dimethylfumarate120MGDelayedReleaseOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1291082-hydrocortisoneacetate25MGRectalSuppository|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|1366550-24HRBudesonide9MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|1360304-Budesonide0.08MG/ACTUAT/formoterolfumarate0.0045MG/ACTUATMeteredDoseInhaler|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1250490-hydrocortisoneacetate5MG/MLTopicalCream|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|1359861-Budesonide0.16MG/ACTUAT/formoterolfumarate0.0045MG/ACTUATMeteredDoseInhaler|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1245919-Marlissa28DayPack|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|1307427-sildenafil10MG/MLOralSuspension|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1245468-DocusateSodium250MGOralCapsule|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|1299917-Tiagabinehydrochloride4MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|1299911-Tiagabinehydrochloride2MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1245230-chlorhexidinegluconate20MG/MLMedicatedLiquidSoap|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|1299909-Tiagabinehydrochloride16MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1243585-Flurbiprofensodium0.3MG/MLOphthalmicSolution|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|1146690-24HRlamotrigine250MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|1119400-everolimus7.5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1242787-Alyacen7/7/7Kit|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|1111641-1MLglatirameracetate20MG/MLPrefilledSyringe|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|1100075-abirateroneacetate250MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1242786-Alyacen1/3528-DayKit|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|1098608-24HRlamotrigine300MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|1299903-Tiagabinehydrochloride12MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|1095229-FlavoxateHydrochloride100MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1234571-PhenylephrineHydrochloride100MG/MLOphthalmicSolution|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|1092357-rufinamide40MG/MLOralSuspension|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|1087964-hydroxyprogesteronecaproate(USP)250MG/MLInjectableSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1193362-100MLLevetiracetam5MG/MLInjection|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|1050493-{21(drospirenone3MG/EthinylEstradiol0.03MG/levomefolatecalcium0.451MGOralTablet)/7(levomefolatecalcium0.451MGOralTabl|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|1013629-{24(drospirenone3MG/EthinylEstradiol0.02MG/levomefolatecalcium0.451MGOralTablet)/4(levomefolatecalcium0.451MGOralTabl|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1193360-100MLLevetiracetam15MG/MLInjection|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|1011739-aliskiren300MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|1011736-aliskiren150MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1193358-100MLLevetiracetam10MG/MLInjection|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|1000001-Amlodipine5MG/Hydrochlorothiazide25MG/Olmesartanmedoxomil40MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|995156-lacosamide10MG/MLOralSolution[Vimpat]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1191315-FluocinoloneAcetonide0.25MG/MLTopicalCream|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|993456-1MLdenosumab60MG/MLPrefilledSyringe[Prolia]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|979115-0.6MLMethylnaltrexonebromide20MG/MLInjection[Relistor]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1191310-FluocinoloneAcetonide0.1MG/MLTopicalSolution|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|978950-Natazia28DayPack|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|903855-2MLPyridostigmineBromide5MG/MLInjection[Regonol]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1191256-FluocinoloneAcetonide0.00025MG/MGTopicalOintment|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|902626-dexlansoprazole60MGDelayedReleaseOralCapsule[Dexilant]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|902624-dexlansoprazole30MGDelayedReleaseOralCapsule[Dexilant]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1191013-Proparacainehydrochloride5MG/MLOphthalmicSolution|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|901614-Aztreonam75MG/MLInhalationSolution[Cayston]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|1304979-icosapentethyl1000MGOralCapsule|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|897126-3MLliraglutide6MG/MLPenInjector[Victoza]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1190655-AtropineSulfate10MG/MLOphthalmicSolution|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|896273-120ACTUATFluticasonepropionate0.23MG/ACTUAT/salmeterol0.021MG/ACTUATMeteredDoseInhaler[Advair]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|896245-120ACTUATFluticasonepropionate0.115MG/ACTUAT/salmeterol0.021MG/ACTUATMeteredDoseInhaler[Advair]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1190572-AtropineSulfate0.025MG/DiphenoxylateHydrochloride2.5MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|896237-120ACTUATFluticasonepropionate0.045MG/ACTUAT/salmeterol0.021MG/ACTUATMeteredDoseInhaler[Advair]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|884619-eltrombopag75MGOralTablet[Promacta]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1190570-AtropineSulfate0.01MG/MGOphthalmicOintment|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|867506-pazopanib200MGOralTablet[Votrient]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|864820-Oxybutyninchloride0.1MG/MGTopicalGel[Gelnique]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1190568-AtropineSulfate0.005MG/ML/DiphenoxylateHydrochloride0.5MG/MLOralSolution|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|861966-Iloprost0.02MG/MLInhalationSolution[Ventavis]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|861045-1.5MLpramlintideacetate1MG/MLPenInjector[Symlin]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1150836-LevobunololHydrochloride5MG/MLOphthalmicSolution|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|861043-2.7MLpramlintideacetate1MG/MLPenInjector[Symlin]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|860898-Vigabatrin500MGPowderforOralSolution[Sabril]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1116758-chloroquinephosphate500MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|860244-interferonbeta-1b0.3MGInjection[Extavia]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|858366-KetorolacTromethamine4.5MG/MLOphthalmicSolution[Acuvail]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1116150-bacitracinzinc0.4UNT/MG/hydrocortisoneacetate0.01MG/MG/NeomycinSulfate0.0035MG/MG/PolymyxinBSulfate10UNT/MGOphthalmic|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|1308569-24HRrivastigmine0.554MG/HRTransdermalSystem|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|858044-saxagliptin2.5MGOralTablet[Onglyza]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|858040-saxagliptin5MGOralTablet[Onglyza]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1115005-DocusateSodium100MGOralCapsule|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|857799-Treprostinil0.6MG/MLInhalationSolution[Tyvaso]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|854852-lisdexamfetaminedimesylate50MGOralCapsule[Vyvanse]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1100457-PyridoxineHydrochloride25MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|854848-lisdexamfetaminedimesylate60MGOralCapsule[Vyvanse]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|854844-lisdexamfetaminedimesylate70MGOralCapsule[Vyvanse]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1099870-DivalproexSodium500MGDelayedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|854840-lisdexamfetaminedimesylate40MGOralCapsule[Vyvanse]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|854836-lisdexamfetaminedimesylate30MGOralCapsule[Vyvanse]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1099687-ValproicAcid50MG/MLOralSolution|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|854832-lisdexamfetaminedimesylate20MGOralCapsule[Vyvanse]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|853356-1MLustekinumab90MG/MLPrefilledSyringe[Stelara]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1099681-ValproicAcid250MGOralCapsule|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|853354-0.5MLustekinumab90MG/MLPrefilledSyringe[Stelara]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|849599-1MLcertolizumabpegol200MG/MLPrefilledSyringe[Cimzia]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1099678-DivalproexSodium250MGDelayedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|848164-0.5MLgolimumab100MG/MLPrefilledSyringe[Simponi]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|847917-60ACTUATexenatide0.005MG/ACTUATPenInjector[Byetta]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1099648-5MLValproicAcid100MG/MLInjection|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|847913-60ACTUATexenatide0.01MG/ACTUATPenInjector[Byetta]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|845512-everolimus10MGOralTablet[Afinitor]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1099625-DivalproexSodium125MGDelayedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|836649-Zolpidemtartrate5MGSublingualTablet[Edluar]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|836645-Zolpidemtartrate10MGSublingualTablet[Edluar]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1099596-DivalproexSodium125MGDelayedReleaseOralCapsule|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|828703-1.2MLPlerixafor20MG/MLInjection[Mozobil]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|1373497-{14(dimethylfumarate120MGDelayedReleaseOralCapsule)/46(dimethylfumarate240MGDelayedReleaseOralCapsule)}Pack|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|828696-Zolpidemtartrate5MG/ACTUATOralSpray[Zolpimist]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1099569-24HRDivalproexSodium500MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|828364-hydrocortisoneacetate10MG/ML/Pramoxinehydrochloride10MG/MLRectalFoam[Proctofoam-HC]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|825429-eltrombopag50MGOralTablet[Promacta]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1099563-24HRDivalproexSodium250MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|825425-eltrombopag25MGOralTablet[Promacta]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|825170-HumiraPen40MG/0.8ML-Crohn'sDiseaseStarterPack|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1099316-DesipramineHydrochloride75MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|810079-24HRFesoterodineFumarate8MGExtendedReleaseOralTablet[Toviaz]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|810075-24HRFesoterodineFumarate4MGExtendedReleaseOralTablet[Toviaz]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1099304-DesipramineHydrochloride50MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|810002-lacosamide50MGOralTablet[Vimpat]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|809998-lacosamide200MGOralTablet[Vimpat]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1099300-DesipramineHydrochloride25MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|809994-lacosamide150MGOralTablet[Vimpat]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|809990-lacosamide100MGOralTablet[Vimpat]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1099296-DesipramineHydrochloride150MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|809159-0.5MLEtanercept50MG/MLPrefilledSyringe[Enbrel]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|802652-1MLEtanercept50MG/MLPrefilledSyringe[Enbrel]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1099292-DesipramineHydrochloride100MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|799830-dasatinib100MGOralTablet[Sprycel]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|795749-RebifTitrationPack|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1099288-DesipramineHydrochloride10MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|795085-certolizumabpegol200MGInjection[Cimzia]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|1487361-1MLglatirameracetate40MG/MLPrefilledSyringe|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|763565-0.4MLadalimumab50MG/MLPrefilledSyringe[Humira]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1098134-24HRNiacin1000MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|758032-0.5MLInterferonbeta-1a0.044MG/MLPrefilledSyringe[Rebif]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|758027-0.5MLInterferonbeta-1a0.088MG/MLPrefilledSyringe[Rebif]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1095725-ClemastineFumarate1.34MGOralTablet[Dayhist-1]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|753443-9HRMethylphenidate3.33MG/HRTransdermalSystem[Daytrana]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|753442-9HRMethylphenidate2.22MG/HRTransdermalSystem[Daytrana]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1094543-Briellyn28DayPack|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|753437-9HRMethylphenidate1.11MG/HRTransdermalSystem[Daytrana]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|748740-Topotecan1MGOralCapsule[Hycamtin]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1094107-Phenazopyridinehydrochloride100MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|748738-Topotecan0.25MGOralCapsule[Hycamtin]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|746609-nilotinib200MGOralCapsule[Tasigna]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1094104-Phenazopyridinehydrochloride200MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|731250-0.3MLdarbepoetinalfa0.2MG/MLPrefilledSyringe[Aranesp]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|731245-0.42MLdarbepoetinalfa0.06MG/MLPrefilledSyringe[Aranesp]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1085745-TriamcinoloneAcetonide1MG/MLTopicalLotion|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|731241-1MLdarbepoetinalfa0.5MG/MLPrefilledSyringe[Aranesp]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|731235-0.4MLdarbepoetinalfa0.5MG/MLPrefilledSyringe[Aranesp]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1085741-TriamcinoloneAcetonide0.25MG/MLTopicalLotion|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|731231-0.3MLdarbepoetinalfa0.5MG/MLPrefilledSyringe[Aranesp]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|731229-0.6MLdarbepoetinalfa0.5MG/MLPrefilledSyringe[Aranesp]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1085686-TriamcinoloneAcetonide5MG/MLTopicalCream|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|731227-0.4MLdarbepoetinalfa0.1MG/MLPrefilledSyringe[Aranesp]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|1547561-Isotretinoin25MGOralCapsule|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|730046-0.5MLdarbepoetinalfa0.2MG/MLPrefilledSyringe[Aranesp]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1085644-TriamcinoloneAcetonide0.25MG/MLTopicalCream|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|727816-0.5MLInterferonbeta-1a0.06MG/MLPrefilledSyringe[Avonex]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|727714-0.67MLanakinra149MG/MLPrefilledSyringe[Kineret]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1085640-TriamcinoloneAcetonide0.005MG/MGTopicalOintment|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|727705-0.8MLadalimumab50MG/MLPrefilledSyringe[Humira]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|723846-orlistat60MGOralCapsule[Alli]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1085636-TriamcinoloneAcetonide0.001MG/MGTopicalOintment|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|706872-Azithromycin10MG/MLOphthalmicSolution[AzaSite]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|700418-Thalidomide150MGOralCapsule[Thalomid]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1085633-TriamcinoloneAcetonide0.00025MG/MGTopicalOintment|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|668606-Vorinostat100MGOralCapsule[Zolinza]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|643722-lenalidomide25MGOralCapsule[Revlimid]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|106387-Permethrin50MG/MLTopicalCream|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|643714-lenalidomide15MGOralCapsule[Revlimid]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|643488-Isotretinoin30MGOralCapsule[Claravis]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|106351-SilverSulfadiazine10MG/MLTopicalCream|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|643177-dasatinib70MGOralTablet[Sprycel]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|643175-dasatinib50MGOralTablet[Sprycel]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|106336-Ketoconazole20MG/MLMedicatedShampoo|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|1591943-ledipasvir90MG/sofosbuvir400MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|643173-dasatinib20MGOralTablet[Sprycel]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|616292-sunitinib50MGOralCapsule[Sutent]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|106258-Hydrocortisone10MG/MLTopicalCream|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|616287-sunitinib25MGOralCapsule[Sutent]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|616283-sunitinib12.5MGOralCapsule[Sutent]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|105585-Methotrexate2.5MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|616116-lenalidomide5MGOralCapsule[Revlimid]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|616114-lenalidomide10MGOralCapsule[Revlimid]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|105583-Fluorouracil50MG/MLTopicalCream|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|616018-abatacept250MGInjection[Orencia]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|615979-sorafenib200MGOralTablet[Nexavar]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1053753-Nystatin100000UNT/ML/TriamcinoloneAcetonide1MG/MLTopicalCream|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|607579-entecavir0.05MG/MLOralSolution[Baraclude]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|603978-nepafenac1MG/MLOphthalmicSuspension[Nevanac]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1053697-Nystatin100UNT/MG/TriamcinoloneAcetonide0.001MG/MGTopicalOintment|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|602862-magnesiumaminoacidchelate133MGOralTablet[MGPlusProtein]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|582595-Iloprost0.01MG/MLInhalationSolution[Ventavis]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|105292-isoniazid10MG/MLOralSolution|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|580286-mesalamine500MGExtendedReleaseOralCapsule[Pentasa]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|540181-alosetron0.5MGOralTablet[Lotronex]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1052760-magnesiumcitrate58.2MG/MLOralSolution|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|404450-Thalidomide200MGOralCapsule[Thalomid]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|404449-Thalidomide100MGOralCapsule[Thalomid]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1050077-DiphenhydramineHydrochloride20MG/MLTopicalCream|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|404065-Isotretinoin40MGOralCapsule[Claravis]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|404062-Isotretinoin20MGOralCapsule[Claravis]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1049909-DiphenhydramineHydrochloride25MGOralCapsule|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|404059-Isotretinoin10MGOralCapsule[Claravis]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|1607792-deferasirox360MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|352262-1MLdarbepoetinalfa0.3MG/MLInjection[Aranesp]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1049906-DiphenhydramineHydrochloride2.5MG/MLOralSolution|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|352047-1MLdarbepoetinalfa0.1MG/MLInjection[Aranesp]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|352046-1MLdarbepoetinalfa0.06MG/MLInjection[Aranesp]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1049630-DiphenhydramineHydrochloride25MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|352045-1MLdarbepoetinalfa0.04MG/MLInjection[Aranesp]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|352044-1MLdarbepoetinalfa0.025MG/MLInjection[Aranesp]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1049167-PseudoephedrineHydrochloride60MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|261362-alosetron1MGOralTablet[Lotronex]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|261105-Etanercept25MG/MLInjectableSolution[Enbrel]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|104884-Metoclopramide1MG/MLOralSolution|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2559707-1.14MLdupilumab175MG/MLAuto-Injector[Dupixent]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2557216-trikafta50MG/37.5MG/25MGand75MGPack|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1047905-HyoscyamineSulfate0.125MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2550713-0.5MLsecukinumab150MG/MLPrefilledSyringe[Cosentyx]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2536758-24HRviloxazine200MGExtendedReleaseOralCapsule[Qelbree]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1047895-HyoscyamineSulfate0.125MG/MLOralSolution|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2536752-24HRviloxazine150MGExtendedReleaseOralCapsule[Qelbree]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2536554-24HRviloxazine100MGExtendedReleaseOralCapsule[Qelbree]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1047881-HyoscyamineSulfate0.025MG/MLOralSolution|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2531134-HumiraPen80MG/0.8ML-StarterPackageforPediatricUlcerativeColitis(4count)|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2475860-vericiguat5MGOralTablet[Verquvo]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1046985-HyoscyamineSulfate0.125MGDisintegratingOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2475856-vericiguat2.5MGOralTablet[Verquvo]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2475852-vericiguat10MGOralTablet[Verquvo]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1043690-hydrocortisoneacetate10MG/MLTopicalCream|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2475406-voclosporin7.9MGOralCapsule[Lupkynis]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2473042-ponatinib10MGOralTablet[Iclusig]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|103951-Tolnaftate10MG/MLTopicalCream|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2463737-epoetinalfa-epbx20000UNT/MLInjectableSolution[Retacrit]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2463733-epoetinalfa-epbx10000UNT/MLInjectableSolution[Retacrit]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|103457-Fluocinonide0.0005MG/MGTopicalOintment|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2395775-30ACTUATfluticasonefuroate0.2MG/ACTUAT/umeclidinium0.0625MG/ACTUAT/vilanterol0.025MG/ACTUATDryPowderInhaler[Trelegy]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2392142-0.5MLetanercept50MG/MLInjection[Enbrel]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|103456-Fluocinonide0.5MG/MLTopicalCream|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2387331-120ACTUATbudesonide0.16MG/ACTUAT/formoterolfumarate0.0048MG/ACTUAT/glycopyrrolate0.009MG/ACTUATMeteredDoseInhaler[Bre|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2373941-bedaquiline20MGOralTablet[Sirturo]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|103403-Hydrocortisone10MG/MLTopicalLotion|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2371768-Oriahnn28DayKit|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2359358-24HRempagliflozin5MG/linagliptin2.5MG/metforminhydrochloride1000MGExtendedReleaseOralTablet[Trijardy]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|103401-Hydrocortisone0.025MG/MGTopicalOintment|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2359353-24HRempagliflozin25MG/linagliptin5MG/metforminhydrochloride1000MGExtendedReleaseOralTablet[Trijardy]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2359290-24HRempagliflozin12.5MG/linagliptin2.5MG/metforminhydrochloride1000MGExtendedReleaseOralTablet[Trijardy]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1020477-DiphenhydramineHydrochloride50MGOralCapsule|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2359285-24HRempagliflozin10MG/linagliptin5MG/metforminhydrochloride1000MGExtendedReleaseOralTablet[Trijardy]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2287905-1.5MLfremanezumab-vfrm150MG/MLAuto-Injector[Ajovy]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1014678-cetirizinehydrochloride10MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2283236-bempedoicacid180MG/ezetimibe10MGOralTablet[Nexlizet]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|1737461-PamidronateDisodium90MGInjection|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2282414-bempedoicacid180MGOralTablet[Nexletol]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1014676-cetirizinehydrochloride5MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2282320-Rimegepant75MGDisintegratingOralTablet[Nurtec]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2273115-24HRtofacitinib22MGExtendedReleaseOralTablet[Xeljanz]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1014673-cetirizinehydrochloride1MG/MLOralSolution|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|226917-orlistat120MGOralCapsule[Xenical]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2268231-ubrogepant50MGOralTablet[Ubrelvy]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1014571-12HRcetirizinehydrochloride5MG/PseudoephedrineHydrochloride120MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2268227-ubrogepant100MGOralTablet[Ubrelvy]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2265689-Voxelotor500MGOralTablet[Oxbryta]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1014314-TriamcinoloneAcetonide1MG/MLTopicalCream|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2262731-MicronizedIsotretinoin8MGOralCapsule[Absorica]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2262727-MicronizedIsotretinoin32MGOralCapsule[Absorica]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1012021-Prednisolonesodiumphosphate2.5MG/ML/SulfacetamideSodium100MG/MLOphthalmicSolution|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2262719-MicronizedIsotretinoin24MGOralCapsule[Absorica]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2262713-MicronizedIsotretinoin16MGOralCapsule[Absorica]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1011852-LidocaineHydrochloride0.02MG/MGTopicalGel|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2257013-trikafta100MG/50MG/75MGand150MGPack|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2256947-lasmiditan50MGOralTablet[Reyvow]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1010878-LidocaineHydrochloride40MG/MLMucousMembraneTopicalSolution|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|1793916-0.5MLSumatriptan8MG/MLAuto-Injector|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2256943-lasmiditan100MGOralTablet[Reyvow]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2205634-1MLbenralizumab30MG/MLAuto-Injector[Fasenra]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1006688-SulfacetamideSodium100MG/MLTopicalLotion|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2203897-ledipasvir45MG/sofosbuvir200MGOralTablet[Harvoni]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2203893-sofosbuvir200MGOralTablet[Sovaldi]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1006120-SulfacetamideSodium100MG/MLOphthalmicSolution|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2201540-romiplostim0.125MGInjection[Nplate]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2196592-120ACTUATformoterolfumarate0.005MG/ACTUAT/mometasonefuroate0.05MG/ACTUATMeteredDoseInhaler[Dulera]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1005856-SulfacetamideSodium100MG/ML/Sulfur50MG/MLTopicalLotion|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2182340-1MLEtanercept50MG/MLCartridge[Enbrel]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2174390-symdeko50MG/75MGand75MGPack|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1000897-PilocarpineHydrochloride40MG/MLOphthalmicSolution|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2173822-1MLmepolizumab100MG/MLPrefilledSyringe[Nucala]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2170993-1MLmepolizumab100MG/MLAuto-Injector[Nucala]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1000862-PilocarpineHydrochloride20MG/MLOphthalmicSolution|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2170613-1MLgalcanezumab-gnlm100MG/MLPrefilledSyringe[Emgality]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2166401-ivacaftor25MGOralGranules[Kalydeco]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1000673-SulfacetamideSodium0.1MG/MGOphthalmicOintment|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|213475-1MLEpoetinAlfa40000UNT/MLInjection[Procrit]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|213360-Thalidomide50MGOralCapsule[Thalomid]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1000647-PilocarpineHydrochloride10MG/MLOphthalmicSolution|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2123314-Mayzent0.25MGStarterPack|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|212219-EpoetinAlfa20000UNT/MLInjectableSolution[Procrit]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1000141-medroxyprogesteroneacetate5MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|212218-EpoetinAlfa20000UNT/MLInjectableSolution[Epogen]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2121100-siponimod2MGOralTablet[Mayzent]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1000135-medroxyprogesteroneacetate2.5MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2121096-siponimod0.25MGOralTablet[Mayzent]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2120195-1MLerenumab-aooe140MG/MLAuto-Injector[Aimovig]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1000114-medroxyprogesteroneacetate10MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2119391-Spravato56MGDoseKit|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2119389-Spravato84MGDoseKit|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1000097-DoxepinHydrochloride75MGOralCapsule|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2107355-prucalopride2MGOralTablet[Motegrity]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2107351-prucalopride1MGOralTablet[Motegrity]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1000076-DoxepinHydrochloride50MGOralCapsule|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2106362-rifamycinSV194MGDelayedReleaseOralTablet[Aemcolo]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2106075-0.9MLtocilizumab180MG/MLAuto-Injector[Actemra]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1000070-DoxepinHydrochloride25MGOralCapsule|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2102705-0.6MLpegfilgrastim-cbqv10MG/MLPrefilledSyringe[Udenyca]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|208083-sargramostim0.25MG/MLInjectableSolution[Leukine]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1000064-DoxepinHydrochloride150MGOralCapsule|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|207059-interferonbeta-1b0.3MGInjection[Betaseron]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|206791-mesalamine250MGExtendedReleaseOralCapsule[Pentasa]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1000058-DoxepinHydrochloride100MGOralCapsule|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|205924-1MLEpoetinAlfa4000UNT/MLInjection[Procrit]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|205923-1MLEpoetinAlfa4000UNT/MLInjection[Epogen]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1000054-DoxepinHydrochloride10MG/MLOralSolution|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|205922-1MLEpoetinAlfa3000UNT/MLInjection[Procrit]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|205921-1MLEpoetinAlfa3000UNT/MLInjection[Epogen]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|1000048-DoxepinHydrochloride10MGOralCapsule|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2059189-amikacinliposomal70.3MG/MLInhalationSuspension[Arikayce]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|1874553-24HRdesvenlafaxinesuccinate100MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|205918-1MLEpoetinAlfa2000UNT/MLInjection[Procrit]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|993804-Gianvi28-DayPack|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|205917-1MLEpoetinAlfa2000UNT/MLInjection[Epogen]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|205913-EpoetinAlfa10000UNT/MLInjectableSolution[Procrit]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|992759-Homatropinehydrobromide50MG/MLOphthalmicSolution[Homatropaire]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|205912-EpoetinAlfa10000UNT/MLInjectableSolution[Epogen]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2058950-0.5MLomalizumab150MG/MLPrefilledSyringe[Xolair]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|992481-PromethazineHydrochloride50MGRectalSuppository[Promethegan]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2058946-1MLomalizumab150MG/MLPrefilledSyringe[Xolair]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2058906-cannabidiol100MG/MLOralSolution[Epidiolex]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|991233-bexarotene0.01MG/MGTopicalGel[Targretin]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2058887-1MLgalcanezumab-gnlm120MG/MLPrefilledSyringe[Emgality]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2058877-1MLgalcanezumab-gnlm120MG/MLAuto-Injector[Emgality]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|967012-POLYETHYLENEGLYCOL3350236000MG/PotassiumChloride2970MG/SodiumBicarbonate6740MG/SodiumChloride5860MG/sodiumsulfate22740|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2057216-0.8MLfilgrastim-aafi0.6MG/MLPrefilledSyringe[Nivestym]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2057205-0.5MLfilgrastim-aafi0.6MG/MLPrefilledSyringe[Nivestym]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|905379-HydralazineHydrochloride37.5MG/IsosorbideDinitrate20MGOralTablet[Bidil]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2056700-1.5MLfremanezumab-vfrm150MG/MLPrefilledSyringe[Ajovy]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2056670-AimovigAutoinjector2-Pack(140MGDose)|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|896031-28ACTUATFluticasonepropionate0.1MG/ACTUATDryPowderInhaler[Flovent]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|205532-DornaseAlfa1MG/MLInhalationSolution[Pulmozyme]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2054995-lusutrombopag3MGOralTablet[Mulpleta]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|896019-60ACTUATFluticasonepropionate0.05MG/ACTUATDryPowderInhaler[Flovent]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2053519-ivacaftor188MG/lumacaftor150MGOralGranules[ORKAMBI]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2053512-ivacaftor125MG/lumacaftor100MGOralGranules[ORKAMBI]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|896006-120ACTUATFluticasonepropionate0.22MG/ACTUATMeteredDoseInhaler[Flovent]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2048568-tofacitinib10MGOralTablet[Xeljanz]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2048025-0.6MLpegfilgrastim-jmdb10MG/MLPrefilledSyringe[Fulphila]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|896001-120ACTUATFluticasonepropionate0.11MG/ACTUATMeteredDoseInhaler[Flovent]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2047623-1MLepoetinalfa-epbx40000UNT/MLInjection[Retacrit]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2047614-1MLepoetinalfa-epbx4000UNT/MLInjection[Retacrit]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|895996-120ACTUATFluticasonepropionate0.044MG/ACTUATMeteredDoseInhaler[Flovent]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2047608-1MLepoetinalfa-epbx3000UNT/MLInjection[Retacrit]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2047602-1MLepoetinalfa-epbx2000UNT/MLInjection[Retacrit]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|890786-Butoconazolenitrate20MG/MLVaginalCream[Gynazole-1]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2047596-1MLepoetinalfa-epbx10000UNT/MLInjection[Retacrit]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2045961-Doptelet60MGDailyDoseCartonPack|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|866049-60ACTUATsalmeterol0.05MG/ACTUATDryPowderInhaler[Serevent]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2045959-Doptelet40MGDailyDoseCartonPack|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2045638-1MLerenumab-aooe70MG/MLAuto-Injector[Aimovig]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|864010-ammoniumlactate120MG/MLTopicalLotion[Geri-Hydrolac]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2003767-1.14MLsarilumab175MG/MLAuto-Injector[Kevzara]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2003757-1.14MLsarilumab132MG/MLAuto-Injector[Kevzara]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|863841-amylase60000UNT/lipase12000UNT/protease38000UNTDelayedReleaseOralCapsule[Creon]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|197696-72HRFentanyl0.075MG/HRTransdermalSystem|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2001321-Roflumilast0.25MGOralTablet[Daliresp]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|2000013-1.1MLhydroxyprogesteronecaproate(USP)250MG/MLAuto-Injector[Makena]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|863836-amylase30000UNT/lipase6000UNT/protease19000UNTDelayedReleaseOralCapsule[Creon]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1999389-symdeko100MG/150MGand150MGPack|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1990869-0.85MLexenatide2.35MG/MLAuto-Injector[Bydureon]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|863829-amylase120000UNT/lipase24000UNT/protease76000UNTDelayedReleaseOralCapsule[Creon]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1989109-1MLbenralizumab30MG/MLPrefilledSyringe[Fasenra]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1989085-bosentan32MGTabletforOralSuspension[Tracleer]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|861834-amylase82000UNT/lipase15000UNT/protease51000UNTDelayedReleaseOralCapsule[Zenpep]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1946522-4-Month1.5MLLeuprolideAcetate20MG/MLPrefilledSyringe[Lupron]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1946520-3-Month1.5MLLeuprolideAcetate20MG/MLPrefilledSyringe[Lupron]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|856467-Tri-Lo-Sprintec28DayPack|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1945048-30ACTUATfluticasonefuroate0.1MG/ACTUAT/umeclidinium0.0625MG/ACTUAT/vilanterol0.025MG/ACTUATDryPowderInhaler[Trelegy]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1927290-infliximab-abda100MGInjection[Renflexis]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|855871-Phenytoinsodium30MGExtendedReleaseOralCapsule[Dilantin]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1925257-0.7MLabatacept125MG/MLPrefilledSyringe[Orencia]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1925255-0.4MLabatacept125MG/MLPrefilledSyringe[Orencia]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|855205-docosanol100MG/MLTopicalCream[Abreva]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1923347-1.14MLsarilumab175MG/MLPrefilledSyringe[Kevzara]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1923338-1.14MLsarilumab132MG/MLPrefilledSyringe[Kevzara]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|854921-BisoprololFumarate5MG/Hydrochlorothiazide6.25MGOralTablet[Ziac]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1921468-HumiraPen80MG/0.8MLand40MG/0.4ML-Psoriasis/UveitisStarterPackage(3count)|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1921245-HumiraPen80MG/0.8ML-StarterPackageforCrohn'sDisease,UlcerativeColitisorHidradenitisSuppurativa(3count)|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|854918-BisoprololFumarate2.5MG/Hydrochlorothiazide6.25MGOralTablet[Ziac]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1921240-0.8MLadalimumab100MG/MLAuto-Injector[Humira]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1921081-1.56MLabaloparatide2MG/MLPenInjector[Tymlos]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|854910-BisoprololFumarate10MG/Hydrochlorothiazide6.25MGOralTablet[Ziac]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1921017-0.2MLadalimumab100MG/MLPrefilledSyringe[Humira]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|198071-Penicillamine250MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1921010-0.1MLadalimumab100MG/MLPrefilledSyringe[Humira]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|845305-Nonoxynol-90.04MG/MGVaginalGel[Conceptrol]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1876609-naldemedine0.2MGOralTablet[Symproic]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1873765-plecanatide3MGOralTablet[Trulance]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|836368-200ACTUATIpratropiumBromide0.017MG/ACTUATMeteredDoseInhaler[Atrovent]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1873704-Mibelas24FeChewable28DayPack|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1873087-HumiraPrefilledSyringe80MG/0.8MLStarterPack-PediatricCrohn'sDisease(3count)|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|830470-1MLrabiesvirusvaccinewistarstrainPM-1503-3M(Human),Inactivated2.5UNT/MLInjection[Imovax]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1872980-0.4MLadalimumab100MG/MLAuto-Injector[Humira]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1871469-lisdexamfetaminedimesylate50MGChewableTablet[Vyvanse]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|830463-1MLrabiesvirusvaccineflury-lepstrain2.5UNT/MLInjection[RabAvert]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1871467-lisdexamfetaminedimesylate60MGChewableTablet[Vyvanse]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1871465-lisdexamfetaminedimesylate10MGChewableTablet[Vyvanse]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|827713-MineralOil0.03MG/MG/Petrolatum0.94MG/MGOphthalmicOintment[SystaneNighttime]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1871463-lisdexamfetaminedimesylate20MGChewableTablet[Vyvanse]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1871461-lisdexamfetaminedimesylate30MGChewableTablet[Vyvanse]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|808118-prednisolone5MGOralTablet[MILLIPRED]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1871459-lisdexamfetaminedimesylate40MGChewableTablet[Vyvanse]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1870968-deflazacort22.75MG/MLOralSuspension[Emflaza]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|797023-DexPakTaperPak13DayPack|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1870960-deflazacort36MGOralTablet[Emflaza]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1870956-deflazacort18MGOralTablet[Emflaza]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|762663-Jolessa91DayPack|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1870952-deflazacort30MGOralTablet[Emflaza]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|1988977-24HRpregabalin330MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1870950-deflazacort6MGOralTablet[Emflaza]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|762334-Velivet28DayPack|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1868020-pirfenidone801MGOralTablet[Esbriet]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1868016-pirfenidone267MGOralTablet[Esbriet]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|762007-Nortrel7/7/728DayPack|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1858833-12HRTreprostinil5MGExtendedReleaseOralTablet[Orenitram]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1855527-HumiraPediatricCrohn'sDiseaseStarterPackage(2count)|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|762001-Kariva28DayPack|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|1860148-Abuse-Deterrent12HROxycodoneHydrochloride80MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1813112-Rajani28DayPack|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1812470-ivacaftor125MG/lumacaftor100MGOralTablet[ORKAMBI]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|759473-20ACTUATZanamivir5MG/ACTUATDryPowderInhaler[Relenza]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1811182-icosapentethyl500MGOralCapsule[Vascepa]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1806942-carfilzomib60MGInjection[Kyprolis]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|759469-Quasense91DayPack|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1801519-Methylnaltrexonebromide150MGOralTablet[Relistor]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1801322-3.5MLevolocumab120MG/MLCartridge[Repatha]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|754766-Metronidazole0.0075MG/MGVaginalGel[MetroGel]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1801278-HumiraPsoriasisStarterPack40MG/0.8MLPen(4count)|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1799230-1MLabatacept125MG/MLAuto-Injector[Orencia]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|753543-Reclipsen28DayPack|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1796096-24HRLinagliptin5MG/Metforminhydrochloride1000MGExtendedReleaseOralTablet[Jentadueto]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1796091-24HRLinagliptin2.5MG/Metforminhydrochloride1000MGExtendedReleaseOralTablet[Jentadueto]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|753482-Apri28DayPack|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1790546-infliximab-dyyb100MGInjection[Inflectra]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|200220-tolcapone100MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1747194-0.4MLMethotrexate56.3MG/MLAuto-Injector[Otrexup]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|751890-Portia28DayPack|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1747187-0.4MLMethotrexate43.8MG/MLAuto-Injector[Otrexup]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1747181-0.4MLMethotrexate31.3MG/MLAuto-Injector[Otrexup]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|751884-Lutera28DayPack|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1746898-10MLreslizumab10MG/MLInjection[Cinqair]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1745114-1MLixekizumab80MG/MLPrefilledSyringe[Taltz]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|751875-Necon0.5/3528DayPack|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1745108-1MLixekizumab80MG/MLAuto-Injector[Taltz]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1741049-24HRtofacitinib11MGExtendedReleaseOralTablet[Xeljanz]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|751871-Nortrel1/3521DayPack|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1734642-elbasvir50MG/grazoprevir100MGOralTablet[Zepatier]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1732165-incobotulinumtoxinA200UNTInjection[Xeomin]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|751870-Nortrel1/3528DayPack|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1732161-incobotulinumtoxinA100UNTInjection[Xeomin]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1732157-incobotulinumtoxinA50UNTInjection[Xeomin]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|750839-erythromycinstearate250MGOralTablet[ErythrocinStearate]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1729076-UptraviTitrationPack|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1729065-selexipag0.8MGOralTablet[Uptravi]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|750264-Necon7/7/728DayPack|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|200328-capecitabine500MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1729061-selexipag0.6MGOralTablet[Uptravi]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1729057-selexipag0.4MGOralTablet[Uptravi]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|750244-Low-Ogestrel28DayPack|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1729053-selexipag0.2MGOralTablet[Uptravi]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1729047-selexipag1.6MGOralTablet[Uptravi]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|750243-Ogestrel28DayPack|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1729033-selexipag1.4MGOralTablet[Uptravi]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1729029-selexipag1.2MGOralTablet[Uptravi]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|749151-Tri-Norinyl28DayPack|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1729013-selexipag1MGOralTablet[Uptravi]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1728099-romiplostim0.5MGInjection[Nplate]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|748865-Trivora28DayPack|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1728095-romiplostim0.25MGInjection[Nplate]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1726846-0.4MLadalimumab100MG/MLPrefilledSyringe[Humira]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|748859-Zovia1/35E28DayPack|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1726639-ponatinib30MGOralTablet[Iclusig]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1721690-1MLEpoetinAlfa10000UNT/MLInjection[Procrit]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|707333-SodiumChloride0.111MEQ/MLNasalSolution[AyrSalineNasal]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1721685-1MLEpoetinAlfa10000UNT/MLInjection[Epogen]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1720606-mepolizumab100MGInjection[Nucala]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|705008-Cefixime40MG/MLOralSuspension[Suprax]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1666334-Ticagrelor60MGOralTablet[Brilinta]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1665906-1MLevolocumab140MG/MLPrefilledSyringe[Repatha]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|692694-thyroid(USP)65MGOralTablet[Westhroid]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1665900-1MLevolocumab140MG/MLAuto-Injector[Repatha]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1663728-Isotretinoin30MGOralCapsule[Myorisan]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|688242-Estrogens,Conjugated(USP)0.625MG/MLVaginalCream[Premarin]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1661567-TOBIPodhalerDailyKit,8|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|240912-Granisetron1MG/MLInjectableSolution|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1660938-60ACTUATformoterolfumarate0.005MG/ACTUAT/mometasonefuroate0.2MG/ACTUATMeteredDoseInhaler[Dulera]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|644304-Tamoxifen2MG/MLOralSolution[Soltamox]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1660934-60ACTUATformoterolfumarate0.005MG/ACTUAT/mometasonefuroate0.1MG/ACTUATMeteredDoseInhaler[Dulera]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1657982-20MLtocilizumab20MG/MLInjection[Actemra]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|630475-SodiumFluoride5.56MG/MLOralSolution[FluoraDay]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1657980-10MLtocilizumab20MG/MLInjection[Actemra]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1657976-4MLtocilizumab20MG/MLInjection[Actemra]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|617333-Amoxicillin25MG/ML/Clavulanate6.25MG/MLOralSuspension[Augmentin]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1657212-omalizumab150MGInjection[Xolair]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1655934-ivacaftor125MG/lumacaftor200MGOralTablet[ORKAMBI]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|616450-MycophenolicAcid180MGDelayedReleaseOralTablet[Myfortic]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1654955-1MLdarbepoetinalfa0.2MG/MLInjection[Aranesp]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1654630-1MLglatirameracetate20MG/MLPrefilledSyringe[Glatopa]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|616449-MycophenolicAcid360MGDelayedReleaseOralTablet[Myfortic]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1654079-0.5MLustekinumab90MG/MLInjection[Stelara]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1653243-1MLsecukinumab150MG/MLAuto-Injector[Cosentyx]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|616444-mycophenolatemofetil200MG/MLOralSuspension[Cellcept]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1653225-1MLEtanercept50MG/MLAuto-Injector[Enbrel]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1653166-1MLgolimumab100MG/MLAuto-Injector[Simponi]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|544597-PotassiumIodide1000MG/MLOralSolution[SSKIbrandofPotassiumIodide]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1653144-0.5MLgolimumab100MG/MLAuto-Injector[Simponi]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1650901-0.5MLInterferonbeta-1a0.06MG/MLAuto-Injector[Avonex]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|542059-Didanosine10MG/MLOralSolution[Videx]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1650282-RebifRebidoseTitrationPack|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|260218-modafinil100MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1650004-0.5MLInterferonbeta-1a0.088MG/MLAuto-Injector[Rebif]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|404550-Estrogens,Conjugated(USP)0.45MGOralTablet[Premarin]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1649996-0.5MLInterferonbeta-1a0.044MG/MLAuto-Injector[Rebif]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1649605-PlegridyPenStarterPack|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|404509-CalciumCarbonate1000MG/Simethicone60MGChewableTablet[MaaloxMaxQuickDissolve]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1649593-0.5MLpeginterferonbeta-1a0.25MG/MLAuto-Injector[Plegridy]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1649495-ivabradine7.5MGOralTablet[Corlanor]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|404492-5MLLaronidase0.58MG/MLInjection[Aldurazyme]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1649491-ivabradine5MGOralTablet[Corlanor]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1648789-30ACTUATfluticasonefuroate0.2MG/ACTUAT/vilanterol0.025MG/ACTUATDryPowderInhaler[Breo]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|404476-Azathioprine100MGOralTablet[Azasan]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1606870-ivacaftor75MGOralGranules[Kalydeco]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1606866-ivacaftor50MGOralGranules[Kalydeco]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|404475-Azathioprine75MGOralTablet[Azasan]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1605455-Otezla28-DayStarterPack|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1605172-0.4MLdarbepoetinalfa0.025MG/MLPrefilledSyringe[Aranesp]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|352210-Mesna400MGOralTablet[Mesnex]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1605075-0.8MLFILGRASTIM-SNDZ0.6MG/MLPrefilledSyringe[Zarxio]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1605071-0.5MLFILGRASTIM-SNDZ0.6MG/MLPrefilledSyringe[Zarxio]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|351901-Sirolimus1MG/MLOralSolution[Rapamune]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1601373-naloxegol25MGOralTablet[Movantik]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1599797-1MLsecukinumab150MG/MLPrefilledSyringe[Cosentyx]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|351750-podofilox0.005MG/MGTopicalGel[Condylox]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1596778-14ACTUATBudesonide2MG/ACTUATRectalFoam[Uceris]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|310437-Galantamine8MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1596023-ferriccitrate1000MGOralTablet[Auryxia]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|351487-thyroid(USP)130MGOralTablet[Westhroid]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1594358-HumiraPediatricCrohn'sDiseaseStarterPackage(3count)|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1593858-lisdexamfetaminedimesylate10MGOralCapsule[Vyvanse]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|312020-Nitroglycerin9MGExtendedReleaseOralCapsule|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1593835-24HRdapagliflozin10MG/Metforminhydrochloride500MGExtendedReleaseOralTablet[Xigduo]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1593833-24HRdapagliflozin5MG/Metforminhydrochloride1000MGExtendedReleaseOralTablet[Xigduo]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|312018-Nitroglycerin6.5MGExtendedReleaseOralCapsule|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1593831-24HRdapagliflozin5MG/Metforminhydrochloride500MGExtendedReleaseOralTablet[Xigduo]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1593775-24HRdapagliflozin10MG/Metforminhydrochloride1000MGExtendedReleaseOralTablet[Xigduo]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|284551-nilutamide150MGOralTablet[Nilandron]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1592752-nintedanib150MGOralCapsule[Ofev]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1592748-nintedanib100MGOralCapsule[Ofev]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|261353-Trimethoprim10MG/MLOralSolution[Primsol]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1592285-pirfenidone267MGOralCapsule[Esbriet]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1551923-naloxegol12.5MGOralTablet[Movantik]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|260409-prednisolone1MG/MLOralSolution[Pediapred]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1551888-0.2MLadalimumab50MG/MLPrefilledSyringe[Humira]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1551886-lanthanumcarbonate750MGOralPowder[Fosrenol]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|2564406-influenzaAvirusA/Tasmania/503/2020(H3N2)antigen158000000UNT/ML/influenzaAvirusA/Victoria/1/2020(H1N1)antigen158000000|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|311204-Itraconazole100MGOralCapsule|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1546198-PlegridyStarterPack|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1546189-0.5MLpeginterferonbeta-1a0.25MG/MLPrefilledSyringe[Plegridy]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|2564038-influenzaAvirusA/Cambodia/e0826360/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.03MG/|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1545174-hydrocortisoneacetate100MG/MLRectalFoam[Cortifoam]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1544918-0.65MLexenatide3.08MG/MLPenInjector[Bydureon]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|2564021-0.5MLinfluenzaAvirusA/Cambodia/e0826360/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1544404-0.15MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1544402-0.6MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|2563039-0.5MLinfluenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.03MG/|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1544398-0.5MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1544396-0.45MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|2563032-0.5MLinfluenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.03MG/|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1544394-0.4MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1544390-0.35MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|2563031-influenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.03MG/ML/in|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1544388-0.3MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1544386-0.25MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|2563020-influenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Washington/19/2020(H1N1)antigen0.03MG/ML/in|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1544383-0.2MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1541928-sunitinib37.5MGOralCapsule[Sutent]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|2563004-0.7MLinfluenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.0857MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.085|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1539893-30ACTUATfluticasonefuroate0.1MG/ACTUAT/vilanterol0.025MG/ACTUATDryPowderInhaler[Breo]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|153324-Interferonbeta-1a0.03MGInjection[Avonex]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|2563002-0.5MLinfluenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.09MG/ML/influenzaAvirusA/Wisconsin/588/2019(H1N1)antigen0.09MG/|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1492746-apremilast30MGOralTablet[Otezla]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1488679-12HRTreprostinil2.5MGExtendedReleaseOralTablet[Orenitram]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|2562996-0.5MLinfluenzaAvirusA/Cambodia/e0826360/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1488675-12HRTreprostinil1MGExtendedReleaseOralTablet[Orenitram]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|313472-Trientinehydrochloride250MGOralCapsule|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1488671-12HRTreprostinil0.25MGExtendedReleaseOralTablet[Orenitram]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|2562995-0.5MLinfluenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Washington/19/2020(H1N1)antigen0.03MG/|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1488667-12HRTreprostinil0.125MGExtendedReleaseOralTablet[Orenitram]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1487076-DiclofenacSodium20MG/MLTopicalSolution[Pennsaid]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|2561275-0.5MLinfluenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.03MG/|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1486981-dapagliflozin5MGOralTablet[Farxiga]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1486977-dapagliflozin10MGOralTablet[Farxiga]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|2561270-0.5MLinfluenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.03MG/|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1484296-sucroferricoxyhydroxide500MGChewableTablet[Velphoro]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1482814-1MLgolimumab100MG/MLPrefilledSyringe[Simponi]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|2178792-0.3MLEpinephrine0.5MG/MLPrefilledSyringe[Symjepi]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1482513-eslicarbazepineacetate200MGOralTablet[Aptiom]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1442143-Macitentan10MGOralTablet[Opsumit]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|2173508-Nonoxynol-91000MGVaginalSponge[TodaySponge]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1441530-0.9MLtocilizumab180MG/MLPrefilledSyringe[Actemra]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1441424-0.4MLMethotrexate62.5MG/MLAuto-Injector[Otrexup]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|213621-Bacitracin0.5UNT/MG/PolymyxinB10UNT/MGOphthalmicOintment[Polycin]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1441418-0.4MLMethotrexate50MG/MLAuto-Injector[Otrexup]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1441413-0.4MLMethotrexate37.5MG/MLAuto-Injector[Otrexup]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|213510-Auranofin3MGOralCapsule[Ridaura]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1441407-0.4MLMethotrexate25MG/MLAuto-Injector[Otrexup]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1439903-riociguat2.5MGOralTablet[Adempas]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|213291-ParoxetineHydrochloride2MG/MLOralSuspension[Paxil]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1439901-riociguat2MGOralTablet[Adempas]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|349407-Treprostinil1MG/MLInjectableSolution|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1439899-riociguat1.5MGOralTablet[Adempas]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|213284-hydroxyurea400MGOralCapsule[Droxia]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1439896-riociguat1MGOralTablet[Adempas]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1439894-riociguat0.5MGOralTablet[Adempas]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|213283-hydroxyurea300MGOralCapsule[Droxia]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1431647-4MLgolimumab12.5MG/MLInjection[Simponi]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1429367-lenalidomide20MGOralCapsule[Revlimid]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|213282-hydroxyurea200MGOralCapsule[Droxia]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1429284-NeostigmineMethylsulfate1MG/MLInjectableSolution[Bloxiverz]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1429282-NeostigmineMethylsulfate0.5MG/MLInjectableSolution[Bloxiverz]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|212373-Estrogens,Esterified(USP)1.25MGOralTablet[Menest]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1375922-bromfenac0.7MG/MLOphthalmicSolution[Prolensa]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1374574-TOBIPodhalerKit,224|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|212232-Estrogens,Esterified(USP)0.625MGOralTablet[Menest]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1373337-Isotretinoin40MGOralCapsule[Zenatane]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1373335-Isotretinoin20MGOralCapsule[Zenatane]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|212039-Estrogens,Esterified(USP)0.3MGOralTablet[Menest]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1373333-Isotretinoin10MGOralCapsule[Zenatane]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1365866-nepafenac3MG/MLOphthalmicSuspension[Ilevro]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|211633-AluminumHydroxide200MG/MagnesiumHydroxide200MG/Simethicone25MGChewableTablet[Gelusil]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1364515-Bedaquiline100MGOralTablet[Sirturo]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1364477-teduglutide5MGInjection[Gattex]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|2110516-60ACTUATFluticasonepropionate0.5MG/ACTUAT/salmeterol0.05MG/ACTUATDryPowderInhaler[Wixela]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1364362-ponatinib45MGOralTablet[Iclusig]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|349434-voriconazole200MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1364358-ponatinib15MGOralTablet[Iclusig]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|2110513-60ACTUATFluticasonepropionate0.25MG/ACTUAT/salmeterol0.05MG/ACTUATDryPowderInhaler[Wixela]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1357547-tofacitinib5MGOralTablet[Xeljanz]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1313061-24HRPhentermine11.25MG/topiramate69MGExtendedReleaseOralCapsule[Qsymia]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|2110510-60ACTUATFluticasonepropionate0.1MG/ACTUAT/salmeterol0.05MG/ACTUATDryPowderInhaler[Wixela]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1310535-teriflunomide7MGOralTablet[Aubagio]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1310531-teriflunomide14MGOralTablet[Aubagio]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|210000-AluminumHydroxide80MG/ML/MagnesiumHydroxide80MG/ML/Simethicone8MG/MLOralSuspension[Almacone]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1310147-everolimus5MGTabletforOralSuspension[Afinitor]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1310144-everolimus3MGTabletforOralSuspension[Afinitor]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|209531-Acetaminophen80MGRectalSuppository[Feverall]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1310138-everolimus2MGTabletforOralSuspension[Afinitor]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1307635-bosutinib500MGOralTablet[Bosulif]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|209360-Acetaminophen325MGRectalSuppository[Acephen]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1307630-bosutinib100MGOralTablet[Bosulif]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1302856-24HRPhentermine15MG/topiramate92MGExtendedReleaseOralCapsule[Qsymia]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|209002-prednisolone1.2MG/MLOphthalmicSuspension[PredMild]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1302845-24HRPhentermine3.75MG/topiramate23MGExtendedReleaseOralCapsule[Qsymia]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1302833-24HRPhentermine7.5MG/topiramate46MGExtendedReleaseOralCapsule[Qsymia]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|208949-Estrogens,Conjugated(USP)0.9MGOralTablet[Premarin]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|351114-5MLzoledronicacid0.8MG/MLInjection|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1300803-24HRmirabegron50MGExtendedReleaseOralTablet[Myrbetriq]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1300797-24HRmirabegron25MGExtendedReleaseOralTablet[Myrbetriq]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|208551-thyroid(USP)300MGOralTablet[ArmourThyroid]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1291092-hydrocortisoneacetate30MGRectalSuppository[Proctocort]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1245003-eltrombopag12.5MGOralTablet[Promacta]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|208549-thyroid(USP)240MGOralTablet[ArmourThyroid]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1244632-AmethiaLo91DayPack|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1244064-0.4MLMethylnaltrexonebromide20MG/MLPrefilledSyringe[Relistor]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|208547-thyroid(USP)180MGOralTablet[ArmourThyroid]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1244062-0.6MLMethylnaltrexonebromide20MG/MLPrefilledSyringe[Relistor]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1243848-24HRMetforminhydrochloride500MG/sitagliptin50MGExtendedReleaseOralTablet[Janumet]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|208513-Estrogens,Conjugated(USP)0.3MGOralTablet[Premarin]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1243843-24HRMetforminhydrochloride1000MG/sitagliptin50MGExtendedReleaseOralTablet[Janumet]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1243833-24HRMetforminhydrochloride1000MG/sitagliptin100MGExtendedReleaseOralTablet[Janumet]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|207949-Succimer100MGOralCapsule[Chemet]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1243052-ivacaftor150MGOralTablet[Kalydeco]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1243040-Linagliptin2.5MG/Metforminhydrochloride850MGOralTablet[Jentadueto]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|207864-crotamiton100MG/MLTopicalCream[Eurax]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1243033-Linagliptin2.5MG/Metforminhydrochloride500MGOralTablet[Jentadueto]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1243026-Linagliptin2.5MG/Metforminhydrochloride1000MGOralTablet[Jentadueto]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|207588-Procarbazine50MGOralCapsule[Matulane]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1242968-exenatide2MGInjection[Bydureon]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1242615-Isotretinoin40MGOralCapsule[Myorisan]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|207478-Primidone50MGOralTablet[Mysoline]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1242613-Isotretinoin20MGOralCapsule[Myorisan]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1242611-Isotretinoin10MGOralCapsule[Myorisan]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|207373-Mitotane500MGOralTablet[Lysodren]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1242233-lenalidomide2.5MGOralCapsule[Revlimid]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1235267-CamreseLo91DayPack|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|207273-Nitroglycerin0.02MG/MGTopicalOintment[Nitro-Bid]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1235157-azilsartanmedoxomil40MG/Chlorthalidone25MGOralTablet[Edarbyclor]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1235150-azilsartanmedoxomil40MG/Chlorthalidone12.5MGOralTablet[Edarbyclor]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|207136-Methylprednisolone2MGOralTablet[Medrol]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1232204-Zolpidemtartrate3.5MGSublingualTablet[Intermezzo]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1232200-Zolpidemtartrate1.75MGSublingualTablet[Intermezzo]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|206978-Ketoconazole20MG/MLMedicatedShampoo[Nizoral]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1232190-asparaginaseErwiniachrysanthemi10000UNTInjection[Erwinaze]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1191128-EdrophoniumChloride10MG/MLInjectableSolution[Enlon]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|206961-Nadolol20MGOralTablet[Corgard]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1149667-Camrese91DayPack|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1149617-COLLAGENASE0.25UNT/MGTopicalOintment[Santyl]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|206314-Hydrocortisone0.01MG/MGTopicalOintment[Cortizone]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1148506-crizotinib250MGOralCapsule[Xalkori]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1148502-crizotinib200MGOralCapsule[Xalkori]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|206216-2MLIron-DextranComplex50MG/MLInjection[InFed]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1145932-1MLabatacept125MG/MLPrefilledSyringe[Orencia]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1116639-Ticagrelor90MGOralTablet[Brilinta]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|206208-aluminumchloride200MG/MLTopicalSolution[Drysol]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1115473-1.5MLLeuprolideAcetate7.5MG/MLPrefilledSyringe[Lupron]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1115468-1.5MLLeuprolideAcetate15MG/MLPrefilledSyringe[Lupron]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|205669-Dexamethasone1MG/MLOphthalmicSuspension[Maxidex]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1115464-1MLLeuprolideAcetate7.5MG/MLPrefilledSyringe[Lupron]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|477347-lanthanumcarbonate500MGChewableTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1115459-1MLLeuprolideAcetate3.75MG/MLPrefilledSyringe[Lupron]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|205562-Estramustine140MGOralCapsule[Emcyt]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1115456-1MLLeuprolideAcetate15MG/MLPrefilledSyringe[Lupron]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1115449-1MLLeuprolideAcetate11.25MG/MLPrefilledSyringe[Lupron]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|2045958-avatrombopag20MGOralTablet[Doptelet]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1115259-1.5MLLeuprolideAcetate30MG/MLPrefilledSyringe[Lupron]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1114096-Vandetanib300MGOralTablet[Caprelsa]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|202301-Estrogens,Conjugated(USP)1.25MGOralTablet[Premarin]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1114074-Vandetanib100MGOralTablet[Caprelsa]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1112687-Amethia91DayPack|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|201747-Primidone250MGOralTablet[Mysoline]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1100706-Linagliptin5MGOralTablet[Tradjenta]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1091843-Roflumilast0.5MGOralTablet[Daliresp]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|201338-Nadolol80MGOralTablet[Corgard]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1091654-azilsartanmedoxomil80MGOralTablet[Edarbi]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1091650-azilsartanmedoxomil40MGOralTablet[Edarbi]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|201337-Nadolol40MGOralTablet[Corgard]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1046402-1.7MLdenosumab70MG/MLInjection[Xgeva]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1045408-dasatinib80MGOralTablet[Sprycel]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|1998774-Breath-Actuated120ACTUATBeclomethasoneDipropionate0.04MG/ACTUATMeteredDoseInhaler[Qvar]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1045404-dasatinib140MGOralTablet[Sprycel]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1043582-24HRMetforminhydrochloride500MG/saxagliptin5MGExtendedReleaseOralTablet[Kombiglyze]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|1998772-Breath-Actuated120ACTUATBeclomethasoneDipropionate0.08MG/ACTUATMeteredDoseInhaler[Qvar]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1043574-24HRMetforminhydrochloride1000MG/saxagliptin5MGExtendedReleaseOralTablet[Kombiglyze]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1043567-24HRMetforminhydrochloride1000MG/saxagliptin2.5MGExtendedReleaseOralTablet[Kombiglyze]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|1995479-amylase168000UNT/lipase40000UNT/protease126000UNTDelayedReleaseOralCapsule[Zenpep]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1040058-DextromethorphanHydrobromide20MG/QuinidineSulfate10MGOralCapsule[Nuedexta]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1037185-LoLoestrinFe28DayPack|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|1989117-0.3MLEpinephrine1MG/MLPrefilledSyringe[Symjepi]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1012899-fingolimod0.5MGOralCapsule[Gilenya]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1011755-aliskiren300MG/Hydrochlorothiazide25MGOralTablet[TekturnaHCT]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|198467-Aspirin325MGDelayedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1011752-aliskiren300MG/Hydrochlorothiazide12.5MGOralTablet[TekturnaHCT]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1011715-aliskiren150MG/Hydrochlorothiazide25MGOralTablet[TekturnaHCT]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|1797880-Nafarelin0.2MG/ACTUATMeteredDoseNasalSpray[Synarel]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1011712-aliskiren150MG/Hydrochlorothiazide12.5MGOralTablet[TekturnaHCT]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1002300-nilotinib150MGOralCapsule[Tasigna]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|1667916-5MLIsoproterenolHydrochloride0.2MG/MLInjection[Isuprel]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Brand|1000089-alcaftadine2.5MG/MLOphthalmicSolution[Lastacaft]|EXPANSION FULL DUALS 632|2002|N|Y|Y||Preferred Generic|998679-168HRClonidine0.0125MG/HRTransdermalSystem|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|1595478-amylase84000UNT/lipase20000UNT/protease63000UNTDelayedReleaseOralCapsule[Zenpep]|EXPANSION FULL DUALS 632|2002|N|Y|Y||Preferred Generic|998675-168HRClonidine0.00833MG/HRTransdermalSystem|EXPANSION FULL DUALS 632|2002|N|Y|Y||Preferred Generic|998671-168HRClonidine0.00417MG/HRTransdermalSystem|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|1595473-amylase63000UNT/lipase15000UNT/protease47000UNTDelayedReleaseOralCapsule[Zenpep]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|485436-entecavir1MGOralTablet|EXPANSION FULL DUALS 632|2002|N|Y|Y||Preferred Generic|860654-epinastinehydrochloride0.5MG/MLOphthalmicSolution|EXPANSION FULL DUALS 632|2002|N|Y|Y||Preferred Generic|856569-24HRPropranololHydrochloride80MGExtendedReleaseOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|1595462-amylase42000UNT/lipase10000UNT/protease32000UNTDelayedReleaseOralCapsule[Zenpep]|EXPANSION FULL DUALS 632|2002|N|Y|Y||Preferred Generic|856535-24HRPropranololHydrochloride60MGExtendedReleaseOralCapsule|EXPANSION FULL DUALS 632|2002|N|Y|Y||Preferred Generic|856481-24HRPropranololHydrochloride160MGExtendedReleaseOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|1595457-amylase24000UNT/lipase5000UNT/protease17000UNTDelayedReleaseOralCapsule[Zenpep]|EXPANSION FULL DUALS 632|2002|N|Y|Y||Preferred Generic|856460-24HRPropranololHydrochloride120MGExtendedReleaseOralCapsule|EXPANSION FULL DUALS 632|2002|N|Y|Y||Preferred Generic|854868-Rabeprazolesodium20MGDelayedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|1595292-amylase14000UNT/lipase3000UNT/protease10000UNTDelayedReleaseOralCapsule[Zenpep]|EXPANSION FULL DUALS 632|2002|N|Y|Y||Preferred Generic|798133-Erythromycin20MG/MLMedicatedPad[Ery]|EXPANSION FULL DUALS 632|2002|N|Y|Y||Preferred Generic|797274-Clindamycin10MG/MLMedicatedPad|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|1594673-amylase105000UNT/lipase25000UNT/protease79000UNTDelayedReleaseOralCapsule[Zenpep]|EXPANSION FULL DUALS 632|2002|N|Y|Y||Preferred Generic|606726-Esomeprazole20MGDelayedReleaseOralCapsule|EXPANSION FULL DUALS 632|2002|N|Y|Y||Preferred Generic|577127-pregabalin225MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|1536586-168HREthinylEstradiol0.00146MG/HR/norelgestromin0.00625MG/HRTransdermalSystem[Xulane]|EXPANSION FULL DUALS 632|2002|N|Y|Y||Preferred Generic|483450-pregabalin75MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|Y|Y||Preferred Generic|483448-pregabalin50MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|153473-Altretamine50MGOralCapsule[Hexalen]|EXPANSION FULL DUALS 632|2002|N|Y|Y||Preferred Generic|483446-pregabalin200MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|Y|Y||Preferred Generic|483444-pregabalin300MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|153183-adapalene0.001MG/MGTopicalGel[Differin]|EXPANSION FULL DUALS 632|2002|N|Y|Y||Preferred Generic|483442-pregabalin25MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|Y|Y||Preferred Generic|483440-pregabalin150MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|152854-Itraconazole10MG/MLOralSolution[Sporanox]|EXPANSION FULL DUALS 632|2002|N|Y|Y||Preferred Generic|483438-pregabalin100MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|Y|Y||Preferred Generic|351134-zolmitriptan5MGDisintegratingOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|150840-Estrogens,Conjugated(USP)0.625MGOralTablet[Premarin]|EXPANSION FULL DUALS 632|2002|N|Y|Y||Preferred Generic|314266-Tacrolimus0.001MG/MGTopicalOintment|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|577348-ramelteon8MGOralTablet|EXPANSION FULL DUALS 632|2002|N|Y|Y||Preferred Generic|314227-Sumatriptan20MG/ACTUATNasalSpray|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|1440936-Hydrocortisone25MG/MLTopicalCream[ProctozoneHC]|EXPANSION FULL DUALS 632|2002|N|Y|Y||Preferred Generic|313189-Tacrolimus0.0003MG/MGTopicalOintment|EXPANSION FULL DUALS 632|2002|N|Y|Y||Preferred Generic|313159-Sumatriptan5MG/ACTUATNasalSpray|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|1426881-Levonorgestrel1.5MGOralTablet[MyWay]|EXPANSION FULL DUALS 632|2002|N|Y|Y||Preferred Generic|311671-Metolazone5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|Y|Y||Preferred Generic|309333-Clindamycin10MG/MLTopicalSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|1422081-Enskyce28DayPack|EXPANSION FULL DUALS 632|2002|N|Y|Y||Preferred Generic|309332-Clindamycin0.01MG/MGTopicalGel|EXPANSION FULL DUALS 632|2002|N|Y|Y||Preferred Generic|284201-zolmitriptan2.5MGDisintegratingOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|1373327-amylase180000UNT/lipase36000UNT/protease114000UNTDelayedReleaseOralCapsule[Creon]|EXPANSION FULL DUALS 632|2002|N|Y|Y||Preferred Generic|244374-BenzoylPeroxide0.05MG/MG/Erythromycin0.03MG/MGTopicalGel|EXPANSION FULL DUALS 632|2002|N|Y|Y||Preferred Generic|200194-zolmitriptan5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|1359135-Tri-LegestFe28DayPack|EXPANSION FULL DUALS 632|2002|N|Y|Y||Preferred Generic|200193-zolmitriptan2.5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|Y|Y||Preferred Generic|2001568-BXRating24HRMethylphenidateHydrochloride54MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|1359134-TiliaFe28DayPack|EXPANSION FULL DUALS 632|2002|N|Y|Y||Preferred Generic|2001566-BXRating24HRMethylphenidateHydrochloride36MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|Y|Y||Preferred Generic|2001565-BXRating24HRMethylphenidateHydrochloride27MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|1359032-Microgestin1.5/3021DayPack|EXPANSION FULL DUALS 632|2002|N|Y|Y||Preferred Generic|2001564-BXRating24HRMethylphenidateHydrochloride18MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|Y|Y||Preferred Generic|197979-Metolazone2.5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|1359030-Junel1.5/3021DayPack|EXPANSION FULL DUALS 632|2002|N|Y|Y||Preferred Generic|197978-Metolazone10MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|578330-candesartancilexetil32MG/Hydrochlorothiazide12.5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|Y|Y||Preferred Generic|197519-Clindamycin10MG/MLTopicalLotion|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|1359027-MicrogestinFe1.5/3028DayPack|EXPANSION FULL DUALS 632|2002|N|Y|Y||Preferred Generic|1806195-50/50Release24HRMethylphenidateHydrochloride10MGExtendedReleaseOralCapsule|EXPANSION FULL DUALS 632|2002|N|Y|Y||Preferred Generic|1806185-50/50Release24HRMethylphenidateHydrochloride60MGExtendedReleaseOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|1359025-JunelFe28DayPack|EXPANSION FULL DUALS 632|2002|N|Y|Y||Preferred Generic|1797865-mometasonefuroate0.05MG/ACTUATMeteredDoseNasalSpray|EXPANSION FULL DUALS 632|2002|N|Y|Y||Preferred Generic|1111343-olopatadine2MG/MLOphthalmicSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|1359020-Microgestin1/2021DayPack|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|403879-imatinib400MGOralTablet|EXPANSION FULL DUALS 632|2002|N|Y|Y||Preferred Generic|1111339-olopatadine1MG/MLOphthalmicSolution|EXPANSION FULL DUALS 632|2002|N|Y|Y||Preferred Brand|2200658-semaglutide7MGOralTablet[Rybelsus]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|1358780-Junel1/2021DayPack|EXPANSION FULL DUALS 632|2002|N|Y|Y||Preferred Brand|2200654-semaglutide3MGOralTablet[Rybelsus]|EXPANSION FULL DUALS 632|2002|N|Y|Y||Preferred Brand|2200650-semaglutide14MGOralTablet[Rybelsus]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|1358775-MicrogestinFe1/2028DayPack|EXPANSION FULL DUALS 632|2002|N|Y|Y||Preferred Brand|1716223-patiromer25200MGPowderforOralSuspension[Veltassa]|EXPANSION FULL DUALS 632|2002|N|Y|Y||Preferred Brand|1716219-patiromer16800MGPowderforOralSuspension[Veltassa]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|1358765-JunelFe1/2028DayPack|EXPANSION FULL DUALS 632|2002|N|Y|Y||Preferred Brand|1716215-patiromer8400MGPowderforOralSuspension[Veltassa]|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Generic|997406-12HRFexofenadinehydrochloride60MG/PseudoephedrineHydrochloride120MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|1293864-ErgotamineTartrate2MGSublingualTablet[Ergomar]|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Generic|996615-24HRMemantinehydrochloride7MGExtendedReleaseOralCapsule|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Generic|996609-24HRMemantinehydrochloride28MGExtendedReleaseOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|1293639-Caffeine100MG/ErgotamineTartrate2MGRectalSuppository[Migergot]|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Generic|996603-24HRMemantinehydrochloride21MGExtendedReleaseOralCapsule|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|597772-deferasirox500MGTabletforOralSuspension|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Generic|996594-24HRMemantinehydrochloride14MGExtendedReleaseOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|1250090-Nonoxynol-90.03MG/MGVaginalGel[GynolII]|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Generic|857564-24HRtrospiumchloride60MGExtendedReleaseOralCapsule|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Generic|857560-trospiumchloride20MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|1233850-Vestura28DayPack|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Generic|855194-tolterodinetartrate2MGOralTablet|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Generic|855189-24HRtolterodinetartrate4MGExtendedReleaseOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|1190225-120ACTUATAlbuterol0.1MG/ACTUAT/IpratropiumBromide0.02MG/ACTUATInhalationSpray[Combivent]|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Generic|855182-24HRtolterodinetartrate2MGExtendedReleaseOralCapsule|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Generic|855178-tolterodinetartrate1MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|1148646-28ACTUATFluticasonepropionate0.25MG/ACTUATDryPowderInhaler[Flovent]|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Generic|825130-24HRmesalamine375MGExtendedReleaseOralCapsule|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Generic|810090-Carbidopa18.75MG/entacapone200MG/Levodopa75MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|1114135-amylase16000UNT/lipase3000UNT/protease10000UNTDelayedReleaseOralCapsule[Zenpep]|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Generic|810083-Carbidopa31.25MG/entacapone200MG/Levodopa125MGOralTablet|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Generic|749206-sevelamercarbonate800MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|1114041-DextromethorphanHydrobromide1MG/MLOralSolution[DayQuilCough]|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Generic|745791-200ACTUATLevalbuterol0.045MG/ACTUATMeteredDoseInhaler|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Generic|730988-Carbidopa50MG/entacapone200MG/Levodopa200MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|1113046-amylase15000UNT/lipase3000UNT/protease9500UNTDelayedReleaseOralCapsule[Creon]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|603203-erlotinib100MGOralTablet|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Generic|686429-mesalamine1200MGDelayedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Generic|606730-Esomeprazole40MGDelayedReleaseOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|1112715-Amethyst28DayPack|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Generic|562806-Pimecrolimus10MG/MLTopicalCream|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Generic|403852-Carbidopa37.5MG/entacapone200MG/Levodopa150MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|1101778-Monobasicpotassiumphosphate0.0408MEQ/MLOralSolution[K-Phos]|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Generic|403851-Carbidopa25MG/entacapone200MG/Levodopa100MGOralTablet|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Generic|403850-Carbidopa12.5MG/entacapone200MG/Levodopa50MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|1099026-Loryna28DayPack|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Generic|349590-Levalbuterol0.103MG/MLInhalationSolution|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Generic|349556-ezetimibe10MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|1098924-SodiumFluoride11MG/MLOralSolution[Flura-Drops]|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Generic|317094-entacapone200MGOralTablet|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Generic|313921-calcipotriene0.05MG/MLTopicalCream|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|1095362-Balziva28DayPack|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Generic|311787-moxifloxacin400MGOralTablet|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Generic|311347-linezolid600MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|1087012-thyroid(USP)32.5MGOralTablet[Westhroid]|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Generic|311345-linezolid20MG/MLOralSuspension|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Generic|311286-Levalbuterol0.21MG/MLInhalationSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|105590-Thioguanine40MGOralTablet[Tabloid]|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Generic|310600-Griseofulvin500MGOralTablet|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Generic|308865-calcipotriene0.05MG/MLTopicalSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|105553-Chlorambucil2MGOralTablet[Leukeran]|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Generic|284008-travoprost0.04MG/MLOphthalmicSolution|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Generic|242831-Griseofulvin125MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|105551-Busulfan2MGOralTablet[Myleran]|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Generic|242754-Levalbuterol0.417MG/MLInhalationSolution|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|642452-lanthanumcarbonate750MGChewableTablet|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Generic|239239-Griseofulvin250MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|1048452-ColestipolHydrochloride5000MGGranulesforOralSuspension[Colestid]|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Generic|204119-Malathion5MG/MLTopicalLotion|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Generic|198373-calcipotriene0.00005MG/MGTopicalOintment|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|1046771-12HRHyoscyamineSulfate0.375MGExtendedReleaseOralTablet[Levbid]|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Generic|197984-Minocycline100MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Generic|197551-Cycloserine250MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|1039273-Hydrocortisone10MG/MLTopicalSolution[ScalpicinItchRelief]|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Generic|197508-Cimetidine800MGOralTablet|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Generic|197507-Cimetidine400MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|102250-Hydrocortisone1.67MG/MLEnema[Cortenema]|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Generic|197506-Cimetidine300MGOralTablet|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Generic|197505-Cimetidine200MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|1020155-Introvale91DayPack|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Generic|197419-Bumetanide2MGOralTablet|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Generic|197418-Bumetanide1MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|1005928-ulipristalacetate30MGOralTablet[Ella]|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Generic|197417-Bumetanide0.5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Generic|1855389-Levalbuterol2.5MG/MLInhalationSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|1000500-Prempro0.625/528DayPack|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Generic|1797863-flunisolide0.025MG/ACTUATMeteredDoseNasalSpray|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Generic|1368954-mesalamine400MGDelayedReleaseOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|1000499-Prempro0.625/2.528DayPack|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Generic|1368438-alogliptin25MG/pioglitazone45MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|700883-temozolomide140MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Generic|1368431-alogliptin25MG/pioglitazone30MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|1000497-Prempro0.45/1.528DayPack|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Generic|1368424-alogliptin25MG/pioglitazone15MGOralTablet|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Generic|1368417-alogliptin12.5MG/pioglitazone45MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|1000491-Prempro0.3/1.528DayPack|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Generic|1368410-alogliptin12.5MG/pioglitazone30MGOralTablet|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Generic|1368403-alogliptin12.5MG/pioglitazone15MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|1000487-Premphase28DayPack|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Generic|1368392-alogliptin12.5MG/Metforminhydrochloride500MGOralTablet|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Generic|1368385-alogliptin12.5MG/Metforminhydrochloride1000MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Brand|1000158-0.65MLmedroxyprogesteroneacetate160MG/MLPrefilledSyringe[depo-subQprovera]|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Generic|1368034-alogliptin12.5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Generic|1368018-alogliptin6.25MGOralTablet|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Generic|1368006-alogliptin25MGOralTablet|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Generic|1246673-Ivermectin5MG/MLTopicalLotion|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Generic|1085816-spinosad9MG/MLMedicatedShampoo|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Brand|996633-NamendaXR28DayTitrationPack|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Brand|856666-rifaximin550MGOralTablet[XIFAXAN]|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Brand|835721-Ethionamide250MGOralTablet[Trecator]|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Brand|833151-Savella4-WeekTitrationPack|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Brand|833149-Milnacipranhydrochloride25MGOralTablet[Savella]|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Brand|833146-Milnacipranhydrochloride50MGOralTablet[Savella]|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Brand|833143-Milnacipranhydrochloride12.5MGOralTablet[Savella]|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Brand|833139-Milnacipranhydrochloride100MGOralTablet[Savella]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|722122-ambrisentan5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Brand|539789-rifaximin200MGOralTablet[XIFAXAN]|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Brand|402092-Cyclosporine0.5MG/MLOphthalmicSuspension[Restasis]|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Brand|2398842-3MLsemaglutide1.34MG/MLPenInjector[Ozempic]|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Brand|2395785-0.5MLdulaglutide9MG/MLAuto-Injector[Trulicity]|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Brand|2395779-0.5MLdulaglutide6MG/MLAuto-Injector[Trulicity]|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Brand|213307-Ciprofloxacin0.003MG/MGOphthalmicOintment[Ciloxan]|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Brand|212381-aminosalicylicacid4000MGOralGranules[PaserD/R]|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Brand|1992821-ertugliflozin15MGOralTablet[Steglatro]|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Brand|1992816-ertugliflozin5MGOralTablet[Steglatro]|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Brand|1992703-ertugliflozin7.5MG/Metforminhydrochloride500MGOralTablet[Segluromet]|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Brand|1992700-ertugliflozin7.5MG/Metforminhydrochloride1000MGOralTablet[Segluromet]|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Brand|1992695-ertugliflozin2.5MG/Metforminhydrochloride500MGOralTablet[Segluromet]|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Brand|1992691-ertugliflozin2.5MG/Metforminhydrochloride1000MGOralTablet[Segluromet]|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Brand|1991317-1MGDose1.5MLsemaglutide1.34MG/MLPenInjector[Ozempic]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|724861-armodafinil250MGOralTablet|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Brand|1991311-0.25MG,0.5MGDose1.5MLsemaglutide1.34MG/MLPenInjector[Ozempic]|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Brand|1801840-lifitegrast50MG/MLOphthalmicSolution[Xiidra]|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Brand|1551306-0.5MLdulaglutide3MG/MLAuto-Injector[Trulicity]|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Brand|1551300-0.5MLdulaglutide1.5MG/MLAuto-Injector[Trulicity]|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Brand|1356673-BenzylAlcohol0.05ML/MLTopicalLotion[Ulesfia]|EXPANSION FULL DUALS 632|2002|N|Y|N||Preferred Brand|1190334-24HRFexofenadinehydrochloride180MG/PseudoephedrineHydrochloride240MGExtendedReleaseOralTablet[Wal-FexD]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|996757-CodeinePhosphate2MG/ML/PhenylephrineHydrochloride1MG/ML/PromethazineHydrochloride1.25MG/MLOralSolution|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|995868-CodeinePhosphate2MG/ML/Guaifenesin20MG/MLOralSolution|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|993890-Acetaminophen300MG/CodeinePhosphate60MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|993781-Acetaminophen300MG/CodeinePhosphate30MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|993770-Acetaminophen300MG/CodeinePhosphate15MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|993755-Acetaminophen24MG/ML/CodeinePhosphate2.4MG/MLOralSolution|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|993470-midodrinehydrochloride5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|993466-midodrinehydrochloride2.5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|993462-midodrinehydrochloride10MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|992668-homatropinemethylbromide0.3MG/ML/HydrocodoneBitartrate1MG/MLOralSolution|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|991528-DextromethorphanHydrobromide3MG/ML/PromethazineHydrochloride1.25MG/MLOralSolution|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|991486-CodeinePhosphate2MG/ML/PromethazineHydrochloride1.25MG/MLOralSolution|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|977880-AmilorideHydrochloride5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|905516-ChlordiazepoxideHydrochloride5MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|905495-ChlordiazepoxideHydrochloride25MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|905369-ChlordiazepoxideHydrochloride10MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|904589-SotalolHydrochloride240MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|904447-Alendronicacid0.933MG/MLOralSolution|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|904419-Alendronicacid10MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|904405-Alendronicacid40MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|899557-dexmethylphenidatehydrochloride2.5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|899548-dexmethylphenidatehydrochloride10MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|899518-dexmethylphenidatehydrochloride5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|897749-HydromorphoneHydrochloride3MGRectalSuppository|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|897710-HydromorphoneHydrochloride8MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|897702-HydromorphoneHydrochloride4MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|897696-HydromorphoneHydrochloride2MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|897659-Verapamilhydrochloride120MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|897640-Verapamilhydrochloride180MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|897630-24HRVerapamilhydrochloride360MGExtendedReleaseOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|897618-24HRVerapamilhydrochloride180MGExtendedReleaseOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|897612-24HRVerapamilhydrochloride120MGExtendedReleaseOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|894780-MorphineSulfate4MG/MLOralSolution|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|892672-MorphineSulfate30MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|892625-MorphineSulfate20MG/MLOralSolution|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|892589-MorphineSulfate2MG/MLOralSolution|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|892582-MorphineSulfate15MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|884386-DextroamphetamineSulfate5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|884385-DextroamphetamineSulfate10MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|866042-NeomycinSulfate500MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|863559-valganciclovir50MG/MLOralSolution|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|862025-24HRGuanfacine4MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|862019-24HRGuanfacine3MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|862013-24HRGuanfacine2MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|862006-24HRGuanfacine1MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|861237-24HRAmphetamineaspartate1.25MG/AmphetamineSulfate1.25MG/Dextroamphetaminesaccharate1.25MG/DextroamphetamineSulfate1.25|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|861232-24HRAmphetamineaspartate7.5MG/AmphetamineSulfate7.5MG/Dextroamphetaminesaccharate7.5MG/DextroamphetamineSulfate7.5MGEx|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|861227-24HRAmphetamineaspartate6.25MG/AmphetamineSulfate6.25MG/Dextroamphetaminesaccharate6.25MG/DextroamphetamineSulfate6.25|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|861225-24HRAmphetamineaspartate5MG/AmphetamineSulfate5MG/Dextroamphetaminesaccharate5MG/DextroamphetamineSulfate5MGExtendedRe|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|861223-24HRAmphetamineaspartate3.75MG/AmphetamineSulfate3.75MG/Dextroamphetaminesaccharate3.75MG/DextroamphetamineSulfate3.75|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|861221-24HRAmphetamineaspartate2.5MG/AmphetamineSulfate2.5MG/Dextroamphetaminesaccharate2.5MG/DextroamphetamineSulfate2.5MGEx|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|857366-EconazoleNitrate10MG/MLTopicalCream|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|857005-Acetaminophen325MG/HydrocodoneBitartrate7.5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|857002-Acetaminophen325MG/HydrocodoneBitartrate5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|856999-Acetaminophen325MG/HydrocodoneBitartrate10MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|856940-Acetaminophen21.7MG/ML/HydrocodoneBitartrate0.5MG/MLOralSolution|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|855633-DiclofenacSodium0.01MG/MGTopicalGel|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|854876-Zolpidemtartrate5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|854873-Zolpidemtartrate10MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|854252-1MLEnoxaparinsodium150MG/MLPrefilledSyringe|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|854248-1MLEnoxaparinsodium100MG/MLPrefilledSyringe|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|854245-0.8MLEnoxaparinsodium150MG/MLPrefilledSyringe|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|854241-0.8MLEnoxaparinsodium100MG/MLPrefilledSyringe|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|854238-0.6MLEnoxaparinsodium100MG/MLPrefilledSyringe|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|854235-0.4MLEnoxaparinsodium100MG/MLPrefilledSyringe|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|854228-0.3MLEnoxaparinsodium100MG/MLPrefilledSyringe|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|847252-3MLInsulinLispro25UNT/ML/insulinlisproprotamine,human75UNT/MLPenInjector|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|847191-3MLinsulinaspartprotamine,human70UNT/ML/insulinaspart,human30UNT/MLPenInjector|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|846378-24HRLevetiracetam750MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|845488-Ramipril1.25MGOralCapsule|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|754508-{1(aprepitant125MGOralCapsule)/2(aprepitant80MGOralCapsule)}Pack|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|835829-testosteronecypionate100MG/MLInjectableSolution|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|835603-tramadolhydrochloride50MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|834022-KetorolacTromethamine10MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|830861-24HRDiltiazemHydrochloride120MGExtendedReleaseOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|830845-24HRDiltiazemHydrochloride180MGExtendedReleaseOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|830837-24HRDiltiazemHydrochloride240MGExtendedReleaseOralCapsule|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|834235-febuxostat40MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|830801-24HRDiltiazemHydrochloride300MGExtendedReleaseOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|807832-24HRLevetiracetam500MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|801966-4MLDiazepam5MG/MLRectalGel|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|801961-2MLDiazepam5MG/MLRectalGel|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|801957-0.5MLDiazepam5MG/MLRectalGel|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|728113-Oseltamivir45MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|728109-Oseltamivir30MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|687043-Amphetamineaspartate3.125MG/AmphetamineSulfate3.125MG/Dextroamphetaminesaccharate3.125MG/DextroamphetamineSulfate3.125|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|686379-celecoxib50MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|636045-Hydrochlorothiazide25MG/valsartan320MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|636042-Hydrochlorothiazide12.5MG/valsartan320MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|608143-atomoxetine80MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|608139-atomoxetine100MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|596934-duloxetine60MGDelayedReleaseOralCapsule|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|845515-everolimus5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|596930-duloxetine30MGDelayedReleaseOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|596926-duloxetine20MGDelayedReleaseOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|577961-Amphetamineaspartate5MG/AmphetamineSulfate5MG/Dextroamphetaminesaccharate5MG/DextroamphetamineSulfate5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|577957-Amphetamineaspartate3.75MG/AmphetamineSulfate3.75MG/Dextroamphetaminesaccharate3.75MG/DextroamphetamineSulfate3.75MGOr|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|541892-Amphetamineaspartate2.5MG/AmphetamineSulfate2.5MG/Dextroamphetaminesaccharate2.5MG/DextroamphetamineSulfate2.5MGOralTa|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|541878-Amphetamineaspartate1.25MG/AmphetamineSulfate1.25MG/Dextroamphetaminesaccharate1.25MG/DextroamphetamineSulfate1.25MGOr|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|541363-Amphetamineaspartate7.5MG/AmphetamineSulfate7.5MG/Dextroamphetaminesaccharate7.5MG/DextroamphetamineSulfate7.5MGOralTa|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|485486-tizanidine2MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|485485-tizanidine4MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|485484-tizanidine6MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|485465-Eszopiclone3MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|485442-Eszopiclone2MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|485440-Eszopiclone1MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|477562-Fenofibrate48MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|477560-Fenofibrate145MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|403923-168HREstradiol0.0025MG/HRTransdermalSystem|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|403922-168HREstradiol0.00156MG/HRTransdermalSystem|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|403884-Levetiracetam100MG/MLOralSolution|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|359818-Nicotine4MGOralLozenge|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|359817-Nicotine2MGOralLozenge|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|351297-insulinaspartprotamine,human70UNT/ML/insulinaspart,human30UNT/MLInjectableSuspension|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|351246-montelukast4MGOralGranules|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|351133-Fenofibrate54MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|351109-Budesonide0.25MG/MLInhalationSuspension|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|349595-atomoxetine60MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|349594-atomoxetine40MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|349593-atomoxetine25MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|349592-atomoxetine18MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|349591-atomoxetine10MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|349514-celecoxib400MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|349483-valsartan40MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|349353-Hydrochlorothiazide25MG/valsartan160MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|349287-Fenofibrate160MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|349201-valsartan160MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|850087-24HRlamotrigine100MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|349200-valsartan320MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|349199-valsartan80MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|349198-Clonazepam0.5MGDisintegratingOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|349197-Clonazepam2MGDisintegratingOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|349196-Clonazepam1MGDisintegratingOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|349195-Clonazepam0.25MGDisintegratingOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|349194-Clonazepam0.125MGDisintegratingOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|349094-Budesonide0.125MG/MLInhalationSuspension|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|318202-Erythromycin20MG/MLTopicalSolution|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|315223-Sumatriptan25MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|314285-zonisamide100MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|314209-rizatriptan10MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|314200-pantoprazole40MGDelayedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|314135-naratriptan2.5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|313762-zaleplon5MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|313761-zaleplon10MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|313571-Vancomycin250MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|313570-Vancomycin125MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|313566-valganciclovir450MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|313415-Tobramycin3MG/MLOphthalmicSolution|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|313413-tizanidine4MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|313412-tizanidine2MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|313222-terbinafine250MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|313161-Sumatriptan50MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|313160-Sumatriptan100MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|312840-rizatriptan5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|312087-Ondansetron8MGDisintegratingOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|312086-Ondansetron8MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|312075-Ofloxacin3MG/MLOphthalmicSolution|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|855626-Twice-Dailydiclofenacepolamine0.013MG/MGMedicatedPatch|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|311975-Nicotine4MGChewingGum|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|311918-naratriptan1MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|311759-montelukast4MGChewableTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|311265-lamotrigine5MGChewableTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|311237-Ketotifen0.25MG/MLOphthalmicSolution|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|311207-Ivermectin3MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|310793-Hydrochlorothiazide12.5MG/irbesartan300MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|310792-Hydrochlorothiazide12.5MG/irbesartan150MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|310467-Gentamicin3MG/MLOphthalmicSolution|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|310465-Gentamicin0.001MG/MGTopicalOintment|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|310289-Fenofibrate200MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|310288-Fenofibrate134MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|310191-estradiolvalerate40MG/MLInjectableSolution|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|310190-estradiolvalerate20MG/MLInjectableSolution|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|310152-Erythromycin0.02MG/MGTopicalGel|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|310149-Erythromycin0.005MG/MGOphthalmicOintment|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|309314-Citalopram40MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|309309-Ciprofloxacin500MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|309307-Ciprofloxacin3MG/MLOphthalmicSolution|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|283407-Mirtazapine30MGDisintegratingOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|261962-Ramipril10MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|259081-12HRAspirin25MG/Dipyridamole200MGExtendedReleaseOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|252559-Budesonide0.5MG/MLInhalationSuspension|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|251872-pantoprazole20MGDelayedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|248478-84HREstradiol0.00104MG/HRTransdermalSystem|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|242892-84HREstradiol0.00417MG/HRTransdermalSystem|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|242891-84HREstradiol0.00208MG/HRTransdermalSystem|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|242462-cilostazol50MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|242461-cilostazol100MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|242438-montelukast5MGChewableTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|242333-168HREstradiol0.00104MG/HRTransdermalSystem|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|241946-84HREstradiol0.00156MG/HRTransdermalSystem|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|241527-168HREstradiol0.00312MG/HRTransdermalSystem|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|860695-24HRgalantaminehydrobromide16MGExtendedReleaseOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|238004-168HREstradiol0.00417MG/HRTransdermalSystem|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|238003-168HREstradiol0.00208MG/HRTransdermalSystem|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|2123111-NDA020503200ACTUATAlbuterol0.09MG/ACTUATMeteredDoseInhaler|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|205323-celecoxib200MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|205322-celecoxib100MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|2047882-1MLtestosteronecypionate200MG/MLInjection|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|203088-Ketoconazole20MG/MLTopicalCream|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|200345-Simvastatin80MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|200329-Omeprazole40MGDelayedReleaseOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|200311-Fenofibrate67MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|200285-Hydrochlorothiazide12.5MG/valsartan160MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|200284-Hydrochlorothiazide12.5MG/valsartan80MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|200224-montelukast10MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|200096-irbesartan300MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|200095-irbesartan150MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|200094-irbesartan75MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|199381-potassiumcitrate10MEQExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|199376-potassiumcitrate5MEQExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|199370-Ciprofloxacin100MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|199206-Riluzole50MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|198342-Urea400MG/MLTopicalCream|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|198318-Triazolam0.25MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|198317-Triazolam0.125MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|198252-tetracyclinehydrochloride500MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|198250-tetracyclinehydrochloride250MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|198242-Temazepam30MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|198241-Temazepam15MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|198189-Ramipril5MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|198188-Ramipril2.5MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|198052-Ondansetron4MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|198051-Omeprazole20MGDelayedReleaseOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|198036-24HRNifedipine90MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|198035-24HRNifedipine60MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|198034-24HRNifedipine30MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|861960-armodafinil200MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|197902-Lorazepam2MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|197900-Lorazepam0.5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|197877-Lidocaine25MG/ML/Prilocaine25MG/MLTopicalCream|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|197739-Glycopyrrolate2MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|197738-Glycopyrrolate1MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|197735-Gentamicin1MG/MLTopicalCream|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|197591-Diazepam5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|197590-Diazepam2MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|197589-Diazepam10MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|197541-Colchicine0.6MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|197529-Clonazepam2MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|197528-Clonazepam1MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|197527-Clonazepam0.5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|197512-Ciprofloxacin750MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|197511-Ciprofloxacin250MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|1926331-0.5UNTDoses3MLInsulinLispro100UNT/MLPenInjector|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|1918209-60ACTUATfluticasonepropionate0.055MG/ACTUAT/salmeterol0.014MG/ACTUATDryPowderInhaler|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|1918203-60ACTUATfluticasonepropionate0.232MG/ACTUAT/salmeterol0.014MG/ACTUATDryPowderInhaler|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|1918194-60ACTUATfluticasonepropionate0.113MG/ACTUAT/salmeterol0.014MG/ACTUATDryPowderInhaler|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|1812015-Osmotic24HRNifedipine90MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|1812013-Osmotic24HRNifedipine60MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|1812011-Osmotic24HRNifedipine30MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|1806197-30/70Release24HRMethylphenidateHydrochloride60MGExtendedReleaseOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|1806193-30/70Release24HRMethylphenidateHydrochloride50MGExtendedReleaseOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|1806191-30/70Release24HRMethylphenidateHydrochloride40MGExtendedReleaseOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|1650142-DoxycyclineMonohydrate100MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|1649990-DoxycyclineMonohydrate100MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|1649401-DoxycyclineMonohydrate50MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|1596780-60ACTUATTestosterone12.5MG/ACTUATTopicalGel|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|864706-MethadoneHydrochloride10MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|1550940-Colchicine0.6MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|1543069-Lidocaine0.05MG/MGTopicalOintment|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|1298091-FlurazepamHydrochloride30MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|1298088-FlurazepamHydrochloride15MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|1244214-Budesonide3MGDelayedReleaseOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|1149632-84HREstradiol0.00313MG/HRTransdermalSystem|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|1115698-Oseltamivir6MG/MLOralSuspension|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|1091497-MethylphenidateHydrochloride5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|1091392-MethylphenidateHydrochloride20MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|1091225-8HRMethylphenidateHydrochloride20MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|1091150-MethylphenidateHydrochloride10MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|1091145-8HRMethylphenidateHydrochloride10MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|106346-Mupirocin0.02MG/MGTopicalOintment|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|1049225-Acetaminophen325MG/OxycodoneHydrochloride7.5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|1049221-Acetaminophen325MG/OxycodoneHydrochloride5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|1049214-Acetaminophen325MG/OxycodoneHydrochloride10MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|104894-Ondansetron4MGDisintegratingOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|1009145-Amphetamineaspartate1.875MG/AmphetamineSulfate1.875MG/Dextroamphetaminesaccharate1.875MG/DextroamphetamineSulfate1.87|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|1000153-1MLmedroxyprogesteroneacetate150MG/MLPrefilledSyringe|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|864978-MethadoneHydrochloride40MGTabletforOralSuspension|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Generic|1000126-1MLmedroxyprogesteroneacetate150MG/MLInjection|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|999965-Glycopyrrolate0.2MG/MLOralSolution[Cuvposa]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|998666-carboxymethylcellulosesodium0.01MG/MGOphthalmicGel[TheraTears]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|901644-0.5MLStreptococcuspneumoniaeserotype1capsularantigendiphtheriaCRM197proteinconjugatevaccine0.0044MG/ML/Streptococcuspn|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|901518-0.5MLNeisseriameningitidisserogroupAoligosaccharidediphtheriaCRM197proteinconjugatevaccine0.02MG/ML/Neisseriameningiti|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|895756-PolyethyleneGlycol4000.004MG/MG/Propyleneglycol0.003MG/MGOphthalmicGel[Systane]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|864650-Ganciclovir0.0015MG/MGOphthalmicGel[Zirgan]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|847213-3MLInsulinLispro50UNT/ML/insulinlisproprotamine,human50UNT/MLPenInjector[HumalogMix]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|847199-3MLinsulinisophane,human100UNT/MLPenInjector[HumulinN]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|847189-3MLinsulinisophane,human70UNT/ML/insulin,regular,human30UNT/MLPenInjector[Humulin]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|836634-1MLhepatitisAvirusstrainCR326Fantigen,inactivated50UNT/MLPrefilledSyringe[Vaqta]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|830263-1MLHepatitisBSurfaceAntigenVaccine0.04MG/MLInjection[Recombivax]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|830253-0.5MLHepatitisBSurfaceAntigenVaccine0.01MG/MLPrefilledSyringe[Recombivax]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|830245-1MLHepatitisBSurfaceAntigenVaccine0.01MG/MLPrefilledSyringe[Recombivax]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|876519-Amlodipine10MG/telmisartan80MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|804186-0.5MLMeaslesVirusVaccineLive,Enders'attenuatedEdmonstonstrain2000UNT/ML/MumpsVirusVaccineLive,JerylLynnStrain25000UNT/|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|803371-1MLHepatitisAVaccine(Inactivated)StrainHM175720UNT/ML/HepatitisBSurfaceAntigenVaccine0.02MG/MLPrefilledSyringe[Twinrix|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|798482-0.5MLHepatitisAVaccine(Inactivated)StrainHM1751440UNT/MLPrefilledSyringe[Havrix]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|798479-1MLHepatitisAVaccine(Inactivated)StrainHM1751440UNT/MLPrefilledSyringe[Havrix]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|798428-1MLHepatitisBSurfaceAntigenVaccine0.02MG/MLPrefilledSyringe[Engerix-B]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|797641-0.5MLNeisseriameningitidisserogroupAcapsularpolysaccharidediphtheriatoxoidproteinconjugatevaccine0.104MG/ML/Neisseriam|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|795737-ChantixStartingMonthPAK|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|795735-ChantixContinuingMonthsOfTherapy1MGPack|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|762602-SalmonellatyphiTy21aliveantigen2000000000UNTDelayedReleaseOralCapsule[Vivotif]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|752388-InsulinLispro25UNT/ML/insulinlisproprotamine,human75UNT/MLInjectableSuspension[HumalogMix]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|731281-InsulinLispro50UNT/ML/insulinlisproprotamine,human50UNT/MLInjectableSuspension[HumalogMix]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|707566-PolyethyleneGlycol4004MG/ML/Propyleneglycol3MG/MLOphthalmicSolution[Systane]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|637190-varenicline1MGOralTablet[Chantix]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|637188-varenicline0.5MGOralTablet[Chantix]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|630981-PolyvinylAlcohol27MG/ML/Povidone20MG/MLOphthalmicSolution[Freshkote]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|404448-84HRoxybutynin0.162MG/HRTransdermalSystem[Oxytrol]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|351859-insulin,regular,human500UNT/MLInjectableSolution[HumulinR]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|351433-24HRNicotine0.292MG/HRTransdermalSystem[NicodermC-Q]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|351429-24HRNicotine0.875MG/HRTransdermalSystem[NicodermC-Q]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|351427-24HRNicotine0.583MG/HRTransdermalSystem[NicodermC-Q]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|311036-insulin,regular,human100UNT/MLInjectableSolution[HumulinR]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|311033-insulin,regular,human100UNT/MLInjectableSolution[NovolinR]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|311027-insulinisophane,human100UNT/MLInjectableSuspension[NovolinN]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|311026-insulinisophane,human100UNT/MLInjectableSuspension[HumulinN]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|261315-Oseltamivir75MGOralCapsule[Tamiflu]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|2360588-0.5MLNeisseriameningitidisserogroupAcapsularpolysaccharidetetanustoxoidproteinconjugatevaccine0.02MG/ML/Neisseriameni|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|2166928-10ACTUATolodaterol0.0025MG/ACTUAT/tiotropium0.0025MG/ACTUATInhalationSpray[Stiolto]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|2166204-10ACTUATtiotropium0.0025MG/ACTUATInhalationSpray[Spiriva]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|213442-insulinisophane,human70UNT/ML/insulin,regular,human30UNT/MLInjectableSuspension[Novolin]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|211947-Atovaquone150MG/MLOralSuspension[Mepron]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|211609-hypromellose5MG/MLOphthalmicSolution[IsoptoAlkaline]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|211140-PentosanPolysulfate100MGOralCapsule[Elmiron]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|2106334-0.5MLdiphtheriatoxoidvaccine,inactivated4UNT/ML/tetanustoxoidvaccine,inactivated4UNT/MLInjection[Tdvax]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|208821-Dexamethasone0.001MG/MG/Tobramycin0.003MG/MGOphthalmicOintment[Tobradex]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|892349-24HRMorphineSulfate60MGExtendedReleaseOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|2059017-rivaroxaban2.5MGOralTablet[Xarelto]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|2053927-sodiumzirconiumcyclosilicate10000MGPowderforOralSuspension[Lokelma]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|2050059-0.5MLHepatitisBSurfaceAntigenVaccine0.04MG/MLPrefilledSyringe[Heplisav-B]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|2047639-sodiumzirconiumcyclosilicate5000MGPowderforOralSuspension[Lokelma]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|2045382-30ACTUATfluticasonefuroate0.05MG/ACTUATDryPowderInhaler[Arnuity]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|2000136-Vancomycin50MG/MLOralSolution[Firvanq]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|2000133-Vancomycin25MG/MLOralSolution[Firvanq]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|1994352-0.5MLHepatitisBSurfaceAntigenVaccine0.04MG/MLInjection[Heplisav-B]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|1992428-Eliquis30-DayStarterPack|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|1992171-3MLInsulinLispro100UNT/MLPenInjector[Admelog]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|1992169-InsulinLispro100UNT/MLInjectableSolution[Admelog]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|1986830-0.5MLVaricellazostervirusglycoproteinE,recombinant0.1MG/MLInjection[Shingrix]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|1797888-Nicotine0.5MG/ACTUATMeteredDoseNasalSpray[Nicotrol]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|1736863-3MLInsulinGlargine100UNT/MLPenInjector[Basaglar]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|1731317-3MLinsulin,regular,human500UNT/MLPenInjector[HumulinR]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|1723478-dabigatranetexilate110MGOralCapsule[Pradaxa]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|1667882-60ACTUATtiotropium0.00125MG/ACTUATInhalationSpray[Spiriva]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|1658472-0.5MLStreptococcuspneumoniaetype1capsularpolysaccharideantigen0.05MG/ML/Streptococcuspneumoniaetype10Acapsularpolysac|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|1658157-1MLHepatitisBSurfaceAntigenVaccine0.02MG/MLInjection[Engerix-B]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|1658155-0.5MLHepatitisBSurfaceAntigenVaccine0.01MG/MLInjection[Recombivax]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|1658150-1MLHepatitisBSurfaceAntigenVaccine0.01MG/MLInjection[Recombivax]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|1658106-0.5MLhepatitisAvirusstrainCR326Fantigen,inactivated50UNT/MLInjection[Vaqta]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|1658102-1MLhepatitisAvirusstrainCR326Fantigen,inactivated50UNT/MLInjection[Vaqta]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|1658060-1MLHepatitisAVaccine(Inactivated)StrainHM1751440UNT/MLInjection[Havrix]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|1656356-sacubitril97MG/valsartan103MGOralTablet[Entresto]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|1656351-sacubitril49MG/valsartan51MGOralTablet[Entresto]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|1656346-sacubitril24MG/valsartan26MGOralTablet[Entresto]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|1601407-0.5MLmeningococcalgroupBvaccine0.1MG/ML/NeisseriameningitidisserogroupBrecombinantFHBPfusionproteinantigen0.1MG/ML/Ne|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|1597103-0.5MLL1protein,Humanpapillomavirustype11Vaccine0.08MG/ML/L1protein,Humanpapillomavirustype16Vaccine0.12MG/ML/L1protei|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|900156-24HRlamotrigine200MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|1597099-0.5MLL1protein,Humanpapillomavirustype11Vaccine0.08MG/ML/L1protein,Humanpapillomavirustype16Vaccine0.12MG/ML/L1protei|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|1596445-7ACTUATumeclidinium0.0625MG/ACTUATDryPowderInhaler[Incruse]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|1593140-0.5MLNeisseriameningitidisserogroupBrecombinantLP2086A05proteinvariantantigen0.12MG/ML/Neisseriameningitidisserogroup|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|1549683-Xarelto30-DayStarterPackKit|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|1547950-CarboxymethylcelluloseSodium2.5MG/MLOphthalmicSolution[TheraTears]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|1547672-30ACTUATfluticasonefuroate0.2MG/ACTUATDryPowderInhaler[Arnuity]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|1547664-14ACTUATfluticasonefuroate0.1MG/ACTUATDryPowderInhaler[Arnuity]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|1547582-0.5MLStreptococcuspneumoniaetype1capsularpolysaccharideantigen0.05MG/ML/Streptococcuspneumoniaetype10Acapsularpolysac|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|1364447-apixaban5MGOralTablet[Eliquis]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|1364441-apixaban2.5MGOralTablet[Eliquis]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|1363484-hypromellose0.003MG/MGOphthalmicGel[SystaneOvernightTherapy]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|1300468-0.5MLHaemophilusinfluenzaetypebstrain1482,capsularpolysaccharideinactivatedtetanustoxoidconjugatevaccine0.068MG/MLInj|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|1300378-0.5MLBordetellapertussisfilamentoushemagglutininvaccine,inactivated0.016MG/ML/Bordetellapertussispertactinvaccine,ina|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|1300370-0.5MLBordetellapertussisfilamentoushemagglutininvaccine,inactivated0.016MG/ML/Bordetellapertussispertactinvaccine,ina|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|1300206-0.5MLBordetellapertussisfilamentoushemagglutininvaccine,inactivated0.01MG/ML/Bordetellapertussisfimbriae2/3vaccine,in|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|1292459-0.5MLVaricella-ZosterVirusVaccineLive(Oka-Merck)strain2700UNT/MLInjection[Varivax]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|1190919-0.5MLdiphtheriatoxoidvaccine,inactivated4UNT/ML/tetanustoxoidvaccine,inactivated10UNT/MLPrefilledSyringe[Tenivac]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|1190916-0.5MLdiphtheriatoxoidvaccine,inactivated4UNT/ML/tetanustoxoidvaccine,inactivated10UNT/MLInjection[Tenivac]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|1115892-MineralOil0.15MG/MG/Petrolatum0.85MG/MGOphthalmicOintment[Puralube]|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|903857-PyridostigmineBromide60MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|106892-insulinisophane,human70UNT/ML/insulin,regular,human30UNT/MLInjectableSuspension[Humulin]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|1049216-Acetaminophen325MG/OxycodoneHydrochloride10MGOralTablet[Endocet]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|1046920-Nicotine4MGInhalationSolution[Nicotrol]|EXPANSION FULL DUALS 632|2002|N|N|Y||Preferred Brand|1037181-dabigatranetexilate75MGOralCapsule[Pradaxa]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|999613-SulfacetamideSodium100MG/ML/Sulfur50MG/MLMedicatedLiquidSoap|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|997501-Fexofenadinehydrochloride60MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|997491-Fexofenadinehydrochloride6MG/MLOralSuspension|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|997420-Fexofenadinehydrochloride180MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|997229-Donepezilhydrochloride5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|997226-Donepezilhydrochloride5MGDisintegratingOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|997223-Donepezilhydrochloride10MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|997220-Donepezilhydrochloride10MGDisintegratingOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|996824-MethylergonovineMaleate0.2MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|996572-{21(Memantinehydrochloride10MGOralTablet)/28(Memantinehydrochloride5MGOralTablet)}Pack|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|968766-PhentermineHydrochloride15MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|996571-Memantinehydrochloride5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|996561-Memantinehydrochloride10MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|996520-DextromethorphanHydrobromide2MG/ML/Guaifenesin20MG/MLOralSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|995666-MeclizineHydrochloride25MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|995632-MeclizineHydrochloride25MGChewableTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|995624-MeclizineHydrochloride12.5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|995607-EthambutolHydrochloride400MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|995599-EthambutolHydrochloride100MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|995281-HydroxyzineHydrochloride50MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|995278-HydroxyzinePamoate50MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|995258-HydroxyzineHydrochloride25MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|995253-HydroxyzinePamoate25MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|995241-HydroxyzineHydrochloride2MG/MLOralSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|995232-HydroxyzinePamoate100MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|995218-HydroxyzineHydrochloride10MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|993943-Acetaminophen325MG/butalbital50MG/Caffeine40MG/CodeinePhosphate30MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|993691-BupropionHydrochloride75MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|993687-BupropionHydrochloride100MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|993557-24HRBupropionHydrochloride300MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|993541-24HRBupropionHydrochloride150MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|993536-12HRBupropionHydrochloride200MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|993518-12HRBupropionHydrochloride150MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|993503-12HRBupropionHydrochloride100MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|992780-MiconazoleNitrate100MGVaginalInsert|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|992775-{1(MiconazoleNitrate1200MGVaginalInsert)/1(9000MG)(MiconazoleNitrate20MG/MLVaginalCream)}Pack|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|992528-Terbinafinehydrochloride10MG/MLTopicalCream|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|992475-PromethazineHydrochloride50MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|992454-PromethazineHydrochloride25MGRectalSuppository|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|992447-PromethazineHydrochloride25MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|992441-PromethazineHydrochloride12.5MGRectalSuppository|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|992438-PromethazineHydrochloride12.5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|992432-PromethazineHydrochloride1.25MG/MLOralSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|992184-methenaminemandelate500MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|992153-methenaminemandelate1000MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|991086-DicyclomineHydrochloride20MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|991061-DicyclomineHydrochloride10MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|979492-LosartanPotassium50MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|979485-LosartanPotassium25MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|979480-LosartanPotassium100MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|979475-MetaproterenolSulfate20MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|979471-Hydrochlorothiazide25MG/LosartanPotassium100MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|979468-Hydrochlorothiazide12.5MG/LosartanPotassium50MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|979464-Hydrochlorothiazide12.5MG/LosartanPotassium100MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|979444-MetaproterenolSulfate2MG/MLOralSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|979409-MetaproterenolSulfate10MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|979092-HydroxychloroquineSulfate200MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|978006-LoperamideHydrochloride2MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|966920-POLYETHYLENEGLYCOL3350236000MG/PotassiumChloride2970MG/SodiumBicarbonate6740MG/SodiumChloride5860MG/sodiumsulfate22740|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|966914-POLYETHYLENEGLYCOL3350240000MG/PotassiumChloride2980MG/SodiumBicarbonate6720MG/SodiumChloride5840MG/sodiumsulfate22720|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|966270-LevothyroxineSodium0.137MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|966253-LevothyroxineSodium0.088MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|966249-LevothyroxineSodium0.175MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|966248-LevothyroxineSodium0.112MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|966225-LevothyroxineSodium0.15MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|966224-LevothyroxineSodium0.125MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|966222-LevothyroxineSodium0.075MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|966221-LevothyroxineSodium0.05MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|966220-LevothyroxineSodium0.025MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|905395-HydralazineHydrochloride50MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|905225-HydralazineHydrochloride25MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|905222-HydralazineHydrochloride100MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|905199-HydralazineHydrochloride10MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|905158-Sirolimus0.5MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|Y||Preferred Brand|665040-sitagliptin25MGOralTablet[Januvia]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|904932-ibandronicacid150MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|904481-PravastatinSodium80MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|904475-PravastatinSodium40MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|904467-PravastatinSodium20MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|904458-PravastatinSodium10MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|904431-Alendronicacid70MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|904396-Alendronicacid35MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|904170-PrimaquinePhosphate26.3MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|903891-FluvoxamineMaleate50MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|903887-FluvoxamineMaleate25MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|903884-FluvoxamineMaleate100MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|903703-liothyroninesodium0.05MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|903697-liothyroninesodium0.025MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|N||Preferred Generic|999991-Amlodipine10MG/Hydrochlorothiazide25MG/Olmesartanmedoxomil40MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|903456-liothyroninesodium0.005MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|898723-Benazeprilhydrochloride5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|898690-Benazeprilhydrochloride20MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|898687-Benazeprilhydrochloride10MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|898378-Benazeprilhydrochloride5MG/Hydrochlorothiazide6.25MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|898372-Benazeprilhydrochloride20MG/Hydrochlorothiazide25MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|Y||Preferred Brand|861821-Metforminhydrochloride500MG/sitagliptin50MGOralTablet[Janumet]|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|898367-Benazeprilhydrochloride20MG/Hydrochlorothiazide12.5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|898359-Amlodipine5MG/Benazeprilhydrochloride40MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|898356-Amlodipine5MG/Benazeprilhydrochloride20MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|898353-Amlodipine5MG/Benazeprilhydrochloride10MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|898350-Amlodipine2.5MG/Benazeprilhydrochloride10MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|898346-Amlodipine10MG/Benazeprilhydrochloride40MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|898342-Amlodipine10MG/Benazeprilhydrochloride20MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|897722-Verapamilhydrochloride40MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|897683-Verapamilhydrochloride80MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|897666-Verapamilhydrochloride120MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|897649-Verapamilhydrochloride240MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|897624-24HRVerapamilhydrochloride240MGExtendedReleaseOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|897596-24HRVerapamilhydrochloride300MGExtendedReleaseOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|897590-24HRVerapamilhydrochloride200MGExtendedReleaseOralCapsule|EXPANSION FULL DUALS 632|2002|Y|N|Y||Preferred Generic|106303-Tretinoin0.5MG/MLTopicalCream|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|897584-24HRVerapamilhydrochloride100MGExtendedReleaseOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|896766-Labetalolhydrochloride300MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|896762-Labetalolhydrochloride200MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|896758-Labetalolhydrochloride100MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|896209-60ACTUATFluticasonepropionate0.25MG/ACTUAT/salmeterol0.05MG/ACTUATDryPowderInhaler|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|895987-Fluticasonepropionate0.5MG/MLTopicalCream|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|895487-Fluticasonepropionate0.00005MG/MGTopicalOintment|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|892255-LevothyroxineSodium0.3MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|892251-LevothyroxineSodium0.2MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|892246-LevothyroxineSodium0.1MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|886671-FlecainideAcetate150MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|886666-FlecainideAcetate100MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|886662-FlecainideAcetate50MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|885857-Balsalazidedisodium750MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|884707-Estradiol0.01MGVaginalInsert|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|884308-Nystatin100UNT/MGTopicalOintment|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|884189-ClonidineHydrochloride0.3MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|884185-ClonidineHydrochloride0.2MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|884173-ClonidineHydrochloride0.1MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|876193-POLYETHYLENEGLYCOL335017000MGPowderforOralSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|866924-MetoprololTartrate25MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|866514-MetoprololTartrate50MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|866511-MetoprololTartrate100MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|866436-24HRmetoprololsuccinate50MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|866427-24HRmetoprololsuccinate25MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|866419-24HRmetoprololsuccinate200MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|866412-24HRmetoprololsuccinate100MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|866144-Cyproheptadinehydrochloride4MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|866111-buspironehydrochloride7.5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|866094-buspironehydrochloride5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|866090-buspironehydrochloride30MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|866083-buspironehydrochloride10MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|866018-buspironehydrochloride15MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|863669-Tamsulosinhydrochloride0.4MGOralCapsule|EXPANSION FULL DUALS 632|2002|Y|N|Y||Preferred Generic|310140-eprosartan600MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|863664-Oxybutyninchloride5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|863636-24HROxybutyninchloride5MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|863628-24HROxybutyninchloride15MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|863619-24HROxybutyninchloride10MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|861753-Glyburide5MG/Metforminhydrochloride500MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|861748-Glyburide2.5MG/Metforminhydrochloride500MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|861743-Glyburide1.25MG/Metforminhydrochloride250MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|861657-24HRNitroglycerin0.1MG/HRTransdermalSystem|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|861495-ClobetasolPropionate0.5MG/MLTopicalCream|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|861487-ClobetasolPropionate0.5MG/MLTopicalSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|861448-ClobetasolPropionate0.0005MG/MGTopicalOintment|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|861430-PropafenoneHydrochloride300MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|861427-PropafenoneHydrochloride225MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|861424-PropafenoneHydrochloride150MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|861416-Azithromycin1000MGPowderforOralSuspension|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|861200-Brimonidinetartrate2MG/MLOphthalmicSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|861171-12HRPropafenoneHydrochloride425MGExtendedReleaseOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|861164-12HRPropafenoneHydrochloride325MGExtendedReleaseOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|861156-12HRPropafenoneHydrochloride225MGExtendedReleaseOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|861132-24HRAlfuzosinhydrochloride10MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|861064-Sertraline20MG/MLOralSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|861010-Metforminhydrochloride850MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|861007-Metforminhydrochloride500MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|861004-Metforminhydrochloride1000MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|860981-24HRMetforminhydrochloride750MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|860975-24HRMetforminhydrochloride500MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|860805-Azelastinehydrochloride0.5MG/MLOphthalmicSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|860225-MegestrolAcetate40MG/MLOralSuspension|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|860221-MegestrolAcetate40MGOralTablet|EXPANSION FULL DUALS 632|2002|Y|N|Y||Preferred Generic|577033-sildenafil20MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|860215-MegestrolAcetate20MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|860107-KetorolacTromethamine5MG/MLOphthalmicSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|859751-Rosuvastatincalcium20MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|859747-Rosuvastatincalcium10MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|859424-Rosuvastatincalcium5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|859419-Rosuvastatincalcium40MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|859193-selegilinehydrochloride5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|859186-selegilinehydrochloride5MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|859052-Pramipexoledihydrochloride1MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|859048-Pramipexoledihydrochloride1.5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|859044-Pramipexoledihydrochloride0.5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|859040-Pramipexoledihydrochloride0.25MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|859033-Pramipexoledihydrochloride0.125MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|858828-EnalaprilMaleate10MG/Hydrochlorothiazide25MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|858824-EnalaprilMaleate5MG/Hydrochlorothiazide12.5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|858817-EnalaprilMaleate10MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|858813-EnalaprilMaleate5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|858810-EnalaprilMaleate20MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|858804-EnalaprilMaleate2.5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|858747-Ursodiol300MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|858625-Pramipexoledihydrochloride0.75MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|858616-Nicardipinehydrochloride30MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|858613-Nicardipinehydrochloride20MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|857683-TerbutalineSulfate5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|857677-TerbutalineSulfate2.5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|857461-ClemastineFumarate2.68MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|857340-BethanecholChloride50MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|857336-BethanecholChloride5MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|857328-BethanecholChloride25MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|857321-BethanecholChloride10MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|857305-ClomipramineHydrochloride75MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|857301-ClomipramineHydrochloride50MGOralCapsule|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|857297-ClomipramineHydrochloride25MGOralCapsule|EXPANSION FULL DUALS 632|2002|Y|N|Y||Preferred Generic|891893-MorphineSulfate60MGExtendedReleaseOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|857187-FosinoprilSodium40MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|857183-FosinoprilSodium20MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|857169-FosinoprilSodium10MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|856853-AmitriptylineHydrochloride75MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|856845-AmitriptylineHydrochloride50MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|856840-AmitriptylineHydrochloride50MG/Perphenazine4MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|856834-AmitriptylineHydrochloride25MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|856825-AmitriptylineHydrochloride25MG/Perphenazine4MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|856797-AmitriptylineHydrochloride25MG/Perphenazine2MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|856783-AmitriptylineHydrochloride10MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|856773-AmitriptylineHydrochloride150MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|856762-AmitriptylineHydrochloride100MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|856733-PropranololHydrochloride8MG/MLOralSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|856724-PropranololHydrochloride4MG/MLOralSolution|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|856720-AmitriptylineHydrochloride10MG/Perphenazine4MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|856706-AmitriptylineHydrochloride10MG/Perphenazine2MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|856578-PropranololHydrochloride80MGOralTablet|EXPANSION FULL DUALS 632|2002|N|N|N||Preferred Generic|856556-PropranololHydrochloride60MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|856519-PropranololHydrochloride40MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|856457-PropranololHydrochloride20MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|856448-PropranololHydrochloride10MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|856429-Hydrochlorothiazide25MG/PropranololHydrochloride80MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|856422-Hydrochlorothiazide25MG/PropranololHydrochloride40MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|856377-TrazodoneHydrochloride50MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|856373-TrazodoneHydrochloride100MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|856364-TrazodoneHydrochloride150MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|855926-DiclofenacSodium75MGDelayedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|855911-2MLPhenytoinsodium50MG/MLCartridge|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|855906-DiclofenacSodium50MGDelayedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|855873-Phenytoinsodium300MGExtendedReleaseOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|855861-Phenytoinsodium200MGExtendedReleaseOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|855818-prasugrel5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|855812-prasugrel10MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|855671-Phenytoinsodium100MGExtendedReleaseOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|855664-DiclofenacSodium25MGDelayedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|855480-alclometasonedipropionate0.0005MG/MGTopicalOintment|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|855474-alclometasonedipropionate0.5MG/MLTopicalCream|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|855344-WarfarinSodium7.5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|855338-WarfarinSodium6MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|855332-WarfarinSodium5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|855324-WarfarinSodium4MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|855318-WarfarinSodium3MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|855312-WarfarinSodium2.5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|855302-WarfarinSodium2MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|855296-WarfarinSodium10MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|855288-WarfarinSodium1MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|855172-levocetirizinedihydrochloride5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|855168-levocetirizinedihydrochloride0.5MG/MLOralSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|854905-BisoprololFumarate5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|854901-BisoprololFumarate10MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|854801-DiclofenacSodium1MG/MLOphthalmicSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|852913-QuinidineSulfate300MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|852877-QuinidineSulfate200MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|849515-DesmopressinAcetate0.1MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|849506-DesmopressinAcetate0.01MG/ACTUATNasalSpray|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|848943-CholestyramineResin4000MGPowderforOralSuspension|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|848176-AugmentedBetamethasone0.5MG/MLTopicalCream|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|847121-CalciumCitrate1500MG/Cholecalciferol250UNTOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|836358-IpratropiumBromide0.2MG/MLInhalationSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|835925-cyclosporine,modified50MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|835913-MefloquineHydrochloride250MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|835894-cyclosporine,modified25MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|835886-cyclosporine,modified100MG/MLOralSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|835593-ImipramineHydrochloride10MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|835568-ImipramineHydrochloride50MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|835564-ImipramineHydrochloride25MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|834127-chlorhexidinegluconate1.2MG/MLMouthwash|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|834102-PenicillinVPotassium500MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|834061-PenicillinVPotassium250MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|834046-PenicillinVPotassium25MG/MLOralSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|834040-PenicillinVPotassium50MG/MLOralSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|833528-Amiodaronehydrochloride200MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|833217-DiltiazemHydrochloride30MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|833008-DesmopressinAcetate0.2MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|832909-CalciumCarbonate1250MG/Cholecalciferol100UNTChewableTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|831261-CromolynSodium20MG/MLOralSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|831109-CromolynSodium40MG/MLOphthalmicSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|831103-DiltiazemHydrochloride60MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|831102-DiltiazemHydrochloride90MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|831054-DiltiazemHydrochloride120MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|830882-24HRDiltiazemHydrochloride300MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|828348-Cyclobenzaprinehydrochloride10MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|828320-Cyclobenzaprinehydrochloride5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|801054-POLYETHYLENEGLYCOL3350420000MG/PotassiumChloride1480MG/SodiumBicarbonate5720MG/SodiumChloride11200MGPowderforOralSolut|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|763185-{21(Prednisone10MGOralTablet)}Pack|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|763181-{21(Prednisone5MGOralTablet)}Pack|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|762675-{21(Methylprednisolone4MGOralTablet)}Pack|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|756209-Zidovudine10MG/MLOralSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|755497-Albuterol0.4MG/MLOralSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|751901-{84(EthinylEstradiol0.03MG/Levonorgestrel0.15MGOralTablet)/7(InertIngredients1MGOralTablet)}Pack|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|749860-{21(EthinylEstradiol0.035MG/norgestimate0.25MGOralTablet)/7(InertIngredients1MGOralTablet)}Pack|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|749784-{7(EthinylEstradiol0.035MG/norgestimate0.18MGOralTablet)/7(EthinylEstradiol0.035MG/norgestimate0.215MGOralTablet)/7(Et|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|749783-{6(Azithromycin250MGOralTablet)}Pack|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|749780-{3(Azithromycin500MGOralTablet)}Pack|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|749157-{7(EthinylEstradiol0.025MG/norgestimate0.18MGOralTablet)/7(EthinylEstradiol0.025MG/norgestimate0.215MGOralTablet)/7(Et|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|748961-{28(Norethindrone0.35MGOralTablet)}Pack|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|748868-{21(EthinylEstradiol0.02MG/Levonorgestrel0.1MGOralTablet)/7(InertIngredients1MGOralTablet)}Pack|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|748800-{21(drospirenone3MG/EthinylEstradiol0.03MGOralTablet)/7(InertIngredients1MGOralTablet)}Pack|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|727316-NDA0194300.3MLEpinephrine0.5MG/MLAuto-Injector|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|722137-Amlodipine5MG/valsartan320MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|722134-Amlodipine5MG/valsartan160MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|722131-Amlodipine10MG/valsartan320MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|722126-Amlodipine10MG/valsartan160MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|702519-Phenobarbital4MG/MLOralSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|702249-ferroussulfate44MG/MLOralSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|692783-Loratadine1MG/MLOralSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|686924-carvedilol3.125MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|686418-ErythromycinEthylsuccinate80MG/MLOralSuspension|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|686405-ErythromycinEthylsuccinate400MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|686400-ErythromycinEthylsuccinate40MG/MLOralSuspension|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|647121-5MLLevetiracetam100MG/MLInjection|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|646456-Nystatin100UNT/MGTopicalPowder|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|646333-Capsaicin1MG/MLTopicalCream|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|643102-Ibuprofen200MGOralTablet[Wal-Profen]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|639566-VitaminB650MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|628953-PotassiumChloride10MEQExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|617993-Amoxicillin120MG/ML/Clavulanate8.58MG/MLOralSuspension|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|617430-Amoxicillin80MG/ML/Clavulanate11.4MG/MLOralSuspension|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|617423-Amoxicillin40MG/ML/Clavulanate5.7MG/MLOralSuspension|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|617322-Amoxicillin50MG/ML/Clavulanate12.5MG/MLOralSuspension|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|617316-Amoxicillin400MG/Clavulanate57MGChewableTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|617312-atorvastatin10MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|617311-atorvastatin40MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|617310-atorvastatin20MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|617309-Amoxicillin200MG/Clavulanate28.5MGChewableTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|617296-Amoxicillin500MG/Clavulanate125MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|598025-Amoxicillin250MGChewableTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|598006-Erythromycin250MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|597852-anagrelide1MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|596843-lansoprazole15MGDelayedReleaseOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|583170-Salsalate750MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|582926-podofilox5MG/MLTopicalSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|577040-CalciumCarbonate648MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|562704-ropinirole4MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|562524-12HRAcetazolamide500MGExtendedReleaseOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|562510-SodiumFluoride2MG/MLMouthwash|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|562508-Amoxicillin875MG/Clavulanate125MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|562251-Amoxicillin250MG/Clavulanate125MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|544455-Lactulose667MG/MLOralSolution[Generlac]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|543546-Nystatin100000UNT/MLTopicalCream|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|486152-24HRNitroglycerin0.4MG/HRTransdermalSystem|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|486148-24HRNitroglycerin0.2MG/HRTransdermalSystem|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|486146-24HRNitroglycerin0.6MG/HRTransdermalSystem|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|486131-BenzoylPeroxide0.1MG/MGTopicalGel|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|476809-Mirtazapine7.5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|476576-cefdinir50MG/MLOralSuspension|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|432402-cinacalcet30MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|432401-cinacalcet60MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|432400-cinacalcet90MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|429503-Hydrochlorothiazide12.5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|403967-zonisamide50MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|403966-zonisamide25MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|403855-Hydrochlorothiazide25MG/Olmesartanmedoxomil40MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|403854-Hydrochlorothiazide12.5MG/Olmesartanmedoxomil40MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|403853-Hydrochlorothiazide12.5MG/Olmesartanmedoxomil20MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|402698-24HRFelodipine2.5MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|402696-24HRFelodipine5MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|402695-24HRFelodipine10MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|393245-Digoxin0.05MG/MLOralSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|391937-Lactulose667MG/MLOralSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|387003-Levetiracetam1000MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|381056-IsosorbideDinitrate10MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|360110-Sirolimus2MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|359601-Guaifenesin400MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|359296-calciumacetate667MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|353538-24HRIsosorbideMononitrate60MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|351250-Escitalopram20MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|351249-Escitalopram5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|351172-Dutasteride0.5MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|351137-Albuterol0.21MG/MLInhalationSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|351136-Albuterol0.417MG/MLInhalationSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|349420-desloratadine5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|349405-Olmesartanmedoxomil40MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|349401-Olmesartanmedoxomil20MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|349373-Olmesartanmedoxomil5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|349332-Escitalopram10MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|349208-Sirolimus1MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|348472-Theophylline600MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|343033-Dexamethasone0.75MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|328161-Methylprednisolone16MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|328160-Cyclosporine100MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|318272-Aspirin81MGChewableTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|317769-Theophylline300MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|317573-pioglitazone15MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|317173-Captopril25MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|317136-Nortriptyline25MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|317128-Misoprostol0.2MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|317110-24HRIsosorbideMononitrate30MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|315187-Prednisone1MG/MLOralSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|315183-PotassiumChloride8MEQExtendedReleaseOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|315134-Levocarnitine100MG/MLOralSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|315107-24HRGlipizide10MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|315102-SodiumFluoride1.1MG/MLOralSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|315090-Erythromycin333MGDelayedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|314277-venlafaxine50MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|314241-Theophylline450MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|314238-Tropicamide10MG/MLOphthalmicSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|314234-Sucralfate1000MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|314231-Simvastatin10MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|314208-ropinirole1MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|314203-quinapril40MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|314182-PotassiumChloride2.67MEQ/MLOralSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|314165-prednisolone10MG/MLOphthalmicSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|314131-Niacin250MGExtendedReleaseOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|314111-Mirtazapine30MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|314106-Metronidazole250MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|314077-Lisinopril20MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|314076-Lisinopril10MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|314072-latanoprost0.05MG/MLOphthalmicSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|314055-IsosorbideDinitrate5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|314006-24HRGlipizide5MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|314000-Glyburide1.5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|313989-Fluoxetine40MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|313988-Furosemide40MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|313979-fludrocortisoneacetate0.1MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|313919-salmoncalcitonin200UNT/ACTUATNasalSpray|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|313888-Cefaclor50MG/MLOralSuspension|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|313850-Amoxicillin40MG/MLOralSuspension|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|313797-Amoxicillin25MG/MLOralSuspension|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|313786-AceticAcid20MG/ML/Hydrocortisone10MG/MLOticSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|313586-venlafaxine75MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|313585-24HRvenlafaxine75MGExtendedReleaseOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|313584-venlafaxine37.5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|313583-24HRvenlafaxine37.5MGExtendedReleaseOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|313582-venlafaxine25MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|313581-24HRvenlafaxine150MGExtendedReleaseOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|313580-venlafaxine100MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|313565-valacyclovir500MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|313564-valacyclovir1000MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|313521-Tropicamide5MG/MLOphthalmicSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|313477-Trifluridine10MG/MLOphthalmicSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|313428-Toremifene60MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|313423-Tolnaftate10MG/MLTopicalSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|313306-Theophylline5.33MG/MLOralSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|313291-Theophylline400MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|313227-terconazole8MG/MLVaginalCream|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|313226-terconazole4MG/MLVaginalCream|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|313219-Terazosin5MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|313217-Terazosin2MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|313215-Terazosin1MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|313195-Tamoxifen20MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|313190-Tacrolimus0.5MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|313142-Sulfasalazine500MGDelayedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|313134-Sulfamethoxazole40MG/ML/Trimethoprim8MG/MLOralSuspension|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|313123-Sucralfate100MG/MLOralSuspension|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|313096-Spironolactone25MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|313092-Sorbitol700MG/MLOralSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|312997-SodiumChloride9MG/MLInhalationSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|312962-Simvastatin5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|312961-Simvastatin20MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|312941-Sertraline50MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|312940-Sertraline25MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|312938-Sertraline100MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|312899-Salsalate500MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|312849-ropinirole5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|312847-ropinirole2MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|312846-ropinirole0.5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|312845-ropinirole0.25MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|312750-quinapril5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|312749-quinapril20MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|312748-quinapril10MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|312641-Progesterone200MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|312635-Prochlorperazine5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|312617-Prednisone5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|312615-Prednisone20MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|312594-Prazosin2MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|312593-Prazosin1MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|312529-PotassiumChloride8MEQExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|312515-PotassiumChloride1.33MEQ/MLOralSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|312504-PotassiumChloride10MEQExtendedReleaseOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|312441-pioglitazone45MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|312440-pioglitazone30MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|312362-Phenobarbital30MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|312357-Phenobarbital15MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|312301-Pentoxifylline400MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|312289-Naloxone0.5MG/Pentazocine50MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|312138-oxcarbazepine600MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|312137-oxcarbazepine300MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|312136-oxcarbazepine150MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|312059-Nystatin500000UNTOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|312055-Nystatin100000UNT/MLOralSuspension|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|312036-Nortriptyline2MG/MLOralSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|312013-Nitroglycerin2.5MGExtendedReleaseOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|311995-NITROFURANTOIN,MACROCRYSTALS50MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|311994-NITROFURANTOIN,MACROCRYSTALS25MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|311989-Nitrofurantoin5MG/MLOralSuspension|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|311963-Niacin750MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|311960-Niacin500MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|311955-Niacin250MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|311893-nabumetone750MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|311892-nabumetone500MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|311727-Misoprostol0.1MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|311726-Mirtazapine45MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|311725-Mirtazapine15MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|311681-Metronidazole500MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|311679-Metronidazole0.0075MG/MGTopicalGel|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|311678-Metronidazole7.5MG/MLTopicalCream|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|311668-Metoclopramide5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|311666-Metoclopramide10MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|311665-Metipranolol3MG/MLOphthalmicSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|311486-meloxicam7.5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|311376-Lorazepam2MG/MLOralSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|311372-Loratadine10MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|311354-Lisinopril5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|311353-Lisinopril2.5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|311296-Levofloxacin750MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|311290-Levetiracetam750MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|311289-Levetiracetam500MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|311288-Levetiracetam250MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|311277-lansoprazole30MGDelayedReleaseOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|311264-lamotrigine25MGChewableTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|311197-IsosorbideMononitrate20MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|311196-24HRIsosorbideMononitrate120MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|311194-IsosorbideDinitrate40MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|311192-IsosorbideMononitrate10MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|311166-isoniazid100MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310982-imiquimod50MG/MLTopicalCream|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310965-Ibuprofen200MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310964-Ibuprofen200MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310891-Hydrocortisone25MG/MLTopicalCream|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310818-Hydrochlorothiazide50MG/Triamterene75MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310812-Hydrochlorothiazide25MG/Triamterene37.5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310809-Hydrochlorothiazide25MG/quinapril20MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310798-Hydrochlorothiazide25MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310797-Hydrochlorothiazide12.5MG/quinapril20MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310796-Hydrochlorothiazide12.5MG/quinapril10MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310687-Hydrocortisone10MG/ML/Neomycin3.5MG/ML/PolymyxinB10000UNT/MLOticSuspension|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310594-Gramicidin0.025MG/ML/Neomycin1.75MG/ML/PolymyxinB10000UNT/MLOphthalmicSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310539-Glyburide6MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310537-Glyburide5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310536-Glyburide3MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310534-Glyburide2.5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310490-Glipizide5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310489-24HRGlipizide2.5MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310488-Glipizide10MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310459-Gemfibrozil600MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310442-Ganciclovir500MGInjection|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310434-gabapentin800MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310433-gabapentin600MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310432-gabapentin400MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310431-gabapentin300MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310430-gabapentin100MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310429-Furosemide20MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310410-FolicAcid1MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310386-Fluoxetine4MG/MLOralSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310385-Fluoxetine20MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310384-Fluoxetine10MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310380-Fluorouracil50MG/MLTopicalSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310379-Fluorouracil20MG/MLTopicalSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310377-Fluorometholone1MG/MLOphthalmicSuspension|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310364-Fluocinonide0.5MG/MLTopicalSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310362-Fluocinonide0.0005MG/MGTopicalGel|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310353-Fluconazole40MG/MLOralSuspension|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310352-Fluconazole10MG/MLOralSuspension|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310346-Finasteride5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310325-ferroussulfate325MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310324-ferroussulfate325MGDelayedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310273-Famotidine20MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310261-exemestane25MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310169-Estradiol0.1MG/MLVaginalCream|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310157-Erythromycin500MGDelayedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310155-Erythromycin250MGDelayedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310154-Erythromycin250MGDelayedReleaseOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310015-dorzolamide20MG/MLOphthalmicSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|309955-Dipyridamole75MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|309952-Dipyridamole25MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|309686-Dexamethasone0.1MG/MLOralSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|309680-Dexamethasone1MG/ML/Neomycin3.5MG/ML/PolymyxinB10000UNT/MLOphthalmicSuspension|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|309679-Dexamethasone0.001MG/MG/Neomycin0.0035MG/MG/PolymyxinB10UNT/MGOphthalmicOintment|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|309594-vitaminB121MG/MLInjectableSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|309371-Clotrimazole10MGOralLozenge|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|309370-Clotrimazole10MG/MLTopicalSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|309367-Clotrimazole10MG/MLTopicalCream|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|309362-clopidogrel75MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|309337-Clindamycin20MG/MLVaginalCream|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|309313-Citalopram2MG/MLOralSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|309291-ciclopirox80MG/MLTopicalSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|309290-ciclopirox7.7MG/MLTopicalLotion|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|309273-cholinesalicylate58.6MG/ML/MagnesiumSalicylate72.4MG/MLOralSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|309115-Cephalexin250MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|309114-Cephalexin500MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|309113-Cephalexin50MG/MLOralSuspension|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|309112-Cephalexin250MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|309110-Cephalexin25MG/MLOralSuspension|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|309098-Cefuroxime500MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|309054-cefdinir25MG/MLOralSuspension|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|309045-Cefaclor250MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|309044-Cefaclor25MG/MLOralSuspension|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|308989-Carbidopa50MG/Levodopa200MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|308988-Carbidopa25MG/Levodopa100MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|308979-Carbamazepine200MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|308976-Carbamazepine20MG/MLOralSuspension|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|308973-Carbamazepine100MGChewableTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|308964-Captopril50MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|308963-Captopril12.5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|308962-Captopril100MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|308891-CalciumCarbonate250MG/MLOralSuspension|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|308868-Calcitriol0.0005MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|308867-Calcitriol0.00025MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|308725-bexarotene75MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|308714-Betamethasone0.5MG/ML/Clotrimazole10MG/MLTopicalCream|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|308696-BenzoylPeroxide50MG/MLMedicatedLiquidSoap|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|308694-BenzoylPeroxide0.05MG/MGTopicalGel|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|308689-BenzoylPeroxide0.025MG/MGTopicalGel|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|308512-Bacitracin0.5UNT/MG/PolymyxinB10UNT/MGTopicalOintment|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|308508-Bacitracin0.5UNT/MGOphthalmicOintment|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|308493-Bacitracin0.4UNT/MG/Neomycin0.0035MG/MG/PolymyxinB10UNT/MGOphthalmicOintment|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|308459-Azithromycin20MG/MLOralSuspension|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|308416-Aspirin81MGDelayedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|308345-apraclonidine5MG/MLOphthalmicSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|308212-Ampicillin500MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|308194-Amoxicillin875MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|308191-Amoxicillin500MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|308189-Amoxicillin80MG/MLOralSuspension|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|308182-Amoxicillin250MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|308177-Amoxicillin125MGChewableTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|308136-Amlodipine2.5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|308135-Amlodipine10MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|308078-AluminumHydroxide64MG/MLOralSuspension|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|307730-Acyclovir40MG/MLOralSuspension|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|307719-Acetylcysteine200MG/MLInhalationSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|307718-Acetylcysteine100MG/MLInhalationSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|307675-Acetaminophen32MG/MLOralSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|284988-Didanosine400MGDelayedReleaseOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|284245-Famotidine40MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|284215-Clindamycin300MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|284185-Didanosine200MGDelayedReleaseOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|284184-Didanosine250MGDelayedReleaseOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|283858-ropinirole3MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|283672-Citalopram10MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|283523-gabapentin50MG/MLOralSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|283485-Mirtazapine45MGDisintegratingOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|283433-Melatonin10MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|283406-Mirtazapine15MGDisintegratingOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|283077-prednisolone3MG/MLOralSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|282755-telmisartan20MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|282401-lamotrigine25MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|260376-Terazosin10MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|260243-Progesterone100MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|259966-Methylprednisolone4MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|259255-atorvastatin80MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|2532159-PMDDfluoxetine10MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|253059-Levocarnitine500MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|253039-Melatonin1MG/MLOralSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|252732-Melatonin5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|251322-Ethosuximide50MG/MLOralSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|251156-ferroussulfate75MG/MLOralSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|248420-mesalamine1000MGRectalSuppository|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|248109-Ribavirin200MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|245314-Albuterol5MG/MLInhalationSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|244967-PolymyxinB10000UNT/ML/Trimethoprim1MG/MLOphthalmicSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|242590-ferrousgluconate240MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|242446-Ofloxacin3MG/MLOticSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|241834-cyclosporine,modified100MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|240209-Betamethasone0.5MG/MLTopicalLotion|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|240029-Cholecalciferol0.125MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|239238-Griseofulvin25MG/MLOralSuspension|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|239191-Amoxicillin50MG/MLOralSuspension|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|238920-Betamethasone0.5MG/MLTopicalCream|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|238600-seleniumsulfide25MG/MLMedicatedShampoo|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|238154-Acetaminophen325MG/butalbital50MG/Caffeine40MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|238151-mesalamine66.7MG/MLEnema|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|238006-Estrogens,Esterified(USP)0.625MG/Methyltestosterone1.25MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|237776-vitaminB121MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|237723-Ergocalciferol0.2MG/MLOralSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|237420-CalciumCarbonate1500MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|226343-Dexamethasonephosphate1MG/MLOphthalmicSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|211365-chlorhexidinegluconate40MG/MLMedicatedLiquidSoap|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|2101899-Sodiumpolystyrenesulfonate15000MGPowderforOralSuspension|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|209890-Acetaminophen500MGOralCapsule[Mapap]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|206842-IsosorbideDinitrate20MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|205326-Lisinopril30MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|205305-telmisartan80MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|205304-telmisartan40MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|205285-leflunomide20MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|205284-leflunomide10MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|204844-Azithromycin600MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|204423-Hydrocortisone10MG/ML/Neomycin3.5MG/ML/PolymyxinB10000UNT/MLOticSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|204135-Desonide0.0005MG/MGTopicalOintment|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|200371-Citalopram20MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|200346-cefdinir300MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|200257-repaglinide0.5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|200256-repaglinide1MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|200133-12HRCarbamazepine200MGExtendedReleaseOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|200132-Acarbose25MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|200131-12HRCarbamazepine300MGExtendedReleaseOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|200064-letrozole2.5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|200060-mycophenolatemofetil500MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|200033-carvedilol25MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|200032-carvedilol12.5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|200031-carvedilol6.25MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|199903-Hydrochlorothiazide12.5MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|199890-topiramate200MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|199889-topiramate100MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|199888-topiramate25MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|199885-Levofloxacin500MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|199884-Levofloxacin250MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|199703-cabergoline0.5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|199425-Melatonin1MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|199390-Etodolac500MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|199353-trandolapril1MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|199352-trandolapril4MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|199351-trandolapril2MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|199246-glimepiride2MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|199245-glimepiride1MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1992303-12HRTimolol5MG/MLOphthalmicSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|199224-anastrozole1MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|199193-famciclovir250MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|199192-famciclovir125MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|199168-Phenobarbital64.8MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|199167-Phenobarbital32.4MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|199164-Phenobarbital97.2MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|199163-Melatonin3MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|199159-Tretinoin10MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|199150-Acarbose100MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|199149-Acarbose50MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|199143-Niacin250MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|199058-mycophenolatemofetil250MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|199047-Famotidine10MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198861-SodiumBicarbonate650MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198857-Simethicone66.7MG/MLOralSuspension|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198760-Niacin50MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198759-Niacin100MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198741-MagnesiumOxide400MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198707-Hydrocortisone5MG/MLTopicalCream|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198630-ferrousgluconate324MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198555-Capsaicin0.25MG/MLTopicalCream|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198546-CalciumGluconate500MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198509-Bisacodyl10MGRectalSuppository|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198440-Acetaminophen500MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198429-lamotrigine200MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198428-lamotrigine150MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198427-lamotrigine100MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198382-famciclovir500MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198380-tioconazole0.065MG/MGVaginalOintment|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198378-Tacrolimus5MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198377-Tacrolimus1MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198372-torsemide5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198371-torsemide20MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198370-torsemide100MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198369-torsemide10MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198365-Prochlorperazine10MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198352-Zidovudine100MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198335-Sulfamethoxazole800MG/Trimethoprim160MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198334-Sulfamethoxazole400MG/Trimethoprim80MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198332-Trimethoprim100MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198316-Hydrochlorothiazide25MG/Triamterene37.5MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198293-Tolazamide500MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198292-Tolazamide250MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198240-Tamoxifen10MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198239-Sulindac200MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198238-Sulindac150MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198232-Sulfasalazine500MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198224-Hydrochlorothiazide25MG/Spironolactone25MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198223-Spironolactone50MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198222-Spironolactone100MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198211-Simvastatin40MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198202-Rifampin300MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198201-Rifampin150MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198181-Pyrazinamide500MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198175-Propylthiouracil50MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198165-Propantheline15MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198153-Colchicine0.5MG/Probenecid500MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198152-Probenecid500MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198148-Prednisone50MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198146-Prednisone2.5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198145-Prednisone10MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198144-Prednisone1MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198141-Prazosin5MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198116-PotassiumChloride20MEQExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198108-Piroxicam20MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198107-Piroxicam10MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198105-Pindolol5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198104-Pindolol10MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198102-vitaminK15MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198089-Phenobarbital60MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198086-Phenobarbital16.2MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198083-Phenobarbital100MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198049-Ofloxacin300MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198047-Nortriptyline75MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198046-Nortriptyline50MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198045-Nortriptyline10MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198040-Nitroglycerin0.6MGSublingualTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198039-Nitroglycerin0.4MGSublingualTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198038-Nitroglycerin0.3MGSublingualTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198033-Nifedipine20MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198032-Nifedipine10MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198024-Niacin500MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198014-Naproxen500MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198013-Naproxen250MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198012-Naproxen375MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197987-Minoxidil2.5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197986-Minoxidil10MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197973-Methylprednisolone8MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197971-Methylprednisolone32MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197963-Hydrochlorothiazide15MG/Methyldopa250MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197960-Hydrochlorothiazide25MG/Methyldopa250MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197958-Methyldopa500MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197956-Methyldopa250MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197944-Methocarbamol750MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197943-Methocarbamol500MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197942-Methimazole5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197941-Methimazole10MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197940-Methazolamide50MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197939-Methazolamide25MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197931-mercaptopurine50MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197919-Melphalan2MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197905-Lovastatin40MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197904-Lovastatin20MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197903-Lovastatin10MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197887-Hydrochlorothiazide25MG/Lisinopril20MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197886-Hydrochlorothiazide12.5MG/Lisinopril20MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197885-Hydrochlorothiazide12.5MG/Lisinopril10MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197884-Lisinopril40MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197863-Leucovorin5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197862-Leucovorin25MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197861-Leucovorin15MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197860-Leucovorin10MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197856-Ketoprofen75MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197855-Ketoprofen50MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197854-Ketoprofen25MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197853-Ketoconazole200MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197839-IsosorbideDinitrate30MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197832-isoniazid300MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197818-Indomethacin50MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197817-Indomethacin25MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197816-Indapamide2.5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197815-Indapamide1.25MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197807-Ibuprofen800MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197806-Ibuprofen600MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197805-Ibuprofen400MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197803-Ibuprofen20MG/MLOralSuspension|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197797-hydroxyurea500MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197787-Hydrocortisone5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197785-Hydrocortisone25MG/MLTopicalLotion|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197783-Hydrocortisone20MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197782-Hydrocortisone10MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197770-Hydrochlorothiazide50MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197746-Guanfacine2MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197745-Guanfacine1MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197741-Guaifenesin200MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197737-Glyburide1.25MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197732-Furosemide80MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197726-Flutamide125MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197701-Fluconazole50MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197700-Fluconazole200MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197699-Fluconazole150MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197698-Fluconazole100MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197686-Etodolac400MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197685-Etodolac300MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197684-Etodolac200MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197682-Ethosuximide250MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197670-Estrogens,Esterified(USP)1.25MG/Methyltestosterone2.5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197659-Estradiol2MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197658-Estradiol1MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|Y||Preferred Generic|892646-MorphineSulfate200MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|Y||Preferred Generic|891893-MorphineSulfate60MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197657-Estradiol0.5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|Y||Preferred Generic|891888-MorphineSulfate30MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|Y||Preferred Generic|891881-MorphineSulfate15MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197650-Erythromycin500MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|Y||Preferred Generic|891874-MorphineSulfate100MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|Y||Preferred Generic|883826-TranexamicAcid650MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197628-Doxazosin8MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|Y||Preferred Generic|835809-testosteroneenanthate200MG/MLInjectableSolution|EXPANSION PARTIAL DUALS 632|2002|Y|N|Y||Preferred Generic|577033-sildenafil20MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197627-Doxazosin4MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|Y||Preferred Generic|313451-Tretinoin0.00025MG/MGTopicalGel|EXPANSION PARTIAL DUALS 632|2002|Y|N|Y||Preferred Generic|313450-Tretinoin0.0001MG/MGTopicalGel|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197626-Doxazosin2MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|Y||Preferred Generic|312084-Ondansetron24MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|Y||Preferred Generic|310140-eprosartan600MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197625-Doxazosin1MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|Y||Preferred Generic|245723-Tretinoin0.0005MG/MGTopicalGel|EXPANSION PARTIAL DUALS 632|2002|Y|N|Y||Preferred Generic|198300-Tretinoin1MG/MLTopicalCream|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197624-Disulfiram500MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|Y||Preferred Generic|197636-dronabinol5MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|Y|N|Y||Preferred Generic|197635-dronabinol2.5MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197623-Disulfiram250MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|Y||Preferred Generic|197634-dronabinol10MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|Y|N|Y||Preferred Generic|106303-Tretinoin0.5MG/MLTopicalCream|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197622-Dipyridamole50MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|Y||Preferred Generic|106302-Tretinoin0.25MG/MLTopicalCream|EXPANSION PARTIAL DUALS 632|2002|Y|N|Y||Preferred Brand|861821-Metforminhydrochloride500MG/sitagliptin50MGOralTablet[Janumet]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197606-Digoxin0.25MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|Y||Preferred Brand|861771-Metforminhydrochloride1000MG/sitagliptin50MGOralTablet[Janumet]|EXPANSION PARTIAL DUALS 632|2002|Y|N|Y||Preferred Brand|804547-difluprednate0.5MG/MLOphthalmicSuspension[Durezol]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197604-Digoxin0.125MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|Y||Preferred Brand|665044-sitagliptin50MGOralTablet[Januvia]|EXPANSION PARTIAL DUALS 632|2002|Y|N|Y||Preferred Brand|665040-sitagliptin25MGOralTablet[Januvia]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197596-Dicloxacillin500MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|Y|N|Y||Preferred Brand|665036-sitagliptin100MGOralTablet[Januvia]|EXPANSION PARTIAL DUALS 632|2002|Y|N|Y||Preferred Brand|1292435-0.65MLVaricella-ZosterVirusVaccineLive(Oka-Merck)strain29800UNT/MLInjection[Zostavax]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197595-Dicloxacillin250MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|999996-Amlodipine5MG/Hydrochlorothiazide12.5MG/Olmesartanmedoxomil40MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|999991-Amlodipine10MG/Hydrochlorothiazide25MG/Olmesartanmedoxomil40MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197583-Dexamethasone6MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|999986-Amlodipine10MG/Hydrochlorothiazide12.5MG/Olmesartanmedoxomil40MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|999967-Amlodipine5MG/Hydrochlorothiazide12.5MG/Olmesartanmedoxomil20MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197582-Dexamethasone4MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|998189-everolimus2.5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|992395-gatifloxacin5MG/MLOphthalmicSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197581-Dexamethasone2MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|990982-2MLphysostigminesalicylate1MG/MLInjection|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|968766-PhentermineHydrochloride15MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197580-Dexamethasone1.5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|904952-3MLibandronicacid1MG/MLPrefilledSyringe|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|903857-PyridostigmineBromide60MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197579-Dexamethasone1MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|903847-PyridostigmineBromide180MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|903843-PyridostigmineBromide12MG/MLOralSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197577-Dexamethasone0.5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|900164-24HRlamotrigine25MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|900156-24HRlamotrigine200MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197575-Desoximetasone0.0025MG/MGTopicalOintment|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|900038-PhentermineHydrochloride30MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|898715-pregabalin20MG/MLOralSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197558-Dapsone25MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|897021-12HRdalfampridine10MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|892349-24HRMorphineSulfate60MGExtendedReleaseOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197557-Dapsone100MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|892342-24HRMorphineSulfate30MGExtendedReleaseOralCapsule|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|886634-ButorphanolTartrate1MG/ACTUATMeteredDoseNasalSpray|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197553-Cyclosporine25MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|881341-adefovirdipivoxil10MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|876529-Amlodipine5MG/telmisartan80MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197518-Clindamycin150MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|876524-Amlodipine5MG/telmisartan40MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|876519-Amlodipine10MG/telmisartan80MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197517-Clarithromycin500MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|876514-Amlodipine10MG/telmisartan40MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|864978-MethadoneHydrochloride40MGTabletforOralSuspension|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197516-Clarithromycin250MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|864769-MethadoneHydrochloride2MG/MLOralSolution|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|864761-MethadoneHydrochloride1MG/MLOralSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197500-Chlorthalidone50MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|864718-MethadoneHydrochloride5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|864706-MethadoneHydrochloride10MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197499-Chlorthalidone25MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|864681-Atovaquone62.5MG/proguanilhydrochloride25MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|864675-Atovaquone250MG/proguanilhydrochloride100MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197454-Cephalexin500MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|863038-bepotastinebesilate15MG/MLOphthalmicSolution|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|861960-armodafinil200MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197449-Cefaclor500MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|861375-sevelamercarbonate800MGPowderforOralSuspension|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|861370-sevelamercarbonate2400MGPowderforOralSuspension|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197448-Levocarnitine330MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|860901-galantaminehydrobromide4MG/MLOralSolution|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|860715-24HRgalantaminehydrobromide8MGExtendedReleaseOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197445-Carbidopa25MG/Levodopa250MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|860707-24HRgalantaminehydrobromide24MGExtendedReleaseOralCapsule|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|860695-24HRgalantaminehydrobromide16MGExtendedReleaseOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197444-Carbidopa25MG/Levodopa100MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|860103-KetorolacTromethamine4MG/MLOphthalmicSolution|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|857700-DiclofenacSodium15MG/MLTopicalSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197443-Carbidopa10MG/Levodopa100MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|857224-Sevelamerhydrochloride800MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|857216-Sevelamerhydrochloride400MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197433-calciumacetate667MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|855642-DiclofenacSodium0.03MG/MGTopicalGel|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|855626-Twice-Dailydiclofenacepolamine0.013MG/MGMedicatedPatch|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197411-Bromocriptine2.5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|854894-Zolpidemtartrate6.25MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|854880-Zolpidemtartrate12.5MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197409-Betamethasone0.001MG/MGTopicalOintment|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|850091-24HRlamotrigine50MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|850087-24HRlamotrigine100MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197408-Betamethasone1MG/MLTopicalLotion|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|848151-Amlodipine10MG/Hydrochlorothiazide25MG/valsartan160MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|848145-Amlodipine5MG/Hydrochlorothiazide25MG/valsartan160MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197407-Betamethasone1MG/MLTopicalCream|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|848140-Amlodipine5MG/Hydrochlorothiazide12.5MG/valsartan160MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|848135-Amlodipine10MG/Hydrochlorothiazide25MG/valsartan320MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197405-Betamethasone0.0005MG/MGTopicalOintment|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|848131-Amlodipine10MG/Hydrochlorothiazide12.5MG/valsartan160MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|845515-everolimus5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197392-Baclofen20MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|834241-febuxostat80MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|834235-febuxostat40MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197391-Baclofen10MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|833234-mesalamine800MGDelayedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|824301-rufinamide400MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197388-Azathioprine50MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|824295-rufinamide200MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|810096-{7(EthinylEstradiol0.01MGOralTablet)/84(EthinylEstradiol0.02MG/Levonorgestrel0.1MGOralTablet)}Pack|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197383-Atenolol50MG/Chlorthalidone25MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|803353-PhentermineHydrochloride37.5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|802749-candesartancilexetil32MG/Hydrochlorothiazide25MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197382-Atenolol100MG/Chlorthalidone25MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|794639-lubiprostone0.008MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|754508-{1(aprepitant125MGOralCapsule)/2(aprepitant80MGOralCapsule)}Pack|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197381-Atenolol50MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|728231-12HRranolazine1000MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|727339-0.5MLSumatriptan12MG/MLPrefilledSyringe|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197380-Atenolol25MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|725023-24HRrivastigmine0.396MG/HRTransdermalSystem|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|725021-24HRrivastigmine0.192MG/HRTransdermalSystem|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197379-Atenolol100MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|724863-armodafinil50MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|724861-armodafinil250MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197362-ammoniumlactate120MG/MLTopicalLotion|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|724859-armodafinil150MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|722122-ambrisentan5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197361-Amlodipine5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|722116-ambrisentan10MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|705824-100MLzoledronicacid0.05MG/MLInjection|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197320-Allopurinol300MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|700885-temozolomide180MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|700883-temozolomide140MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197319-Allopurinol100MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|672149-lapatinib250MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|656659-bosentan125MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197318-Albuterol4MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|644088-aprepitant40MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|642452-lanthanumcarbonate750MGChewableTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197316-Albuterol2MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|639537-candesartancilexetil32MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|616749-12HRranolazine500MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197313-Acyclovir800MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|616578-lubiprostone0.024MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|603208-erlotinib25MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197311-Acyclovir400MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|603206-erlotinib150MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|603203-erlotinib100MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197310-Acyclovir200MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|602635-lanthanumcarbonate1000MGChewableTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|597772-deferasirox500MGTabletforOralSuspension|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197305-AceticAcid20MG/MLOticSolution|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|597770-deferasirox250MGTabletforOralSuspension|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|597768-deferasirox125MGTabletforOralSuspension|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197304-Acetazolamide250MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|579148-Galantamine12MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|578330-candesartancilexetil32MG/Hydrochlorothiazide12.5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197303-Acetazolamide125MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|578325-candesartancilexetil16MG/Hydrochlorothiazide12.5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|578018-bromfenac0.9MG/MLOphthalmicSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1946772-Methotrexate25MG/MLInjectableSolution|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|577776-candesartancilexetil16MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|577348-ramelteon8MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1923809-thyroid(USP)120MGOralTablet[NPThyroid]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|577208-Omega-3AcidEthylEsters(USP)1000MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|577057-72HRFentanyl0.012MG/HRTransdermalSystem|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1923432-dorzolamide20MG/ML/Timolol5MG/MLOphthalmicSolution|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|545835-LeuprolideAcetate5MG/MLInjectableSolution|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|543218-1MLGranisetron0.1MG/MLInjection|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1923428-Timolol2.5MG/MLOphthalmicSolution|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|485489-Temazepam22.5MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|485436-entecavir1MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1923426-SotalolHydrochloride80MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|485434-entecavir0.5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|485423-24HRdarifenacin7.5MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1923424-SotalolHydrochloride160MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|485421-24HRdarifenacin15MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|477372-solifenacinsuccinate10MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1923422-SotalolHydrochloride120MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|477367-solifenacinsuccinate5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|477347-lanthanumcarbonate500MGChewableTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1870230-NDA0208000.3MLEpinephrine1MG/MLAuto-Injector|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|477130-Hydrochlorothiazide25MG/telmisartan80MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|465355-voriconazole40MG/MLOralSuspension|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1860100-ferroussulfate324MGDelayedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|403930-Isotretinoin30MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|403879-imatinib400MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1855086-thyroid(USP)15MGOralTablet[NPThyroid]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|403878-imatinib100MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|403818-moxifloxacin5MG/MLOphthalmicSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1806189-30/70Release24HRMethylphenidateHydrochloride30MGExtendedReleaseOralCapsule|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|403811-aprepitant125MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|402506-12HRCarbamazepine400MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1806187-30/70Release24HRMethylphenidateHydrochloride20MGExtendedReleaseOralCapsule|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|402505-12HRCarbamazepine200MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|351114-5MLzoledronicacid0.8MG/MLInjection|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1806181-30/70Release24HRMethylphenidateHydrochloride10MGExtendedReleaseOralCapsule|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|349435-voriconazole50MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|349434-voriconazole200MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1801298-MicroencapsulatedPotassiumChloride10MEQExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|349410-Treprostinil5MG/MLInjectableSolution|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|349409-Treprostinil2.5MG/MLInjectableSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1801294-MicroencapsulatedPotassiumChloride20MEQExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|349408-Treprostinil10MG/MLInjectableSolution|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|349407-Treprostinil1MG/MLInjectableSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1801289-SmokingCessation12HRBupropionHydrochloride150MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|349253-bosentan62.5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|348719-Tobramycin60MG/MLInhalationSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1797913-TriamcinoloneAcetonide0.055MG/ACTUATMeteredDoseNasalSpray|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|317160-temozolomide100MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|313472-Trientinehydrochloride250MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1797907-Fluticasonepropionate0.05MG/ACTUATMeteredDoseNasalSpray|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|313211-temozolomide5MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|313210-temozolomide250MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1797867-Azelastinehydrochloride0.137MG/ACTUATMeteredDoseNasalSpray|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|313209-temozolomide20MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|313165-0.5MLSumatriptan12MG/MLInjection|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1797851-CromolynSodium5.2MG/ACTUATMeteredDoseNasalSpray|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|312835-rivastigmine3MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|311204-Itraconazole100MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1738511-ParoxetineHydrochloride40MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|310599-Granisetron1MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|310437-Galantamine8MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1738503-ParoxetineHydrochloride30MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|310436-Galantamine4MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|283317-Hydrochlorothiazide12.5MG/telmisartan80MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1738495-ParoxetineHydrochloride20MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|283316-Hydrochlorothiazide12.5MG/telmisartan40MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|260218-modafinil100MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1738483-ParoxetineHydrochloride10MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|245136-72HRFentanyl0.1MG/HRTransdermalSystem|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|245135-72HRFentanyl0.05MG/HRTransdermalSystem|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1731350-deferoxaminemesylate500MGInjection|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|245134-72HRFentanyl0.025MG/HRTransdermalSystem|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|240912-Granisetron1MG/MLInjectableSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1731345-deferoxaminemesylate2000MGInjection|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|2198370-pretomanid200MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|2123194-PulmonaryHypertensiontadalafil20MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1724481-thyroid(USP)60MGOralTablet[NPThyroid]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|205324-modafinil200MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|205316-topiramate15MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1724439-thyroid(USP)30MGOralTablet[NPThyroid]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|205315-topiramate25MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|200328-capecitabine500MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1724437-thyroid(USP)90MGOralTablet[NPThyroid]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|200327-capecitabine150MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|200220-tolcapone100MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1665188-1MLLorazepam2MG/MLInjection|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|199521-Vigabatrin500MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|199378-12HRCarbamazepine100MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1665050-Cefazolin1000MGInjection|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1988980-24HRpregabalin82.5MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1988977-24HRpregabalin330MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1659263-1MLheparinsodium,porcine5000UNT/MLInjection|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1988974-24HRpregabalin165MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|198243-Temazepam7.5MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1655968-8MLMethotrexate25MG/MLInjection|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|198200-Rifabutin150MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|198071-Penicillamine250MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1648759-NITROFURANTOIN,MACROCRYSTALS100MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|198070-Penicillamine250MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|197845-Isotretinoin40MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1648755-NITROFURANTOIN,MACROCRYSTALS25MG/Nitrofurantoin,Monohydrate75MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|197844-Isotretinoin20MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|197843-Isotretinoin10MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1547771-Tetracainehydrochloride5MG/MLOphthalmicSolution|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|197730-Furosemide10MG/MLOralSolution|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|197696-72HRFentanyl0.075MG/HRTransdermalSystem|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|152695-meloxicam15MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1923828-deferasirox180MGOralGranules|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1923826-deferasirox360MGOralGranules|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|151226-topiramate50MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1923822-deferasirox90MGOralGranules|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1918042-abirateroneacetate500MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1440184-hydrocortisoneacetate0.01MG/MGTopicalOintment|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1874559-24HRdesvenlafaxinesuccinate50MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1874553-24HRdesvenlafaxinesuccinate100MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1437702-Albuterol0.833MG/ML/IpratropiumBromide0.167MG/MLInhalationSolution|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1860157-Abuse-Deterrent12HROxycodoneHydrochloride10MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1860154-Abuse-Deterrent12HROxycodoneHydrochloride15MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|142034-BenzoylPeroxide100MG/MLMedicatedLiquidSoap|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1860151-Abuse-Deterrent12HROxycodoneHydrochloride30MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1860148-Abuse-Deterrent12HROxycodoneHydrochloride80MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|141963-Azithromycin40MG/MLOralSuspension|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1860137-Abuse-Deterrent12HROxycodoneHydrochloride40MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1860129-Abuse-Deterrent12HROxycodoneHydrochloride20MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1376336-prednisoloneacetate10MG/MLOphthalmicSuspension|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1860127-Abuse-Deterrent12HROxycodoneHydrochloride60MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1799212-sofosbuvir400MG/velpatasvir100MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1367436-21DAYEthinylEstradiol0.000625MG/HR/Etonogestrel0.005MG/HRVaginalSystem|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1796690-1MLhydroxyprogesteronecaproate(USP)250MG/MLInjection|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1793916-0.5MLSumatriptan8MG/MLAuto-Injector|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1367410-Ergocalciferol1.25MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1745091-Lidocaine0.05MG/MGMedicatedPatch|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1737461-PamidronateDisodium90MGInjection|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1366116-bacitracinzinc0.5UNT/MGTopicalOintment|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1737459-PamidronateDisodium30MGInjection|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1734399-1MLGranisetron1MG/MLInjection|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1363309-ChlorpheniramineMaleate4MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1728055-5MLpalonosetron0.05MG/MLInjection|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1657173-0.5MLSumatriptan8MG/MLCartridge|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1362720-MexiletineHydrochloride250MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1657160-0.5MLSumatriptan12MG/MLCartridge|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1607990-{24(EthinylEstradiol0.025MG/Norethindrone0.8MGChewableTablet)/4(Ferrousfumarate75MGChewableTablet)}Pack|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1362712-MexiletineHydrochloride200MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1607796-deferasirox90MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1607792-deferasirox360MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1362706-MexiletineHydrochloride150MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1607784-deferasirox180MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1607617-24HRdesvenlafaxinesuccinate25MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1359858-Fluticasonepropionate0.5MG/ACTUAT/salmeterol0.05MG/ACTUATDryPowderInhaler|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1599949-60ACTUATTestosterone30MG/ACTUATTopicalSolution|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1597129-5000MGTestosterone0.01MG/MGTopicalGel|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1359779-Fluticasonepropionate0.1MG/ACTUAT/salmeterol0.05MG/ACTUATDryPowderInhaler|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1597123-2500MGTestosterone0.01MG/MGTopicalGel|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1591943-ledipasvir90MG/sofosbuvir400MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1359117-{24(EthinylEstradiol0.02MG/norethindroneacetate1MGOralTablet)/4(Ferrousfumarate75MGOralTablet)}Pack|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1547565-Isotretinoin35MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1547561-Isotretinoin25MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1313885-Phenytoin50MGChewableTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|153823-candesartancilexetil8MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|153822-candesartancilexetil4MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1313112-Phenytoin25MG/MLOralSuspension|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1490065-RaloxifeneHydrochloride60MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1487361-1MLglatirameracetate40MG/MLPrefilledSyringe|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1298072-Cyclopentolatehydrochloride5MG/MLOphthalmicSolution|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1435115-28ACTUATTeriparatide0.02MG/ACTUATPenInjector|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1426600-{24(EthinylEstradiol0.02MG/norethindroneacetate1MGChewableTablet)/4(Ferrousfumarate75MGOralTablet)}Pack|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1298070-Cyclopentolatehydrochloride20MG/MLOphthalmicSolution|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1373503-{7(EthinylEstradiol0.01MGOralTablet)/42(EthinylEstradiol0.02MG/Levonorgestrel0.15MGOralTablet)/21(EthinylEstradiol0.0|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1373497-{14(dimethylfumarate120MGDelayedReleaseOralCapsule)/46(dimethylfumarate240MGDelayedReleaseOralCapsule)}Pack|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1298066-Cyclopentolatehydrochloride10MG/MLOphthalmicSolution|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1373491-dimethylfumarate240MGDelayedReleaseOralCapsule|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1373483-dimethylfumarate120MGDelayedReleaseOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1291082-hydrocortisoneacetate25MGRectalSuppository|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1366550-24HRBudesonide9MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1360304-Budesonide0.08MG/ACTUAT/formoterolfumarate0.0045MG/ACTUATMeteredDoseInhaler|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1250490-hydrocortisoneacetate5MG/MLTopicalCream|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1359861-Budesonide0.16MG/ACTUAT/formoterolfumarate0.0045MG/ACTUATMeteredDoseInhaler|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1308569-24HRrivastigmine0.554MG/HRTransdermalSystem|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1245919-Marlissa28DayPack|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1307427-sildenafil10MG/MLOralSuspension|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1304979-icosapentethyl1000MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1245468-DocusateSodium250MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1299917-Tiagabinehydrochloride4MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1299911-Tiagabinehydrochloride2MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1245230-chlorhexidinegluconate20MG/MLMedicatedLiquidSoap|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1299909-Tiagabinehydrochloride16MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1299903-Tiagabinehydrochloride12MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1243585-Flurbiprofensodium0.3MG/MLOphthalmicSolution|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1146690-24HRlamotrigine250MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1119400-everolimus7.5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1242787-Alyacen7/7/7Kit|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1111641-1MLglatirameracetate20MG/MLPrefilledSyringe|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1100075-abirateroneacetate250MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1242786-Alyacen1/3528-DayKit|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1098608-24HRlamotrigine300MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1095229-FlavoxateHydrochloride100MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1234571-PhenylephrineHydrochloride100MG/MLOphthalmicSolution|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1092357-rufinamide40MG/MLOralSuspension|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1087964-hydroxyprogesteronecaproate(USP)250MG/MLInjectableSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1193362-100MLLevetiracetam5MG/MLInjection|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1050493-{21(drospirenone3MG/EthinylEstradiol0.03MG/levomefolatecalcium0.451MGOralTablet)/7(levomefolatecalcium0.451MGOralTabl|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1013629-{24(drospirenone3MG/EthinylEstradiol0.02MG/levomefolatecalcium0.451MGOralTablet)/4(levomefolatecalcium0.451MGOralTabl|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1193360-100MLLevetiracetam15MG/MLInjection|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1011739-aliskiren300MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1011736-aliskiren150MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1193358-100MLLevetiracetam10MG/MLInjection|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1000001-Amlodipine5MG/Hydrochlorothiazide25MG/Olmesartanmedoxomil40MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|995156-lacosamide10MG/MLOralSolution[Vimpat]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1191315-FluocinoloneAcetonide0.25MG/MLTopicalCream|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|993456-1MLdenosumab60MG/MLPrefilledSyringe[Prolia]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|979115-0.6MLMethylnaltrexonebromide20MG/MLInjection[Relistor]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1191310-FluocinoloneAcetonide0.1MG/MLTopicalSolution|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|978950-Natazia28DayPack|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|903855-2MLPyridostigmineBromide5MG/MLInjection[Regonol]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1191256-FluocinoloneAcetonide0.00025MG/MGTopicalOintment|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|902626-dexlansoprazole60MGDelayedReleaseOralCapsule[Dexilant]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|902624-dexlansoprazole30MGDelayedReleaseOralCapsule[Dexilant]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1191013-Proparacainehydrochloride5MG/MLOphthalmicSolution|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|901614-Aztreonam75MG/MLInhalationSolution[Cayston]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|897126-3MLliraglutide6MG/MLPenInjector[Victoza]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1190655-AtropineSulfate10MG/MLOphthalmicSolution|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|896273-120ACTUATFluticasonepropionate0.23MG/ACTUAT/salmeterol0.021MG/ACTUATMeteredDoseInhaler[Advair]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|896245-120ACTUATFluticasonepropionate0.115MG/ACTUAT/salmeterol0.021MG/ACTUATMeteredDoseInhaler[Advair]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1190572-AtropineSulfate0.025MG/DiphenoxylateHydrochloride2.5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|896237-120ACTUATFluticasonepropionate0.045MG/ACTUAT/salmeterol0.021MG/ACTUATMeteredDoseInhaler[Advair]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|884619-eltrombopag75MGOralTablet[Promacta]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1190570-AtropineSulfate0.01MG/MGOphthalmicOintment|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|867506-pazopanib200MGOralTablet[Votrient]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|864820-Oxybutyninchloride0.1MG/MGTopicalGel[Gelnique]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1190568-AtropineSulfate0.005MG/ML/DiphenoxylateHydrochloride0.5MG/MLOralSolution|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|861966-Iloprost0.02MG/MLInhalationSolution[Ventavis]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|861045-1.5MLpramlintideacetate1MG/MLPenInjector[Symlin]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1150836-LevobunololHydrochloride5MG/MLOphthalmicSolution|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|861043-2.7MLpramlintideacetate1MG/MLPenInjector[Symlin]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|860898-Vigabatrin500MGPowderforOralSolution[Sabril]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1116758-chloroquinephosphate500MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|860244-interferonbeta-1b0.3MGInjection[Extavia]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|858366-KetorolacTromethamine4.5MG/MLOphthalmicSolution[Acuvail]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1116150-bacitracinzinc0.4UNT/MG/hydrocortisoneacetate0.01MG/MG/NeomycinSulfate0.0035MG/MG/PolymyxinBSulfate10UNT/MGOphthalmic|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|858044-saxagliptin2.5MGOralTablet[Onglyza]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|858040-saxagliptin5MGOralTablet[Onglyza]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1115005-DocusateSodium100MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|857799-Treprostinil0.6MG/MLInhalationSolution[Tyvaso]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|854852-lisdexamfetaminedimesylate50MGOralCapsule[Vyvanse]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1100457-PyridoxineHydrochloride25MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|854848-lisdexamfetaminedimesylate60MGOralCapsule[Vyvanse]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|854844-lisdexamfetaminedimesylate70MGOralCapsule[Vyvanse]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1099870-DivalproexSodium500MGDelayedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|854840-lisdexamfetaminedimesylate40MGOralCapsule[Vyvanse]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|854836-lisdexamfetaminedimesylate30MGOralCapsule[Vyvanse]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1099687-ValproicAcid50MG/MLOralSolution|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|854832-lisdexamfetaminedimesylate20MGOralCapsule[Vyvanse]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|853356-1MLustekinumab90MG/MLPrefilledSyringe[Stelara]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1099681-ValproicAcid250MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|853354-0.5MLustekinumab90MG/MLPrefilledSyringe[Stelara]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|849599-1MLcertolizumabpegol200MG/MLPrefilledSyringe[Cimzia]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1099678-DivalproexSodium250MGDelayedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|848164-0.5MLgolimumab100MG/MLPrefilledSyringe[Simponi]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|847917-60ACTUATexenatide0.005MG/ACTUATPenInjector[Byetta]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1099648-5MLValproicAcid100MG/MLInjection|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|847913-60ACTUATexenatide0.01MG/ACTUATPenInjector[Byetta]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|845512-everolimus10MGOralTablet[Afinitor]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1099625-DivalproexSodium125MGDelayedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|836649-Zolpidemtartrate5MGSublingualTablet[Edluar]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|836645-Zolpidemtartrate10MGSublingualTablet[Edluar]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1099596-DivalproexSodium125MGDelayedReleaseOralCapsule|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|828703-1.2MLPlerixafor20MG/MLInjection[Mozobil]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|828696-Zolpidemtartrate5MG/ACTUATOralSpray[Zolpimist]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1099569-24HRDivalproexSodium500MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|828364-hydrocortisoneacetate10MG/ML/Pramoxinehydrochloride10MG/MLRectalFoam[Proctofoam-HC]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|825429-eltrombopag50MGOralTablet[Promacta]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1099563-24HRDivalproexSodium250MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|825425-eltrombopag25MGOralTablet[Promacta]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|825170-HumiraPen40MG/0.8ML-Crohn'sDiseaseStarterPack|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1099316-DesipramineHydrochloride75MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|810079-24HRFesoterodineFumarate8MGExtendedReleaseOralTablet[Toviaz]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|810075-24HRFesoterodineFumarate4MGExtendedReleaseOralTablet[Toviaz]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1099304-DesipramineHydrochloride50MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|810002-lacosamide50MGOralTablet[Vimpat]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|809998-lacosamide200MGOralTablet[Vimpat]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1099300-DesipramineHydrochloride25MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|809994-lacosamide150MGOralTablet[Vimpat]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|809990-lacosamide100MGOralTablet[Vimpat]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1099296-DesipramineHydrochloride150MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|809159-0.5MLEtanercept50MG/MLPrefilledSyringe[Enbrel]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|802652-1MLEtanercept50MG/MLPrefilledSyringe[Enbrel]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1099292-DesipramineHydrochloride100MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|799830-dasatinib100MGOralTablet[Sprycel]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|795749-RebifTitrationPack|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1099288-DesipramineHydrochloride10MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|795085-certolizumabpegol200MGInjection[Cimzia]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|763565-0.4MLadalimumab50MG/MLPrefilledSyringe[Humira]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1098134-24HRNiacin1000MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|758032-0.5MLInterferonbeta-1a0.044MG/MLPrefilledSyringe[Rebif]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|758027-0.5MLInterferonbeta-1a0.088MG/MLPrefilledSyringe[Rebif]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1095725-ClemastineFumarate1.34MGOralTablet[Dayhist-1]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|753443-9HRMethylphenidate3.33MG/HRTransdermalSystem[Daytrana]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|753442-9HRMethylphenidate2.22MG/HRTransdermalSystem[Daytrana]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1094543-Briellyn28DayPack|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|753437-9HRMethylphenidate1.11MG/HRTransdermalSystem[Daytrana]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|748740-Topotecan1MGOralCapsule[Hycamtin]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1094107-Phenazopyridinehydrochloride100MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|748738-Topotecan0.25MGOralCapsule[Hycamtin]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|746609-nilotinib200MGOralCapsule[Tasigna]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1094104-Phenazopyridinehydrochloride200MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|731250-0.3MLdarbepoetinalfa0.2MG/MLPrefilledSyringe[Aranesp]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|731245-0.42MLdarbepoetinalfa0.06MG/MLPrefilledSyringe[Aranesp]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1085745-TriamcinoloneAcetonide1MG/MLTopicalLotion|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|731241-1MLdarbepoetinalfa0.5MG/MLPrefilledSyringe[Aranesp]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|731235-0.4MLdarbepoetinalfa0.5MG/MLPrefilledSyringe[Aranesp]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1085741-TriamcinoloneAcetonide0.25MG/MLTopicalLotion|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|731231-0.3MLdarbepoetinalfa0.5MG/MLPrefilledSyringe[Aranesp]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|731229-0.6MLdarbepoetinalfa0.5MG/MLPrefilledSyringe[Aranesp]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1085686-TriamcinoloneAcetonide5MG/MLTopicalCream|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|731227-0.4MLdarbepoetinalfa0.1MG/MLPrefilledSyringe[Aranesp]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|730046-0.5MLdarbepoetinalfa0.2MG/MLPrefilledSyringe[Aranesp]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1085644-TriamcinoloneAcetonide0.25MG/MLTopicalCream|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|727816-0.5MLInterferonbeta-1a0.06MG/MLPrefilledSyringe[Avonex]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|727714-0.67MLanakinra149MG/MLPrefilledSyringe[Kineret]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1085640-TriamcinoloneAcetonide0.005MG/MGTopicalOintment|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|727705-0.8MLadalimumab50MG/MLPrefilledSyringe[Humira]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|723846-orlistat60MGOralCapsule[Alli]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1085636-TriamcinoloneAcetonide0.001MG/MGTopicalOintment|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|706872-Azithromycin10MG/MLOphthalmicSolution[AzaSite]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|700418-Thalidomide150MGOralCapsule[Thalomid]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1085633-TriamcinoloneAcetonide0.00025MG/MGTopicalOintment|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|668606-Vorinostat100MGOralCapsule[Zolinza]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|643722-lenalidomide25MGOralCapsule[Revlimid]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|106387-Permethrin50MG/MLTopicalCream|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|643714-lenalidomide15MGOralCapsule[Revlimid]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|643488-Isotretinoin30MGOralCapsule[Claravis]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|106351-SilverSulfadiazine10MG/MLTopicalCream|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|643177-dasatinib70MGOralTablet[Sprycel]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|643175-dasatinib50MGOralTablet[Sprycel]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|106336-Ketoconazole20MG/MLMedicatedShampoo|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|643173-dasatinib20MGOralTablet[Sprycel]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|616292-sunitinib50MGOralCapsule[Sutent]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|106258-Hydrocortisone10MG/MLTopicalCream|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|616287-sunitinib25MGOralCapsule[Sutent]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|616283-sunitinib12.5MGOralCapsule[Sutent]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|105585-Methotrexate2.5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|616116-lenalidomide5MGOralCapsule[Revlimid]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|616114-lenalidomide10MGOralCapsule[Revlimid]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|105583-Fluorouracil50MG/MLTopicalCream|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|616018-abatacept250MGInjection[Orencia]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|615979-sorafenib200MGOralTablet[Nexavar]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1053753-Nystatin100000UNT/ML/TriamcinoloneAcetonide1MG/MLTopicalCream|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|607579-entecavir0.05MG/MLOralSolution[Baraclude]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|603978-nepafenac1MG/MLOphthalmicSuspension[Nevanac]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1053697-Nystatin100UNT/MG/TriamcinoloneAcetonide0.001MG/MGTopicalOintment|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|602862-magnesiumaminoacidchelate133MGOralTablet[MGPlusProtein]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|582595-Iloprost0.01MG/MLInhalationSolution[Ventavis]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|105292-isoniazid10MG/MLOralSolution|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|580286-mesalamine500MGExtendedReleaseOralCapsule[Pentasa]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|540181-alosetron0.5MGOralTablet[Lotronex]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1052760-magnesiumcitrate58.2MG/MLOralSolution|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|404450-Thalidomide200MGOralCapsule[Thalomid]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|404449-Thalidomide100MGOralCapsule[Thalomid]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1050077-DiphenhydramineHydrochloride20MG/MLTopicalCream|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|404065-Isotretinoin40MGOralCapsule[Claravis]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|404062-Isotretinoin20MGOralCapsule[Claravis]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1049909-DiphenhydramineHydrochloride25MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|404059-Isotretinoin10MGOralCapsule[Claravis]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|352262-1MLdarbepoetinalfa0.3MG/MLInjection[Aranesp]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1049906-DiphenhydramineHydrochloride2.5MG/MLOralSolution|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|352047-1MLdarbepoetinalfa0.1MG/MLInjection[Aranesp]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|352046-1MLdarbepoetinalfa0.06MG/MLInjection[Aranesp]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1049630-DiphenhydramineHydrochloride25MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|352045-1MLdarbepoetinalfa0.04MG/MLInjection[Aranesp]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|352044-1MLdarbepoetinalfa0.025MG/MLInjection[Aranesp]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1049167-PseudoephedrineHydrochloride60MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|261362-alosetron1MGOralTablet[Lotronex]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|261105-Etanercept25MG/MLInjectableSolution[Enbrel]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|104884-Metoclopramide1MG/MLOralSolution|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2559707-1.14MLdupilumab175MG/MLAuto-Injector[Dupixent]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2557216-trikafta50MG/37.5MG/25MGand75MGPack|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1047905-HyoscyamineSulfate0.125MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2550713-0.5MLsecukinumab150MG/MLPrefilledSyringe[Cosentyx]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2536758-24HRviloxazine200MGExtendedReleaseOralCapsule[Qelbree]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1047895-HyoscyamineSulfate0.125MG/MLOralSolution|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2536752-24HRviloxazine150MGExtendedReleaseOralCapsule[Qelbree]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2536554-24HRviloxazine100MGExtendedReleaseOralCapsule[Qelbree]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1047881-HyoscyamineSulfate0.025MG/MLOralSolution|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2531134-HumiraPen80MG/0.8ML-StarterPackageforPediatricUlcerativeColitis(4count)|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2475860-vericiguat5MGOralTablet[Verquvo]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1046985-HyoscyamineSulfate0.125MGDisintegratingOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2475856-vericiguat2.5MGOralTablet[Verquvo]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2475852-vericiguat10MGOralTablet[Verquvo]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1043690-hydrocortisoneacetate10MG/MLTopicalCream|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2475406-voclosporin7.9MGOralCapsule[Lupkynis]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2473042-ponatinib10MGOralTablet[Iclusig]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|103951-Tolnaftate10MG/MLTopicalCream|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2463737-epoetinalfa-epbx20000UNT/MLInjectableSolution[Retacrit]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2463733-epoetinalfa-epbx10000UNT/MLInjectableSolution[Retacrit]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|103457-Fluocinonide0.0005MG/MGTopicalOintment|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2395775-30ACTUATfluticasonefuroate0.2MG/ACTUAT/umeclidinium0.0625MG/ACTUAT/vilanterol0.025MG/ACTUATDryPowderInhaler[Trelegy]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2392142-0.5MLetanercept50MG/MLInjection[Enbrel]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|103456-Fluocinonide0.5MG/MLTopicalCream|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2387331-120ACTUATbudesonide0.16MG/ACTUAT/formoterolfumarate0.0048MG/ACTUAT/glycopyrrolate0.009MG/ACTUATMeteredDoseInhaler[Bre|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2373941-bedaquiline20MGOralTablet[Sirturo]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|103403-Hydrocortisone10MG/MLTopicalLotion|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2371768-Oriahnn28DayKit|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2359358-24HRempagliflozin5MG/linagliptin2.5MG/metforminhydrochloride1000MGExtendedReleaseOralTablet[Trijardy]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|103401-Hydrocortisone0.025MG/MGTopicalOintment|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2359353-24HRempagliflozin25MG/linagliptin5MG/metforminhydrochloride1000MGExtendedReleaseOralTablet[Trijardy]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2359290-24HRempagliflozin12.5MG/linagliptin2.5MG/metforminhydrochloride1000MGExtendedReleaseOralTablet[Trijardy]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1020477-DiphenhydramineHydrochloride50MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2359285-24HRempagliflozin10MG/linagliptin5MG/metforminhydrochloride1000MGExtendedReleaseOralTablet[Trijardy]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2287905-1.5MLfremanezumab-vfrm150MG/MLAuto-Injector[Ajovy]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1014678-cetirizinehydrochloride10MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2283236-bempedoicacid180MG/ezetimibe10MGOralTablet[Nexlizet]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2282414-bempedoicacid180MGOralTablet[Nexletol]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1014676-cetirizinehydrochloride5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2282320-Rimegepant75MGDisintegratingOralTablet[Nurtec]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2273115-24HRtofacitinib22MGExtendedReleaseOralTablet[Xeljanz]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1014673-cetirizinehydrochloride1MG/MLOralSolution|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|226917-orlistat120MGOralCapsule[Xenical]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2268231-ubrogepant50MGOralTablet[Ubrelvy]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1014571-12HRcetirizinehydrochloride5MG/PseudoephedrineHydrochloride120MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2268227-ubrogepant100MGOralTablet[Ubrelvy]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2265689-Voxelotor500MGOralTablet[Oxbryta]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1014314-TriamcinoloneAcetonide1MG/MLTopicalCream|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2262731-MicronizedIsotretinoin8MGOralCapsule[Absorica]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2262727-MicronizedIsotretinoin32MGOralCapsule[Absorica]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1012021-Prednisolonesodiumphosphate2.5MG/ML/SulfacetamideSodium100MG/MLOphthalmicSolution|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2262719-MicronizedIsotretinoin24MGOralCapsule[Absorica]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2262713-MicronizedIsotretinoin16MGOralCapsule[Absorica]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1011852-LidocaineHydrochloride0.02MG/MGTopicalGel|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2257013-trikafta100MG/50MG/75MGand150MGPack|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2256947-lasmiditan50MGOralTablet[Reyvow]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1010878-LidocaineHydrochloride40MG/MLMucousMembraneTopicalSolution|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2256943-lasmiditan100MGOralTablet[Reyvow]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2205634-1MLbenralizumab30MG/MLAuto-Injector[Fasenra]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1006688-SulfacetamideSodium100MG/MLTopicalLotion|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2203897-ledipasvir45MG/sofosbuvir200MGOralTablet[Harvoni]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2203893-sofosbuvir200MGOralTablet[Sovaldi]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1006120-SulfacetamideSodium100MG/MLOphthalmicSolution|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2201540-romiplostim0.125MGInjection[Nplate]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2196592-120ACTUATformoterolfumarate0.005MG/ACTUAT/mometasonefuroate0.05MG/ACTUATMeteredDoseInhaler[Dulera]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1005856-SulfacetamideSodium100MG/ML/Sulfur50MG/MLTopicalLotion|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2182340-1MLEtanercept50MG/MLCartridge[Enbrel]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2174390-symdeko50MG/75MGand75MGPack|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1000897-PilocarpineHydrochloride40MG/MLOphthalmicSolution|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2173822-1MLmepolizumab100MG/MLPrefilledSyringe[Nucala]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2170993-1MLmepolizumab100MG/MLAuto-Injector[Nucala]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1000862-PilocarpineHydrochloride20MG/MLOphthalmicSolution|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2170613-1MLgalcanezumab-gnlm100MG/MLPrefilledSyringe[Emgality]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2166401-ivacaftor25MGOralGranules[Kalydeco]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1000673-SulfacetamideSodium0.1MG/MGOphthalmicOintment|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|213475-1MLEpoetinAlfa40000UNT/MLInjection[Procrit]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|213360-Thalidomide50MGOralCapsule[Thalomid]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1000647-PilocarpineHydrochloride10MG/MLOphthalmicSolution|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2123314-Mayzent0.25MGStarterPack|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|212219-EpoetinAlfa20000UNT/MLInjectableSolution[Procrit]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1000141-medroxyprogesteroneacetate5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|212218-EpoetinAlfa20000UNT/MLInjectableSolution[Epogen]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2121100-siponimod2MGOralTablet[Mayzent]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1000135-medroxyprogesteroneacetate2.5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2121096-siponimod0.25MGOralTablet[Mayzent]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2120195-1MLerenumab-aooe140MG/MLAuto-Injector[Aimovig]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1000114-medroxyprogesteroneacetate10MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2119391-Spravato56MGDoseKit|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2119389-Spravato84MGDoseKit|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1000097-DoxepinHydrochloride75MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2107355-prucalopride2MGOralTablet[Motegrity]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2107351-prucalopride1MGOralTablet[Motegrity]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1000076-DoxepinHydrochloride50MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2106362-rifamycinSV194MGDelayedReleaseOralTablet[Aemcolo]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2106075-0.9MLtocilizumab180MG/MLAuto-Injector[Actemra]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1000070-DoxepinHydrochloride25MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2102705-0.6MLpegfilgrastim-cbqv10MG/MLPrefilledSyringe[Udenyca]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|208083-sargramostim0.25MG/MLInjectableSolution[Leukine]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1000064-DoxepinHydrochloride150MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|207059-interferonbeta-1b0.3MGInjection[Betaseron]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|206791-mesalamine250MGExtendedReleaseOralCapsule[Pentasa]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1000058-DoxepinHydrochloride100MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|205924-1MLEpoetinAlfa4000UNT/MLInjection[Procrit]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|205923-1MLEpoetinAlfa4000UNT/MLInjection[Epogen]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1000054-DoxepinHydrochloride10MG/MLOralSolution|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|205922-1MLEpoetinAlfa3000UNT/MLInjection[Procrit]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|205921-1MLEpoetinAlfa3000UNT/MLInjection[Epogen]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1000048-DoxepinHydrochloride10MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2059189-amikacinliposomal70.3MG/MLInhalationSuspension[Arikayce]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|205918-1MLEpoetinAlfa2000UNT/MLInjection[Procrit]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|993804-Gianvi28-DayPack|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|205917-1MLEpoetinAlfa2000UNT/MLInjection[Epogen]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|205913-EpoetinAlfa10000UNT/MLInjectableSolution[Procrit]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|992759-Homatropinehydrobromide50MG/MLOphthalmicSolution[Homatropaire]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|205912-EpoetinAlfa10000UNT/MLInjectableSolution[Epogen]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2058950-0.5MLomalizumab150MG/MLPrefilledSyringe[Xolair]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|992481-PromethazineHydrochloride50MGRectalSuppository[Promethegan]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2058946-1MLomalizumab150MG/MLPrefilledSyringe[Xolair]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2058906-cannabidiol100MG/MLOralSolution[Epidiolex]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|991233-bexarotene0.01MG/MGTopicalGel[Targretin]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2058887-1MLgalcanezumab-gnlm120MG/MLPrefilledSyringe[Emgality]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2058877-1MLgalcanezumab-gnlm120MG/MLAuto-Injector[Emgality]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|967012-POLYETHYLENEGLYCOL3350236000MG/PotassiumChloride2970MG/SodiumBicarbonate6740MG/SodiumChloride5860MG/sodiumsulfate22740|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2057216-0.8MLfilgrastim-aafi0.6MG/MLPrefilledSyringe[Nivestym]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2057205-0.5MLfilgrastim-aafi0.6MG/MLPrefilledSyringe[Nivestym]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|905379-HydralazineHydrochloride37.5MG/IsosorbideDinitrate20MGOralTablet[Bidil]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2056700-1.5MLfremanezumab-vfrm150MG/MLPrefilledSyringe[Ajovy]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2056670-AimovigAutoinjector2-Pack(140MGDose)|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|896031-28ACTUATFluticasonepropionate0.1MG/ACTUATDryPowderInhaler[Flovent]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|205532-DornaseAlfa1MG/MLInhalationSolution[Pulmozyme]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2054995-lusutrombopag3MGOralTablet[Mulpleta]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|896019-60ACTUATFluticasonepropionate0.05MG/ACTUATDryPowderInhaler[Flovent]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2053519-ivacaftor188MG/lumacaftor150MGOralGranules[ORKAMBI]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2053512-ivacaftor125MG/lumacaftor100MGOralGranules[ORKAMBI]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|896006-120ACTUATFluticasonepropionate0.22MG/ACTUATMeteredDoseInhaler[Flovent]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2048568-tofacitinib10MGOralTablet[Xeljanz]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2048025-0.6MLpegfilgrastim-jmdb10MG/MLPrefilledSyringe[Fulphila]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|896001-120ACTUATFluticasonepropionate0.11MG/ACTUATMeteredDoseInhaler[Flovent]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2047623-1MLepoetinalfa-epbx40000UNT/MLInjection[Retacrit]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2047614-1MLepoetinalfa-epbx4000UNT/MLInjection[Retacrit]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|895996-120ACTUATFluticasonepropionate0.044MG/ACTUATMeteredDoseInhaler[Flovent]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2047608-1MLepoetinalfa-epbx3000UNT/MLInjection[Retacrit]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2047602-1MLepoetinalfa-epbx2000UNT/MLInjection[Retacrit]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|890786-Butoconazolenitrate20MG/MLVaginalCream[Gynazole-1]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2047596-1MLepoetinalfa-epbx10000UNT/MLInjection[Retacrit]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2045961-Doptelet60MGDailyDoseCartonPack|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|866049-60ACTUATsalmeterol0.05MG/ACTUATDryPowderInhaler[Serevent]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2045959-Doptelet40MGDailyDoseCartonPack|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2045638-1MLerenumab-aooe70MG/MLAuto-Injector[Aimovig]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|864010-ammoniumlactate120MG/MLTopicalLotion[Geri-Hydrolac]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2003767-1.14MLsarilumab175MG/MLAuto-Injector[Kevzara]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2003757-1.14MLsarilumab132MG/MLAuto-Injector[Kevzara]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|863841-amylase60000UNT/lipase12000UNT/protease38000UNTDelayedReleaseOralCapsule[Creon]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2001321-Roflumilast0.25MGOralTablet[Daliresp]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2000013-1.1MLhydroxyprogesteronecaproate(USP)250MG/MLAuto-Injector[Makena]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|863836-amylase30000UNT/lipase6000UNT/protease19000UNTDelayedReleaseOralCapsule[Creon]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1999389-symdeko100MG/150MGand150MGPack|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1990869-0.85MLexenatide2.35MG/MLAuto-Injector[Bydureon]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|863829-amylase120000UNT/lipase24000UNT/protease76000UNTDelayedReleaseOralCapsule[Creon]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1989109-1MLbenralizumab30MG/MLPrefilledSyringe[Fasenra]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1989085-bosentan32MGTabletforOralSuspension[Tracleer]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|861834-amylase82000UNT/lipase15000UNT/protease51000UNTDelayedReleaseOralCapsule[Zenpep]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1946522-4-Month1.5MLLeuprolideAcetate20MG/MLPrefilledSyringe[Lupron]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1946520-3-Month1.5MLLeuprolideAcetate20MG/MLPrefilledSyringe[Lupron]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|856467-Tri-Lo-Sprintec28DayPack|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1945048-30ACTUATfluticasonefuroate0.1MG/ACTUAT/umeclidinium0.0625MG/ACTUAT/vilanterol0.025MG/ACTUATDryPowderInhaler[Trelegy]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1927290-infliximab-abda100MGInjection[Renflexis]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|855871-Phenytoinsodium30MGExtendedReleaseOralCapsule[Dilantin]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1925257-0.7MLabatacept125MG/MLPrefilledSyringe[Orencia]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1925255-0.4MLabatacept125MG/MLPrefilledSyringe[Orencia]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|855205-docosanol100MG/MLTopicalCream[Abreva]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1923347-1.14MLsarilumab175MG/MLPrefilledSyringe[Kevzara]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1923338-1.14MLsarilumab132MG/MLPrefilledSyringe[Kevzara]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|854921-BisoprololFumarate5MG/Hydrochlorothiazide6.25MGOralTablet[Ziac]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1921468-HumiraPen80MG/0.8MLand40MG/0.4ML-Psoriasis/UveitisStarterPackage(3count)|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1921245-HumiraPen80MG/0.8ML-StarterPackageforCrohn'sDisease,UlcerativeColitisorHidradenitisSuppurativa(3count)|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|854918-BisoprololFumarate2.5MG/Hydrochlorothiazide6.25MGOralTablet[Ziac]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1921240-0.8MLadalimumab100MG/MLAuto-Injector[Humira]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1921081-1.56MLabaloparatide2MG/MLPenInjector[Tymlos]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|854910-BisoprololFumarate10MG/Hydrochlorothiazide6.25MGOralTablet[Ziac]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1921017-0.2MLadalimumab100MG/MLPrefilledSyringe[Humira]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1921010-0.1MLadalimumab100MG/MLPrefilledSyringe[Humira]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|845305-Nonoxynol-90.04MG/MGVaginalGel[Conceptrol]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1876609-naldemedine0.2MGOralTablet[Symproic]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1873765-plecanatide3MGOralTablet[Trulance]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|836368-200ACTUATIpratropiumBromide0.017MG/ACTUATMeteredDoseInhaler[Atrovent]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1873704-Mibelas24FeChewable28DayPack|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1873087-HumiraPrefilledSyringe80MG/0.8MLStarterPack-PediatricCrohn'sDisease(3count)|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|830470-1MLrabiesvirusvaccinewistarstrainPM-1503-3M(Human),Inactivated2.5UNT/MLInjection[Imovax]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1872980-0.4MLadalimumab100MG/MLAuto-Injector[Humira]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1871469-lisdexamfetaminedimesylate50MGChewableTablet[Vyvanse]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|830463-1MLrabiesvirusvaccineflury-lepstrain2.5UNT/MLInjection[RabAvert]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1871467-lisdexamfetaminedimesylate60MGChewableTablet[Vyvanse]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1871465-lisdexamfetaminedimesylate10MGChewableTablet[Vyvanse]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|827713-MineralOil0.03MG/MG/Petrolatum0.94MG/MGOphthalmicOintment[SystaneNighttime]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1871463-lisdexamfetaminedimesylate20MGChewableTablet[Vyvanse]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1871461-lisdexamfetaminedimesylate30MGChewableTablet[Vyvanse]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|808118-prednisolone5MGOralTablet[MILLIPRED]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1871459-lisdexamfetaminedimesylate40MGChewableTablet[Vyvanse]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1870968-deflazacort22.75MG/MLOralSuspension[Emflaza]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|797023-DexPakTaperPak13DayPack|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1870960-deflazacort36MGOralTablet[Emflaza]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1870956-deflazacort18MGOralTablet[Emflaza]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|762663-Jolessa91DayPack|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1870952-deflazacort30MGOralTablet[Emflaza]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1870950-deflazacort6MGOralTablet[Emflaza]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|762334-Velivet28DayPack|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1868020-pirfenidone801MGOralTablet[Esbriet]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1868016-pirfenidone267MGOralTablet[Esbriet]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|762007-Nortrel7/7/728DayPack|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1858833-12HRTreprostinil5MGExtendedReleaseOralTablet[Orenitram]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1855527-HumiraPediatricCrohn'sDiseaseStarterPackage(2count)|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|762001-Kariva28DayPack|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1813112-Rajani28DayPack|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1812470-ivacaftor125MG/lumacaftor100MGOralTablet[ORKAMBI]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|759473-20ACTUATZanamivir5MG/ACTUATDryPowderInhaler[Relenza]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1811182-icosapentethyl500MGOralCapsule[Vascepa]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1806942-carfilzomib60MGInjection[Kyprolis]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|759469-Quasense91DayPack|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1801519-Methylnaltrexonebromide150MGOralTablet[Relistor]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1801322-3.5MLevolocumab120MG/MLCartridge[Repatha]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|754766-Metronidazole0.0075MG/MGVaginalGel[MetroGel]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1801278-HumiraPsoriasisStarterPack40MG/0.8MLPen(4count)|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1799230-1MLabatacept125MG/MLAuto-Injector[Orencia]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|753543-Reclipsen28DayPack|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1796096-24HRLinagliptin5MG/Metforminhydrochloride1000MGExtendedReleaseOralTablet[Jentadueto]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1796091-24HRLinagliptin2.5MG/Metforminhydrochloride1000MGExtendedReleaseOralTablet[Jentadueto]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|753482-Apri28DayPack|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1790546-infliximab-dyyb100MGInjection[Inflectra]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1747194-0.4MLMethotrexate56.3MG/MLAuto-Injector[Otrexup]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|751890-Portia28DayPack|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1747187-0.4MLMethotrexate43.8MG/MLAuto-Injector[Otrexup]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1747181-0.4MLMethotrexate31.3MG/MLAuto-Injector[Otrexup]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|751884-Lutera28DayPack|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1746898-10MLreslizumab10MG/MLInjection[Cinqair]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1745114-1MLixekizumab80MG/MLPrefilledSyringe[Taltz]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|751875-Necon0.5/3528DayPack|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1745108-1MLixekizumab80MG/MLAuto-Injector[Taltz]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1741049-24HRtofacitinib11MGExtendedReleaseOralTablet[Xeljanz]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|751871-Nortrel1/3521DayPack|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1734642-elbasvir50MG/grazoprevir100MGOralTablet[Zepatier]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1732165-incobotulinumtoxinA200UNTInjection[Xeomin]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|751870-Nortrel1/3528DayPack|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1732161-incobotulinumtoxinA100UNTInjection[Xeomin]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1732157-incobotulinumtoxinA50UNTInjection[Xeomin]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|750839-erythromycinstearate250MGOralTablet[ErythrocinStearate]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1729076-UptraviTitrationPack|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1729065-selexipag0.8MGOralTablet[Uptravi]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|750264-Necon7/7/728DayPack|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1729061-selexipag0.6MGOralTablet[Uptravi]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1729057-selexipag0.4MGOralTablet[Uptravi]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|750244-Low-Ogestrel28DayPack|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1729053-selexipag0.2MGOralTablet[Uptravi]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1729047-selexipag1.6MGOralTablet[Uptravi]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|750243-Ogestrel28DayPack|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1729033-selexipag1.4MGOralTablet[Uptravi]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1729029-selexipag1.2MGOralTablet[Uptravi]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|749151-Tri-Norinyl28DayPack|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1729013-selexipag1MGOralTablet[Uptravi]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1728099-romiplostim0.5MGInjection[Nplate]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|748865-Trivora28DayPack|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1728095-romiplostim0.25MGInjection[Nplate]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1726846-0.4MLadalimumab100MG/MLPrefilledSyringe[Humira]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|748859-Zovia1/35E28DayPack|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1726639-ponatinib30MGOralTablet[Iclusig]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1721690-1MLEpoetinAlfa10000UNT/MLInjection[Procrit]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|707333-SodiumChloride0.111MEQ/MLNasalSolution[AyrSalineNasal]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1721685-1MLEpoetinAlfa10000UNT/MLInjection[Epogen]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1720606-mepolizumab100MGInjection[Nucala]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|705008-Cefixime40MG/MLOralSuspension[Suprax]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1666334-Ticagrelor60MGOralTablet[Brilinta]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1665906-1MLevolocumab140MG/MLPrefilledSyringe[Repatha]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|692694-thyroid(USP)65MGOralTablet[Westhroid]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1665900-1MLevolocumab140MG/MLAuto-Injector[Repatha]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1663728-Isotretinoin30MGOralCapsule[Myorisan]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|688242-Estrogens,Conjugated(USP)0.625MG/MLVaginalCream[Premarin]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1661567-TOBIPodhalerDailyKit,8|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1660938-60ACTUATformoterolfumarate0.005MG/ACTUAT/mometasonefuroate0.2MG/ACTUATMeteredDoseInhaler[Dulera]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|644304-Tamoxifen2MG/MLOralSolution[Soltamox]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1660934-60ACTUATformoterolfumarate0.005MG/ACTUAT/mometasonefuroate0.1MG/ACTUATMeteredDoseInhaler[Dulera]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1657982-20MLtocilizumab20MG/MLInjection[Actemra]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|630475-SodiumFluoride5.56MG/MLOralSolution[FluoraDay]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1657980-10MLtocilizumab20MG/MLInjection[Actemra]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1657976-4MLtocilizumab20MG/MLInjection[Actemra]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|617333-Amoxicillin25MG/ML/Clavulanate6.25MG/MLOralSuspension[Augmentin]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1657212-omalizumab150MGInjection[Xolair]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1655934-ivacaftor125MG/lumacaftor200MGOralTablet[ORKAMBI]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|616450-MycophenolicAcid180MGDelayedReleaseOralTablet[Myfortic]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1654955-1MLdarbepoetinalfa0.2MG/MLInjection[Aranesp]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1654630-1MLglatirameracetate20MG/MLPrefilledSyringe[Glatopa]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|616449-MycophenolicAcid360MGDelayedReleaseOralTablet[Myfortic]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1654079-0.5MLustekinumab90MG/MLInjection[Stelara]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1653243-1MLsecukinumab150MG/MLAuto-Injector[Cosentyx]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|616444-mycophenolatemofetil200MG/MLOralSuspension[Cellcept]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1653225-1MLEtanercept50MG/MLAuto-Injector[Enbrel]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1653166-1MLgolimumab100MG/MLAuto-Injector[Simponi]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|544597-PotassiumIodide1000MG/MLOralSolution[SSKIbrandofPotassiumIodide]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1653144-0.5MLgolimumab100MG/MLAuto-Injector[Simponi]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1650901-0.5MLInterferonbeta-1a0.06MG/MLAuto-Injector[Avonex]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|542059-Didanosine10MG/MLOralSolution[Videx]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1650282-RebifRebidoseTitrationPack|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1650004-0.5MLInterferonbeta-1a0.088MG/MLAuto-Injector[Rebif]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|404550-Estrogens,Conjugated(USP)0.45MGOralTablet[Premarin]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1649996-0.5MLInterferonbeta-1a0.044MG/MLAuto-Injector[Rebif]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1649605-PlegridyPenStarterPack|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|404509-CalciumCarbonate1000MG/Simethicone60MGChewableTablet[MaaloxMaxQuickDissolve]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1649593-0.5MLpeginterferonbeta-1a0.25MG/MLAuto-Injector[Plegridy]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1649495-ivabradine7.5MGOralTablet[Corlanor]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|404492-5MLLaronidase0.58MG/MLInjection[Aldurazyme]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1649491-ivabradine5MGOralTablet[Corlanor]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1648789-30ACTUATfluticasonefuroate0.2MG/ACTUAT/vilanterol0.025MG/ACTUATDryPowderInhaler[Breo]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|404476-Azathioprine100MGOralTablet[Azasan]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1606870-ivacaftor75MGOralGranules[Kalydeco]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1606866-ivacaftor50MGOralGranules[Kalydeco]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|404475-Azathioprine75MGOralTablet[Azasan]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1605455-Otezla28-DayStarterPack|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1605172-0.4MLdarbepoetinalfa0.025MG/MLPrefilledSyringe[Aranesp]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|352210-Mesna400MGOralTablet[Mesnex]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1605075-0.8MLFILGRASTIM-SNDZ0.6MG/MLPrefilledSyringe[Zarxio]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1605071-0.5MLFILGRASTIM-SNDZ0.6MG/MLPrefilledSyringe[Zarxio]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|351901-Sirolimus1MG/MLOralSolution[Rapamune]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1601373-naloxegol25MGOralTablet[Movantik]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1599797-1MLsecukinumab150MG/MLPrefilledSyringe[Cosentyx]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|351750-podofilox0.005MG/MGTopicalGel[Condylox]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1596778-14ACTUATBudesonide2MG/ACTUATRectalFoam[Uceris]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1596023-ferriccitrate1000MGOralTablet[Auryxia]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|351487-thyroid(USP)130MGOralTablet[Westhroid]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1594358-HumiraPediatricCrohn'sDiseaseStarterPackage(3count)|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1593858-lisdexamfetaminedimesylate10MGOralCapsule[Vyvanse]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|312020-Nitroglycerin9MGExtendedReleaseOralCapsule|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1593835-24HRdapagliflozin10MG/Metforminhydrochloride500MGExtendedReleaseOralTablet[Xigduo]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1593833-24HRdapagliflozin5MG/Metforminhydrochloride1000MGExtendedReleaseOralTablet[Xigduo]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|312018-Nitroglycerin6.5MGExtendedReleaseOralCapsule|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1593831-24HRdapagliflozin5MG/Metforminhydrochloride500MGExtendedReleaseOralTablet[Xigduo]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1593775-24HRdapagliflozin10MG/Metforminhydrochloride1000MGExtendedReleaseOralTablet[Xigduo]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|284551-nilutamide150MGOralTablet[Nilandron]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1592752-nintedanib150MGOralCapsule[Ofev]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1592748-nintedanib100MGOralCapsule[Ofev]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|261353-Trimethoprim10MG/MLOralSolution[Primsol]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1592285-pirfenidone267MGOralCapsule[Esbriet]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1551923-naloxegol12.5MGOralTablet[Movantik]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|260409-prednisolone1MG/MLOralSolution[Pediapred]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1551888-0.2MLadalimumab50MG/MLPrefilledSyringe[Humira]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1551886-lanthanumcarbonate750MGOralPowder[Fosrenol]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|2564406-influenzaAvirusA/Tasmania/503/2020(H3N2)antigen158000000UNT/ML/influenzaAvirusA/Victoria/1/2020(H1N1)antigen158000000|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1546198-PlegridyStarterPack|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1546189-0.5MLpeginterferonbeta-1a0.25MG/MLPrefilledSyringe[Plegridy]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|2564038-influenzaAvirusA/Cambodia/e0826360/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.03MG/|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1545174-hydrocortisoneacetate100MG/MLRectalFoam[Cortifoam]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1544918-0.65MLexenatide3.08MG/MLPenInjector[Bydureon]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|2564021-0.5MLinfluenzaAvirusA/Cambodia/e0826360/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1544404-0.15MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1544402-0.6MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|2563039-0.5MLinfluenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.03MG/|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1544398-0.5MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1544396-0.45MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|2563032-0.5MLinfluenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.03MG/|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1544394-0.4MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1544390-0.35MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|2563031-influenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.03MG/ML/in|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1544388-0.3MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1544386-0.25MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|2563020-influenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Washington/19/2020(H1N1)antigen0.03MG/ML/in|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1544383-0.2MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1541928-sunitinib37.5MGOralCapsule[Sutent]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|2563004-0.7MLinfluenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.0857MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.085|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1539893-30ACTUATfluticasonefuroate0.1MG/ACTUAT/vilanterol0.025MG/ACTUATDryPowderInhaler[Breo]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|153324-Interferonbeta-1a0.03MGInjection[Avonex]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|2563002-0.5MLinfluenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.09MG/ML/influenzaAvirusA/Wisconsin/588/2019(H1N1)antigen0.09MG/|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1492746-apremilast30MGOralTablet[Otezla]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1488679-12HRTreprostinil2.5MGExtendedReleaseOralTablet[Orenitram]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|2562996-0.5MLinfluenzaAvirusA/Cambodia/e0826360/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1488675-12HRTreprostinil1MGExtendedReleaseOralTablet[Orenitram]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1488671-12HRTreprostinil0.25MGExtendedReleaseOralTablet[Orenitram]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|2562995-0.5MLinfluenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Washington/19/2020(H1N1)antigen0.03MG/|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1488667-12HRTreprostinil0.125MGExtendedReleaseOralTablet[Orenitram]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1487076-DiclofenacSodium20MG/MLTopicalSolution[Pennsaid]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|2561275-0.5MLinfluenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.03MG/|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1486981-dapagliflozin5MGOralTablet[Farxiga]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1486977-dapagliflozin10MGOralTablet[Farxiga]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|2561270-0.5MLinfluenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.03MG/|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1484296-sucroferricoxyhydroxide500MGChewableTablet[Velphoro]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1482814-1MLgolimumab100MG/MLPrefilledSyringe[Simponi]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|2178792-0.3MLEpinephrine0.5MG/MLPrefilledSyringe[Symjepi]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1482513-eslicarbazepineacetate200MGOralTablet[Aptiom]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1442143-Macitentan10MGOralTablet[Opsumit]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|2173508-Nonoxynol-91000MGVaginalSponge[TodaySponge]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1441530-0.9MLtocilizumab180MG/MLPrefilledSyringe[Actemra]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1441424-0.4MLMethotrexate62.5MG/MLAuto-Injector[Otrexup]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|213621-Bacitracin0.5UNT/MG/PolymyxinB10UNT/MGOphthalmicOintment[Polycin]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1441418-0.4MLMethotrexate50MG/MLAuto-Injector[Otrexup]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1441413-0.4MLMethotrexate37.5MG/MLAuto-Injector[Otrexup]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|213510-Auranofin3MGOralCapsule[Ridaura]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1441407-0.4MLMethotrexate25MG/MLAuto-Injector[Otrexup]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1439903-riociguat2.5MGOralTablet[Adempas]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|213291-ParoxetineHydrochloride2MG/MLOralSuspension[Paxil]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1439901-riociguat2MGOralTablet[Adempas]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1439899-riociguat1.5MGOralTablet[Adempas]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|213284-hydroxyurea400MGOralCapsule[Droxia]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1439896-riociguat1MGOralTablet[Adempas]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1439894-riociguat0.5MGOralTablet[Adempas]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|213283-hydroxyurea300MGOralCapsule[Droxia]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1431647-4MLgolimumab12.5MG/MLInjection[Simponi]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1429367-lenalidomide20MGOralCapsule[Revlimid]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|213282-hydroxyurea200MGOralCapsule[Droxia]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1429284-NeostigmineMethylsulfate1MG/MLInjectableSolution[Bloxiverz]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1429282-NeostigmineMethylsulfate0.5MG/MLInjectableSolution[Bloxiverz]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|212373-Estrogens,Esterified(USP)1.25MGOralTablet[Menest]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1375922-bromfenac0.7MG/MLOphthalmicSolution[Prolensa]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1374574-TOBIPodhalerKit,224|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|212232-Estrogens,Esterified(USP)0.625MGOralTablet[Menest]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1373337-Isotretinoin40MGOralCapsule[Zenatane]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1373335-Isotretinoin20MGOralCapsule[Zenatane]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|212039-Estrogens,Esterified(USP)0.3MGOralTablet[Menest]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1373333-Isotretinoin10MGOralCapsule[Zenatane]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1365866-nepafenac3MG/MLOphthalmicSuspension[Ilevro]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|211633-AluminumHydroxide200MG/MagnesiumHydroxide200MG/Simethicone25MGChewableTablet[Gelusil]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1364515-Bedaquiline100MGOralTablet[Sirturo]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1364477-teduglutide5MGInjection[Gattex]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|2110516-60ACTUATFluticasonepropionate0.5MG/ACTUAT/salmeterol0.05MG/ACTUATDryPowderInhaler[Wixela]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1364362-ponatinib45MGOralTablet[Iclusig]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1364358-ponatinib15MGOralTablet[Iclusig]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|2110513-60ACTUATFluticasonepropionate0.25MG/ACTUAT/salmeterol0.05MG/ACTUATDryPowderInhaler[Wixela]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1357547-tofacitinib5MGOralTablet[Xeljanz]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1313061-24HRPhentermine11.25MG/topiramate69MGExtendedReleaseOralCapsule[Qsymia]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|2110510-60ACTUATFluticasonepropionate0.1MG/ACTUAT/salmeterol0.05MG/ACTUATDryPowderInhaler[Wixela]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1310535-teriflunomide7MGOralTablet[Aubagio]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1310531-teriflunomide14MGOralTablet[Aubagio]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|210000-AluminumHydroxide80MG/ML/MagnesiumHydroxide80MG/ML/Simethicone8MG/MLOralSuspension[Almacone]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1310147-everolimus5MGTabletforOralSuspension[Afinitor]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1310144-everolimus3MGTabletforOralSuspension[Afinitor]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|209531-Acetaminophen80MGRectalSuppository[Feverall]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1310138-everolimus2MGTabletforOralSuspension[Afinitor]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1307635-bosutinib500MGOralTablet[Bosulif]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|209360-Acetaminophen325MGRectalSuppository[Acephen]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1307630-bosutinib100MGOralTablet[Bosulif]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1302856-24HRPhentermine15MG/topiramate92MGExtendedReleaseOralCapsule[Qsymia]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|209002-prednisolone1.2MG/MLOphthalmicSuspension[PredMild]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1302845-24HRPhentermine3.75MG/topiramate23MGExtendedReleaseOralCapsule[Qsymia]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1302833-24HRPhentermine7.5MG/topiramate46MGExtendedReleaseOralCapsule[Qsymia]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|208949-Estrogens,Conjugated(USP)0.9MGOralTablet[Premarin]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1300803-24HRmirabegron50MGExtendedReleaseOralTablet[Myrbetriq]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1300797-24HRmirabegron25MGExtendedReleaseOralTablet[Myrbetriq]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|208551-thyroid(USP)300MGOralTablet[ArmourThyroid]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1291092-hydrocortisoneacetate30MGRectalSuppository[Proctocort]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1245003-eltrombopag12.5MGOralTablet[Promacta]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|208549-thyroid(USP)240MGOralTablet[ArmourThyroid]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1244632-AmethiaLo91DayPack|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1244064-0.4MLMethylnaltrexonebromide20MG/MLPrefilledSyringe[Relistor]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|208547-thyroid(USP)180MGOralTablet[ArmourThyroid]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1244062-0.6MLMethylnaltrexonebromide20MG/MLPrefilledSyringe[Relistor]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1243848-24HRMetforminhydrochloride500MG/sitagliptin50MGExtendedReleaseOralTablet[Janumet]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|208513-Estrogens,Conjugated(USP)0.3MGOralTablet[Premarin]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1243843-24HRMetforminhydrochloride1000MG/sitagliptin50MGExtendedReleaseOralTablet[Janumet]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1243833-24HRMetforminhydrochloride1000MG/sitagliptin100MGExtendedReleaseOralTablet[Janumet]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|207949-Succimer100MGOralCapsule[Chemet]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1243052-ivacaftor150MGOralTablet[Kalydeco]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1243040-Linagliptin2.5MG/Metforminhydrochloride850MGOralTablet[Jentadueto]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|207864-crotamiton100MG/MLTopicalCream[Eurax]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1243033-Linagliptin2.5MG/Metforminhydrochloride500MGOralTablet[Jentadueto]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1243026-Linagliptin2.5MG/Metforminhydrochloride1000MGOralTablet[Jentadueto]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|207588-Procarbazine50MGOralCapsule[Matulane]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1242968-exenatide2MGInjection[Bydureon]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1242615-Isotretinoin40MGOralCapsule[Myorisan]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|207478-Primidone50MGOralTablet[Mysoline]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1242613-Isotretinoin20MGOralCapsule[Myorisan]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1242611-Isotretinoin10MGOralCapsule[Myorisan]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|207373-Mitotane500MGOralTablet[Lysodren]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1242233-lenalidomide2.5MGOralCapsule[Revlimid]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1235267-CamreseLo91DayPack|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|207273-Nitroglycerin0.02MG/MGTopicalOintment[Nitro-Bid]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1235157-azilsartanmedoxomil40MG/Chlorthalidone25MGOralTablet[Edarbyclor]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1235150-azilsartanmedoxomil40MG/Chlorthalidone12.5MGOralTablet[Edarbyclor]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|207136-Methylprednisolone2MGOralTablet[Medrol]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1232204-Zolpidemtartrate3.5MGSublingualTablet[Intermezzo]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1232200-Zolpidemtartrate1.75MGSublingualTablet[Intermezzo]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|206978-Ketoconazole20MG/MLMedicatedShampoo[Nizoral]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1232190-asparaginaseErwiniachrysanthemi10000UNTInjection[Erwinaze]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1191128-EdrophoniumChloride10MG/MLInjectableSolution[Enlon]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|206961-Nadolol20MGOralTablet[Corgard]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1149667-Camrese91DayPack|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1149617-COLLAGENASE0.25UNT/MGTopicalOintment[Santyl]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|206314-Hydrocortisone0.01MG/MGTopicalOintment[Cortizone]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1148506-crizotinib250MGOralCapsule[Xalkori]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1148502-crizotinib200MGOralCapsule[Xalkori]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|206216-2MLIron-DextranComplex50MG/MLInjection[InFed]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1145932-1MLabatacept125MG/MLPrefilledSyringe[Orencia]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1116639-Ticagrelor90MGOralTablet[Brilinta]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|206208-aluminumchloride200MG/MLTopicalSolution[Drysol]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1115473-1.5MLLeuprolideAcetate7.5MG/MLPrefilledSyringe[Lupron]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1115468-1.5MLLeuprolideAcetate15MG/MLPrefilledSyringe[Lupron]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|205669-Dexamethasone1MG/MLOphthalmicSuspension[Maxidex]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1115464-1MLLeuprolideAcetate7.5MG/MLPrefilledSyringe[Lupron]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1115459-1MLLeuprolideAcetate3.75MG/MLPrefilledSyringe[Lupron]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|205562-Estramustine140MGOralCapsule[Emcyt]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1115456-1MLLeuprolideAcetate15MG/MLPrefilledSyringe[Lupron]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1115449-1MLLeuprolideAcetate11.25MG/MLPrefilledSyringe[Lupron]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|2045958-avatrombopag20MGOralTablet[Doptelet]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1115259-1.5MLLeuprolideAcetate30MG/MLPrefilledSyringe[Lupron]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1114096-Vandetanib300MGOralTablet[Caprelsa]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|202301-Estrogens,Conjugated(USP)1.25MGOralTablet[Premarin]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1114074-Vandetanib100MGOralTablet[Caprelsa]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1112687-Amethia91DayPack|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|201747-Primidone250MGOralTablet[Mysoline]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1100706-Linagliptin5MGOralTablet[Tradjenta]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1091843-Roflumilast0.5MGOralTablet[Daliresp]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|201338-Nadolol80MGOralTablet[Corgard]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1091654-azilsartanmedoxomil80MGOralTablet[Edarbi]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1091650-azilsartanmedoxomil40MGOralTablet[Edarbi]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|201337-Nadolol40MGOralTablet[Corgard]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1046402-1.7MLdenosumab70MG/MLInjection[Xgeva]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1045408-dasatinib80MGOralTablet[Sprycel]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1998774-Breath-Actuated120ACTUATBeclomethasoneDipropionate0.04MG/ACTUATMeteredDoseInhaler[Qvar]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1045404-dasatinib140MGOralTablet[Sprycel]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1043582-24HRMetforminhydrochloride500MG/saxagliptin5MGExtendedReleaseOralTablet[Kombiglyze]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1998772-Breath-Actuated120ACTUATBeclomethasoneDipropionate0.08MG/ACTUATMeteredDoseInhaler[Qvar]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1043574-24HRMetforminhydrochloride1000MG/saxagliptin5MGExtendedReleaseOralTablet[Kombiglyze]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1043567-24HRMetforminhydrochloride1000MG/saxagliptin2.5MGExtendedReleaseOralTablet[Kombiglyze]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1995479-amylase168000UNT/lipase40000UNT/protease126000UNTDelayedReleaseOralCapsule[Zenpep]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1040058-DextromethorphanHydrobromide20MG/QuinidineSulfate10MGOralCapsule[Nuedexta]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1037185-LoLoestrinFe28DayPack|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1989117-0.3MLEpinephrine1MG/MLPrefilledSyringe[Symjepi]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1012899-fingolimod0.5MGOralCapsule[Gilenya]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1011755-aliskiren300MG/Hydrochlorothiazide25MGOralTablet[TekturnaHCT]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|198467-Aspirin325MGDelayedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1011752-aliskiren300MG/Hydrochlorothiazide12.5MGOralTablet[TekturnaHCT]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1011715-aliskiren150MG/Hydrochlorothiazide25MGOralTablet[TekturnaHCT]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1797880-Nafarelin0.2MG/ACTUATMeteredDoseNasalSpray[Synarel]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1011712-aliskiren150MG/Hydrochlorothiazide12.5MGOralTablet[TekturnaHCT]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1002300-nilotinib150MGOralCapsule[Tasigna]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1667916-5MLIsoproterenolHydrochloride0.2MG/MLInjection[Isuprel]|EXPANSION PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1000089-alcaftadine2.5MG/MLOphthalmicSolution[Lastacaft]|EXPANSION PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|998679-168HRClonidine0.0125MG/HRTransdermalSystem|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1595478-amylase84000UNT/lipase20000UNT/protease63000UNTDelayedReleaseOralCapsule[Zenpep]|EXPANSION PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|998675-168HRClonidine0.00833MG/HRTransdermalSystem|EXPANSION PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|998671-168HRClonidine0.00417MG/HRTransdermalSystem|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1595473-amylase63000UNT/lipase15000UNT/protease47000UNTDelayedReleaseOralCapsule[Zenpep]|EXPANSION PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|860654-epinastinehydrochloride0.5MG/MLOphthalmicSolution|EXPANSION PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|856569-24HRPropranololHydrochloride80MGExtendedReleaseOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1595462-amylase42000UNT/lipase10000UNT/protease32000UNTDelayedReleaseOralCapsule[Zenpep]|EXPANSION PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|856535-24HRPropranololHydrochloride60MGExtendedReleaseOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|856481-24HRPropranololHydrochloride160MGExtendedReleaseOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1595457-amylase24000UNT/lipase5000UNT/protease17000UNTDelayedReleaseOralCapsule[Zenpep]|EXPANSION PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|856460-24HRPropranololHydrochloride120MGExtendedReleaseOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|854868-Rabeprazolesodium20MGDelayedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1595292-amylase14000UNT/lipase3000UNT/protease10000UNTDelayedReleaseOralCapsule[Zenpep]|EXPANSION PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|798133-Erythromycin20MG/MLMedicatedPad[Ery]|EXPANSION PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|797274-Clindamycin10MG/MLMedicatedPad|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1594673-amylase105000UNT/lipase25000UNT/protease79000UNTDelayedReleaseOralCapsule[Zenpep]|EXPANSION PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|606726-Esomeprazole20MGDelayedReleaseOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|577127-pregabalin225MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1536586-168HREthinylEstradiol0.00146MG/HR/norelgestromin0.00625MG/HRTransdermalSystem[Xulane]|EXPANSION PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|483450-pregabalin75MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|483448-pregabalin50MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|153473-Altretamine50MGOralCapsule[Hexalen]|EXPANSION PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|483446-pregabalin200MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|483444-pregabalin300MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|153183-adapalene0.001MG/MGTopicalGel[Differin]|EXPANSION PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|483442-pregabalin25MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|483440-pregabalin150MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|152854-Itraconazole10MG/MLOralSolution[Sporanox]|EXPANSION PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|483438-pregabalin100MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|351134-zolmitriptan5MGDisintegratingOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|150840-Estrogens,Conjugated(USP)0.625MGOralTablet[Premarin]|EXPANSION PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|314266-Tacrolimus0.001MG/MGTopicalOintment|EXPANSION PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|314227-Sumatriptan20MG/ACTUATNasalSpray|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1440936-Hydrocortisone25MG/MLTopicalCream[ProctozoneHC]|EXPANSION PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|313189-Tacrolimus0.0003MG/MGTopicalOintment|EXPANSION PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|313159-Sumatriptan5MG/ACTUATNasalSpray|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1426881-Levonorgestrel1.5MGOralTablet[MyWay]|EXPANSION PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|311671-Metolazone5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|309333-Clindamycin10MG/MLTopicalSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1422081-Enskyce28DayPack|EXPANSION PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|309332-Clindamycin0.01MG/MGTopicalGel|EXPANSION PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|284201-zolmitriptan2.5MGDisintegratingOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1373327-amylase180000UNT/lipase36000UNT/protease114000UNTDelayedReleaseOralCapsule[Creon]|EXPANSION PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|244374-BenzoylPeroxide0.05MG/MG/Erythromycin0.03MG/MGTopicalGel|EXPANSION PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|200194-zolmitriptan5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1359135-Tri-LegestFe28DayPack|EXPANSION PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|200193-zolmitriptan2.5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|2001568-BXRating24HRMethylphenidateHydrochloride54MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1359134-TiliaFe28DayPack|EXPANSION PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|2001566-BXRating24HRMethylphenidateHydrochloride36MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|2001565-BXRating24HRMethylphenidateHydrochloride27MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1359032-Microgestin1.5/3021DayPack|EXPANSION PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|2001564-BXRating24HRMethylphenidateHydrochloride18MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|197979-Metolazone2.5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1359030-Junel1.5/3021DayPack|EXPANSION PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|197978-Metolazone10MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|197519-Clindamycin10MG/MLTopicalLotion|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1359027-MicrogestinFe1.5/3028DayPack|EXPANSION PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|1806195-50/50Release24HRMethylphenidateHydrochloride10MGExtendedReleaseOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|1806185-50/50Release24HRMethylphenidateHydrochloride60MGExtendedReleaseOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1359025-JunelFe28DayPack|EXPANSION PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|1797865-mometasonefuroate0.05MG/ACTUATMeteredDoseNasalSpray|EXPANSION PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|1111343-olopatadine2MG/MLOphthalmicSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1359020-Microgestin1/2021DayPack|EXPANSION PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|1111339-olopatadine1MG/MLOphthalmicSolution|EXPANSION PARTIAL DUALS 632|2002|N|Y|Y||Preferred Brand|2200658-semaglutide7MGOralTablet[Rybelsus]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1358780-Junel1/2021DayPack|EXPANSION PARTIAL DUALS 632|2002|N|Y|Y||Preferred Brand|2200654-semaglutide3MGOralTablet[Rybelsus]|EXPANSION PARTIAL DUALS 632|2002|N|Y|Y||Preferred Brand|2200650-semaglutide14MGOralTablet[Rybelsus]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1358775-MicrogestinFe1/2028DayPack|EXPANSION PARTIAL DUALS 632|2002|N|Y|Y||Preferred Brand|1716223-patiromer25200MGPowderforOralSuspension[Veltassa]|EXPANSION PARTIAL DUALS 632|2002|N|Y|Y||Preferred Brand|1716219-patiromer16800MGPowderforOralSuspension[Veltassa]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1358765-JunelFe1/2028DayPack|EXPANSION PARTIAL DUALS 632|2002|N|Y|Y||Preferred Brand|1716215-patiromer8400MGPowderforOralSuspension[Veltassa]|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|997406-12HRFexofenadinehydrochloride60MG/PseudoephedrineHydrochloride120MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1293864-ErgotamineTartrate2MGSublingualTablet[Ergomar]|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|996615-24HRMemantinehydrochloride7MGExtendedReleaseOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|996609-24HRMemantinehydrochloride28MGExtendedReleaseOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1293639-Caffeine100MG/ErgotamineTartrate2MGRectalSuppository[Migergot]|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|996603-24HRMemantinehydrochloride21MGExtendedReleaseOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|996594-24HRMemantinehydrochloride14MGExtendedReleaseOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1250090-Nonoxynol-90.03MG/MGVaginalGel[GynolII]|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|857564-24HRtrospiumchloride60MGExtendedReleaseOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|857560-trospiumchloride20MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1233850-Vestura28DayPack|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|855194-tolterodinetartrate2MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|855189-24HRtolterodinetartrate4MGExtendedReleaseOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1190225-120ACTUATAlbuterol0.1MG/ACTUAT/IpratropiumBromide0.02MG/ACTUATInhalationSpray[Combivent]|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|855182-24HRtolterodinetartrate2MGExtendedReleaseOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|855178-tolterodinetartrate1MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1148646-28ACTUATFluticasonepropionate0.25MG/ACTUATDryPowderInhaler[Flovent]|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|825130-24HRmesalamine375MGExtendedReleaseOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|810090-Carbidopa18.75MG/entacapone200MG/Levodopa75MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1114135-amylase16000UNT/lipase3000UNT/protease10000UNTDelayedReleaseOralCapsule[Zenpep]|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|810083-Carbidopa31.25MG/entacapone200MG/Levodopa125MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|749206-sevelamercarbonate800MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1114041-DextromethorphanHydrobromide1MG/MLOralSolution[DayQuilCough]|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|745791-200ACTUATLevalbuterol0.045MG/ACTUATMeteredDoseInhaler|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|730988-Carbidopa50MG/entacapone200MG/Levodopa200MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1113046-amylase15000UNT/lipase3000UNT/protease9500UNTDelayedReleaseOralCapsule[Creon]|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|686429-mesalamine1200MGDelayedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|606730-Esomeprazole40MGDelayedReleaseOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1112715-Amethyst28DayPack|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|562806-Pimecrolimus10MG/MLTopicalCream|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|403852-Carbidopa37.5MG/entacapone200MG/Levodopa150MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1101778-Monobasicpotassiumphosphate0.0408MEQ/MLOralSolution[K-Phos]|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|403851-Carbidopa25MG/entacapone200MG/Levodopa100MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|403850-Carbidopa12.5MG/entacapone200MG/Levodopa50MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1099026-Loryna28DayPack|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|349590-Levalbuterol0.103MG/MLInhalationSolution|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|349556-ezetimibe10MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1098924-SodiumFluoride11MG/MLOralSolution[Flura-Drops]|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|317094-entacapone200MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|313921-calcipotriene0.05MG/MLTopicalCream|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1095362-Balziva28DayPack|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|311787-moxifloxacin400MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|311347-linezolid600MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1087012-thyroid(USP)32.5MGOralTablet[Westhroid]|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|311345-linezolid20MG/MLOralSuspension|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|311286-Levalbuterol0.21MG/MLInhalationSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|105590-Thioguanine40MGOralTablet[Tabloid]|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|310600-Griseofulvin500MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|308865-calcipotriene0.05MG/MLTopicalSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|105553-Chlorambucil2MGOralTablet[Leukeran]|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|284008-travoprost0.04MG/MLOphthalmicSolution|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|242831-Griseofulvin125MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|105551-Busulfan2MGOralTablet[Myleran]|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|242754-Levalbuterol0.417MG/MLInhalationSolution|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|239239-Griseofulvin250MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1048452-ColestipolHydrochloride5000MGGranulesforOralSuspension[Colestid]|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|204119-Malathion5MG/MLTopicalLotion|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|198373-calcipotriene0.00005MG/MGTopicalOintment|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1046771-12HRHyoscyamineSulfate0.375MGExtendedReleaseOralTablet[Levbid]|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|197984-Minocycline100MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|197551-Cycloserine250MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1039273-Hydrocortisone10MG/MLTopicalSolution[ScalpicinItchRelief]|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|197508-Cimetidine800MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|197507-Cimetidine400MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|102250-Hydrocortisone1.67MG/MLEnema[Cortenema]|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|197506-Cimetidine300MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|197505-Cimetidine200MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1020155-Introvale91DayPack|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|197419-Bumetanide2MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|197418-Bumetanide1MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1005928-ulipristalacetate30MGOralTablet[Ella]|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|197417-Bumetanide0.5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|1855389-Levalbuterol2.5MG/MLInhalationSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1000500-Prempro0.625/528DayPack|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|1797863-flunisolide0.025MG/ACTUATMeteredDoseNasalSpray|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|1368954-mesalamine400MGDelayedReleaseOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1000499-Prempro0.625/2.528DayPack|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|1368438-alogliptin25MG/pioglitazone45MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|1368431-alogliptin25MG/pioglitazone30MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1000497-Prempro0.45/1.528DayPack|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|1368424-alogliptin25MG/pioglitazone15MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|1368417-alogliptin12.5MG/pioglitazone45MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1000491-Prempro0.3/1.528DayPack|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|1368410-alogliptin12.5MG/pioglitazone30MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|1368403-alogliptin12.5MG/pioglitazone15MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1000487-Premphase28DayPack|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|1368392-alogliptin12.5MG/Metforminhydrochloride500MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|1368385-alogliptin12.5MG/Metforminhydrochloride1000MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1000158-0.65MLmedroxyprogesteroneacetate160MG/MLPrefilledSyringe[depo-subQprovera]|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|1368034-alogliptin12.5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|1368018-alogliptin6.25MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|1368006-alogliptin25MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|1246673-Ivermectin5MG/MLTopicalLotion|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|1085816-spinosad9MG/MLMedicatedShampoo|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Brand|996633-NamendaXR28DayTitrationPack|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Brand|856666-rifaximin550MGOralTablet[XIFAXAN]|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Brand|835721-Ethionamide250MGOralTablet[Trecator]|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Brand|833151-Savella4-WeekTitrationPack|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Brand|833149-Milnacipranhydrochloride25MGOralTablet[Savella]|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Brand|833146-Milnacipranhydrochloride50MGOralTablet[Savella]|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Brand|833143-Milnacipranhydrochloride12.5MGOralTablet[Savella]|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Brand|833139-Milnacipranhydrochloride100MGOralTablet[Savella]|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Brand|539789-rifaximin200MGOralTablet[XIFAXAN]|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Brand|402092-Cyclosporine0.5MG/MLOphthalmicSuspension[Restasis]|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Brand|2398842-3MLsemaglutide1.34MG/MLPenInjector[Ozempic]|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Brand|2395785-0.5MLdulaglutide9MG/MLAuto-Injector[Trulicity]|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Brand|2395779-0.5MLdulaglutide6MG/MLAuto-Injector[Trulicity]|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Brand|213307-Ciprofloxacin0.003MG/MGOphthalmicOintment[Ciloxan]|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Brand|212381-aminosalicylicacid4000MGOralGranules[PaserD/R]|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Brand|1992821-ertugliflozin15MGOralTablet[Steglatro]|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Brand|1992816-ertugliflozin5MGOralTablet[Steglatro]|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Brand|1992703-ertugliflozin7.5MG/Metforminhydrochloride500MGOralTablet[Segluromet]|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Brand|1992700-ertugliflozin7.5MG/Metforminhydrochloride1000MGOralTablet[Segluromet]|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Brand|1992695-ertugliflozin2.5MG/Metforminhydrochloride500MGOralTablet[Segluromet]|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Brand|1992691-ertugliflozin2.5MG/Metforminhydrochloride1000MGOralTablet[Segluromet]|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Brand|1991317-1MGDose1.5MLsemaglutide1.34MG/MLPenInjector[Ozempic]|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Brand|1991311-0.25MG,0.5MGDose1.5MLsemaglutide1.34MG/MLPenInjector[Ozempic]|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Brand|1801840-lifitegrast50MG/MLOphthalmicSolution[Xiidra]|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Brand|1551306-0.5MLdulaglutide3MG/MLAuto-Injector[Trulicity]|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Brand|1551300-0.5MLdulaglutide1.5MG/MLAuto-Injector[Trulicity]|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Brand|1356673-BenzylAlcohol0.05ML/MLTopicalLotion[Ulesfia]|EXPANSION PARTIAL DUALS 632|2002|N|Y|N||Preferred Brand|1190334-24HRFexofenadinehydrochloride180MG/PseudoephedrineHydrochloride240MGExtendedReleaseOralTablet[Wal-FexD]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|996757-CodeinePhosphate2MG/ML/PhenylephrineHydrochloride1MG/ML/PromethazineHydrochloride1.25MG/MLOralSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|995868-CodeinePhosphate2MG/ML/Guaifenesin20MG/MLOralSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|993890-Acetaminophen300MG/CodeinePhosphate60MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|993781-Acetaminophen300MG/CodeinePhosphate30MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|993770-Acetaminophen300MG/CodeinePhosphate15MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|993755-Acetaminophen24MG/ML/CodeinePhosphate2.4MG/MLOralSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|993470-midodrinehydrochloride5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|993466-midodrinehydrochloride2.5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|993462-midodrinehydrochloride10MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|992668-homatropinemethylbromide0.3MG/ML/HydrocodoneBitartrate1MG/MLOralSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|991528-DextromethorphanHydrobromide3MG/ML/PromethazineHydrochloride1.25MG/MLOralSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|991486-CodeinePhosphate2MG/ML/PromethazineHydrochloride1.25MG/MLOralSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|977880-AmilorideHydrochloride5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|905516-ChlordiazepoxideHydrochloride5MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|905495-ChlordiazepoxideHydrochloride25MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|905369-ChlordiazepoxideHydrochloride10MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|904589-SotalolHydrochloride240MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|904447-Alendronicacid0.933MG/MLOralSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|904419-Alendronicacid10MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|904405-Alendronicacid40MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|899557-dexmethylphenidatehydrochloride2.5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|899548-dexmethylphenidatehydrochloride10MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|899518-dexmethylphenidatehydrochloride5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|897749-HydromorphoneHydrochloride3MGRectalSuppository|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|897710-HydromorphoneHydrochloride8MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|897702-HydromorphoneHydrochloride4MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|897696-HydromorphoneHydrochloride2MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|897659-Verapamilhydrochloride120MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|897640-Verapamilhydrochloride180MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|897630-24HRVerapamilhydrochloride360MGExtendedReleaseOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|897618-24HRVerapamilhydrochloride180MGExtendedReleaseOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|897612-24HRVerapamilhydrochloride120MGExtendedReleaseOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|894780-MorphineSulfate4MG/MLOralSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|892672-MorphineSulfate30MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|892625-MorphineSulfate20MG/MLOralSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|892589-MorphineSulfate2MG/MLOralSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|892582-MorphineSulfate15MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|884386-DextroamphetamineSulfate5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|884385-DextroamphetamineSulfate10MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|866042-NeomycinSulfate500MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|863559-valganciclovir50MG/MLOralSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|862025-24HRGuanfacine4MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|862019-24HRGuanfacine3MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|862013-24HRGuanfacine2MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|862006-24HRGuanfacine1MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|861237-24HRAmphetamineaspartate1.25MG/AmphetamineSulfate1.25MG/Dextroamphetaminesaccharate1.25MG/DextroamphetamineSulfate1.25|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|861232-24HRAmphetamineaspartate7.5MG/AmphetamineSulfate7.5MG/Dextroamphetaminesaccharate7.5MG/DextroamphetamineSulfate7.5MGEx|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|861227-24HRAmphetamineaspartate6.25MG/AmphetamineSulfate6.25MG/Dextroamphetaminesaccharate6.25MG/DextroamphetamineSulfate6.25|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|861225-24HRAmphetamineaspartate5MG/AmphetamineSulfate5MG/Dextroamphetaminesaccharate5MG/DextroamphetamineSulfate5MGExtendedRe|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|861223-24HRAmphetamineaspartate3.75MG/AmphetamineSulfate3.75MG/Dextroamphetaminesaccharate3.75MG/DextroamphetamineSulfate3.75|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|861221-24HRAmphetamineaspartate2.5MG/AmphetamineSulfate2.5MG/Dextroamphetaminesaccharate2.5MG/DextroamphetamineSulfate2.5MGEx|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|857366-EconazoleNitrate10MG/MLTopicalCream|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|857005-Acetaminophen325MG/HydrocodoneBitartrate7.5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|857002-Acetaminophen325MG/HydrocodoneBitartrate5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|856999-Acetaminophen325MG/HydrocodoneBitartrate10MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|856940-Acetaminophen21.7MG/ML/HydrocodoneBitartrate0.5MG/MLOralSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|855633-DiclofenacSodium0.01MG/MGTopicalGel|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|854876-Zolpidemtartrate5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|854873-Zolpidemtartrate10MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|854252-1MLEnoxaparinsodium150MG/MLPrefilledSyringe|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|854248-1MLEnoxaparinsodium100MG/MLPrefilledSyringe|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|854245-0.8MLEnoxaparinsodium150MG/MLPrefilledSyringe|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|854241-0.8MLEnoxaparinsodium100MG/MLPrefilledSyringe|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|854238-0.6MLEnoxaparinsodium100MG/MLPrefilledSyringe|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|854235-0.4MLEnoxaparinsodium100MG/MLPrefilledSyringe|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|854228-0.3MLEnoxaparinsodium100MG/MLPrefilledSyringe|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|847252-3MLInsulinLispro25UNT/ML/insulinlisproprotamine,human75UNT/MLPenInjector|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|847191-3MLinsulinaspartprotamine,human70UNT/ML/insulinaspart,human30UNT/MLPenInjector|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|846378-24HRLevetiracetam750MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|845488-Ramipril1.25MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|835829-testosteronecypionate100MG/MLInjectableSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|835603-tramadolhydrochloride50MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|834022-KetorolacTromethamine10MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|830861-24HRDiltiazemHydrochloride120MGExtendedReleaseOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|830845-24HRDiltiazemHydrochloride180MGExtendedReleaseOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|830837-24HRDiltiazemHydrochloride240MGExtendedReleaseOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|830801-24HRDiltiazemHydrochloride300MGExtendedReleaseOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|807832-24HRLevetiracetam500MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|801966-4MLDiazepam5MG/MLRectalGel|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|801961-2MLDiazepam5MG/MLRectalGel|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|801957-0.5MLDiazepam5MG/MLRectalGel|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|728113-Oseltamivir45MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|728109-Oseltamivir30MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|687043-Amphetamineaspartate3.125MG/AmphetamineSulfate3.125MG/Dextroamphetaminesaccharate3.125MG/DextroamphetamineSulfate3.125|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|686379-celecoxib50MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|636045-Hydrochlorothiazide25MG/valsartan320MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|636042-Hydrochlorothiazide12.5MG/valsartan320MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|608143-atomoxetine80MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|608139-atomoxetine100MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|596934-duloxetine60MGDelayedReleaseOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|596930-duloxetine30MGDelayedReleaseOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|596926-duloxetine20MGDelayedReleaseOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|577961-Amphetamineaspartate5MG/AmphetamineSulfate5MG/Dextroamphetaminesaccharate5MG/DextroamphetamineSulfate5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|577957-Amphetamineaspartate3.75MG/AmphetamineSulfate3.75MG/Dextroamphetaminesaccharate3.75MG/DextroamphetamineSulfate3.75MGOr|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|541892-Amphetamineaspartate2.5MG/AmphetamineSulfate2.5MG/Dextroamphetaminesaccharate2.5MG/DextroamphetamineSulfate2.5MGOralTa|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|541878-Amphetamineaspartate1.25MG/AmphetamineSulfate1.25MG/Dextroamphetaminesaccharate1.25MG/DextroamphetamineSulfate1.25MGOr|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|541363-Amphetamineaspartate7.5MG/AmphetamineSulfate7.5MG/Dextroamphetaminesaccharate7.5MG/DextroamphetamineSulfate7.5MGOralTa|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|485486-tizanidine2MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|485485-tizanidine4MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|485484-tizanidine6MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|485465-Eszopiclone3MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|485442-Eszopiclone2MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|485440-Eszopiclone1MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|477562-Fenofibrate48MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|477560-Fenofibrate145MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|403923-168HREstradiol0.0025MG/HRTransdermalSystem|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|403922-168HREstradiol0.00156MG/HRTransdermalSystem|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|403884-Levetiracetam100MG/MLOralSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|359818-Nicotine4MGOralLozenge|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|359817-Nicotine2MGOralLozenge|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|351297-insulinaspartprotamine,human70UNT/ML/insulinaspart,human30UNT/MLInjectableSuspension|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|351246-montelukast4MGOralGranules|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|351133-Fenofibrate54MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|351109-Budesonide0.25MG/MLInhalationSuspension|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|349595-atomoxetine60MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|349594-atomoxetine40MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|349593-atomoxetine25MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|349592-atomoxetine18MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|349591-atomoxetine10MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|349514-celecoxib400MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|349483-valsartan40MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|349353-Hydrochlorothiazide25MG/valsartan160MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|349287-Fenofibrate160MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|349201-valsartan160MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|349200-valsartan320MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|349199-valsartan80MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|349198-Clonazepam0.5MGDisintegratingOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|349197-Clonazepam2MGDisintegratingOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|349196-Clonazepam1MGDisintegratingOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|349195-Clonazepam0.25MGDisintegratingOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|349194-Clonazepam0.125MGDisintegratingOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|349094-Budesonide0.125MG/MLInhalationSuspension|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|318202-Erythromycin20MG/MLTopicalSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|315223-Sumatriptan25MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|314285-zonisamide100MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|314209-rizatriptan10MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|314200-pantoprazole40MGDelayedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|314135-naratriptan2.5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|313762-zaleplon5MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|313761-zaleplon10MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|313571-Vancomycin250MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|313570-Vancomycin125MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|313566-valganciclovir450MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|313415-Tobramycin3MG/MLOphthalmicSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|313413-tizanidine4MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|313412-tizanidine2MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|313222-terbinafine250MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|313161-Sumatriptan50MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|313160-Sumatriptan100MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|312840-rizatriptan5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|312087-Ondansetron8MGDisintegratingOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|312086-Ondansetron8MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|312075-Ofloxacin3MG/MLOphthalmicSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|311975-Nicotine4MGChewingGum|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|311918-naratriptan1MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|311759-montelukast4MGChewableTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|311265-lamotrigine5MGChewableTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|311237-Ketotifen0.25MG/MLOphthalmicSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|311207-Ivermectin3MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|310793-Hydrochlorothiazide12.5MG/irbesartan300MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|310792-Hydrochlorothiazide12.5MG/irbesartan150MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|310467-Gentamicin3MG/MLOphthalmicSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|310465-Gentamicin0.001MG/MGTopicalOintment|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|310289-Fenofibrate200MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|310288-Fenofibrate134MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|310191-estradiolvalerate40MG/MLInjectableSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|310190-estradiolvalerate20MG/MLInjectableSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|310152-Erythromycin0.02MG/MGTopicalGel|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|310149-Erythromycin0.005MG/MGOphthalmicOintment|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|309314-Citalopram40MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|309309-Ciprofloxacin500MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|309307-Ciprofloxacin3MG/MLOphthalmicSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|283407-Mirtazapine30MGDisintegratingOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|261962-Ramipril10MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|259081-12HRAspirin25MG/Dipyridamole200MGExtendedReleaseOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|252559-Budesonide0.5MG/MLInhalationSuspension|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|251872-pantoprazole20MGDelayedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|248478-84HREstradiol0.00104MG/HRTransdermalSystem|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|242892-84HREstradiol0.00417MG/HRTransdermalSystem|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|242891-84HREstradiol0.00208MG/HRTransdermalSystem|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|242462-cilostazol50MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|242461-cilostazol100MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|242438-montelukast5MGChewableTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|242333-168HREstradiol0.00104MG/HRTransdermalSystem|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|241946-84HREstradiol0.00156MG/HRTransdermalSystem|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|241527-168HREstradiol0.00312MG/HRTransdermalSystem|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|238004-168HREstradiol0.00417MG/HRTransdermalSystem|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|238003-168HREstradiol0.00208MG/HRTransdermalSystem|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|2123111-NDA020503200ACTUATAlbuterol0.09MG/ACTUATMeteredDoseInhaler|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|205323-celecoxib200MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|205322-celecoxib100MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|2047882-1MLtestosteronecypionate200MG/MLInjection|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|203088-Ketoconazole20MG/MLTopicalCream|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|200345-Simvastatin80MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|200329-Omeprazole40MGDelayedReleaseOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|200311-Fenofibrate67MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|200285-Hydrochlorothiazide12.5MG/valsartan160MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|200284-Hydrochlorothiazide12.5MG/valsartan80MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|200224-montelukast10MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|200096-irbesartan300MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|200095-irbesartan150MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|200094-irbesartan75MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|199381-potassiumcitrate10MEQExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|199376-potassiumcitrate5MEQExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|199370-Ciprofloxacin100MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|199206-Riluzole50MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|198342-Urea400MG/MLTopicalCream|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|198318-Triazolam0.25MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|198317-Triazolam0.125MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|198252-tetracyclinehydrochloride500MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|198250-tetracyclinehydrochloride250MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|198242-Temazepam30MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|198241-Temazepam15MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|198189-Ramipril5MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|198188-Ramipril2.5MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|198052-Ondansetron4MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|198051-Omeprazole20MGDelayedReleaseOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|198036-24HRNifedipine90MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|198035-24HRNifedipine60MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|198034-24HRNifedipine30MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|197902-Lorazepam2MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|197900-Lorazepam0.5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|197877-Lidocaine25MG/ML/Prilocaine25MG/MLTopicalCream|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|197739-Glycopyrrolate2MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|197738-Glycopyrrolate1MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|197735-Gentamicin1MG/MLTopicalCream|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|197591-Diazepam5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|197590-Diazepam2MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|197589-Diazepam10MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|197541-Colchicine0.6MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|197529-Clonazepam2MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|197528-Clonazepam1MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|197527-Clonazepam0.5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|197512-Ciprofloxacin750MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|197511-Ciprofloxacin250MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|1926331-0.5UNTDoses3MLInsulinLispro100UNT/MLPenInjector|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|1918209-60ACTUATfluticasonepropionate0.055MG/ACTUAT/salmeterol0.014MG/ACTUATDryPowderInhaler|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|1918203-60ACTUATfluticasonepropionate0.232MG/ACTUAT/salmeterol0.014MG/ACTUATDryPowderInhaler|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|1918194-60ACTUATfluticasonepropionate0.113MG/ACTUAT/salmeterol0.014MG/ACTUATDryPowderInhaler|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|1812015-Osmotic24HRNifedipine90MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|1812013-Osmotic24HRNifedipine60MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|1812011-Osmotic24HRNifedipine30MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|1806197-30/70Release24HRMethylphenidateHydrochloride60MGExtendedReleaseOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|1806193-30/70Release24HRMethylphenidateHydrochloride50MGExtendedReleaseOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|1806191-30/70Release24HRMethylphenidateHydrochloride40MGExtendedReleaseOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|1650142-DoxycyclineMonohydrate100MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|1649990-DoxycyclineMonohydrate100MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|1649401-DoxycyclineMonohydrate50MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|1596780-60ACTUATTestosterone12.5MG/ACTUATTopicalGel|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|1550940-Colchicine0.6MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|1543069-Lidocaine0.05MG/MGTopicalOintment|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|1298091-FlurazepamHydrochloride30MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|1298088-FlurazepamHydrochloride15MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|1244214-Budesonide3MGDelayedReleaseOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|1149632-84HREstradiol0.00313MG/HRTransdermalSystem|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|1115698-Oseltamivir6MG/MLOralSuspension|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|1091497-MethylphenidateHydrochloride5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|1091392-MethylphenidateHydrochloride20MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|1091225-8HRMethylphenidateHydrochloride20MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|1091150-MethylphenidateHydrochloride10MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|1091145-8HRMethylphenidateHydrochloride10MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|106346-Mupirocin0.02MG/MGTopicalOintment|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|1049225-Acetaminophen325MG/OxycodoneHydrochloride7.5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|1049221-Acetaminophen325MG/OxycodoneHydrochloride5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|1049214-Acetaminophen325MG/OxycodoneHydrochloride10MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|104894-Ondansetron4MGDisintegratingOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|1009145-Amphetamineaspartate1.875MG/AmphetamineSulfate1.875MG/Dextroamphetaminesaccharate1.875MG/DextroamphetamineSulfate1.87|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|1000153-1MLmedroxyprogesteroneacetate150MG/MLPrefilledSyringe|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|1000126-1MLmedroxyprogesteroneacetate150MG/MLInjection|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|999965-Glycopyrrolate0.2MG/MLOralSolution[Cuvposa]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|998666-carboxymethylcellulosesodium0.01MG/MGOphthalmicGel[TheraTears]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|901644-0.5MLStreptococcuspneumoniaeserotype1capsularantigendiphtheriaCRM197proteinconjugatevaccine0.0044MG/ML/Streptococcuspn|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|901518-0.5MLNeisseriameningitidisserogroupAoligosaccharidediphtheriaCRM197proteinconjugatevaccine0.02MG/ML/Neisseriameningiti|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|895756-PolyethyleneGlycol4000.004MG/MG/Propyleneglycol0.003MG/MGOphthalmicGel[Systane]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|864650-Ganciclovir0.0015MG/MGOphthalmicGel[Zirgan]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|847213-3MLInsulinLispro50UNT/ML/insulinlisproprotamine,human50UNT/MLPenInjector[HumalogMix]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|847199-3MLinsulinisophane,human100UNT/MLPenInjector[HumulinN]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|847189-3MLinsulinisophane,human70UNT/ML/insulin,regular,human30UNT/MLPenInjector[Humulin]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|836634-1MLhepatitisAvirusstrainCR326Fantigen,inactivated50UNT/MLPrefilledSyringe[Vaqta]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|830263-1MLHepatitisBSurfaceAntigenVaccine0.04MG/MLInjection[Recombivax]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|830253-0.5MLHepatitisBSurfaceAntigenVaccine0.01MG/MLPrefilledSyringe[Recombivax]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|830245-1MLHepatitisBSurfaceAntigenVaccine0.01MG/MLPrefilledSyringe[Recombivax]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|804186-0.5MLMeaslesVirusVaccineLive,Enders'attenuatedEdmonstonstrain2000UNT/ML/MumpsVirusVaccineLive,JerylLynnStrain25000UNT/|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|803371-1MLHepatitisAVaccine(Inactivated)StrainHM175720UNT/ML/HepatitisBSurfaceAntigenVaccine0.02MG/MLPrefilledSyringe[Twinrix|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|798482-0.5MLHepatitisAVaccine(Inactivated)StrainHM1751440UNT/MLPrefilledSyringe[Havrix]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|798479-1MLHepatitisAVaccine(Inactivated)StrainHM1751440UNT/MLPrefilledSyringe[Havrix]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|798428-1MLHepatitisBSurfaceAntigenVaccine0.02MG/MLPrefilledSyringe[Engerix-B]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|797641-0.5MLNeisseriameningitidisserogroupAcapsularpolysaccharidediphtheriatoxoidproteinconjugatevaccine0.104MG/ML/Neisseriam|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|795737-ChantixStartingMonthPAK|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|795735-ChantixContinuingMonthsOfTherapy1MGPack|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|762602-SalmonellatyphiTy21aliveantigen2000000000UNTDelayedReleaseOralCapsule[Vivotif]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|752388-InsulinLispro25UNT/ML/insulinlisproprotamine,human75UNT/MLInjectableSuspension[HumalogMix]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|731281-InsulinLispro50UNT/ML/insulinlisproprotamine,human50UNT/MLInjectableSuspension[HumalogMix]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|707566-PolyethyleneGlycol4004MG/ML/Propyleneglycol3MG/MLOphthalmicSolution[Systane]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|637190-varenicline1MGOralTablet[Chantix]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|637188-varenicline0.5MGOralTablet[Chantix]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|630981-PolyvinylAlcohol27MG/ML/Povidone20MG/MLOphthalmicSolution[Freshkote]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|404448-84HRoxybutynin0.162MG/HRTransdermalSystem[Oxytrol]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|351859-insulin,regular,human500UNT/MLInjectableSolution[HumulinR]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|351433-24HRNicotine0.292MG/HRTransdermalSystem[NicodermC-Q]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|351429-24HRNicotine0.875MG/HRTransdermalSystem[NicodermC-Q]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|351427-24HRNicotine0.583MG/HRTransdermalSystem[NicodermC-Q]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|311036-insulin,regular,human100UNT/MLInjectableSolution[HumulinR]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|311033-insulin,regular,human100UNT/MLInjectableSolution[NovolinR]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|311027-insulinisophane,human100UNT/MLInjectableSuspension[NovolinN]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|311026-insulinisophane,human100UNT/MLInjectableSuspension[HumulinN]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|261315-Oseltamivir75MGOralCapsule[Tamiflu]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|2360588-0.5MLNeisseriameningitidisserogroupAcapsularpolysaccharidetetanustoxoidproteinconjugatevaccine0.02MG/ML/Neisseriameni|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|2166928-10ACTUATolodaterol0.0025MG/ACTUAT/tiotropium0.0025MG/ACTUATInhalationSpray[Stiolto]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|2166204-10ACTUATtiotropium0.0025MG/ACTUATInhalationSpray[Spiriva]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|213442-insulinisophane,human70UNT/ML/insulin,regular,human30UNT/MLInjectableSuspension[Novolin]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|211947-Atovaquone150MG/MLOralSuspension[Mepron]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|211609-hypromellose5MG/MLOphthalmicSolution[IsoptoAlkaline]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|211140-PentosanPolysulfate100MGOralCapsule[Elmiron]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|2106334-0.5MLdiphtheriatoxoidvaccine,inactivated4UNT/ML/tetanustoxoidvaccine,inactivated4UNT/MLInjection[Tdvax]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|208821-Dexamethasone0.001MG/MG/Tobramycin0.003MG/MGOphthalmicOintment[Tobradex]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|2059017-rivaroxaban2.5MGOralTablet[Xarelto]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|2053927-sodiumzirconiumcyclosilicate10000MGPowderforOralSuspension[Lokelma]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|2050059-0.5MLHepatitisBSurfaceAntigenVaccine0.04MG/MLPrefilledSyringe[Heplisav-B]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|2047639-sodiumzirconiumcyclosilicate5000MGPowderforOralSuspension[Lokelma]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|2045382-30ACTUATfluticasonefuroate0.05MG/ACTUATDryPowderInhaler[Arnuity]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|2000136-Vancomycin50MG/MLOralSolution[Firvanq]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|2000133-Vancomycin25MG/MLOralSolution[Firvanq]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1994352-0.5MLHepatitisBSurfaceAntigenVaccine0.04MG/MLInjection[Heplisav-B]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1992428-Eliquis30-DayStarterPack|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1992171-3MLInsulinLispro100UNT/MLPenInjector[Admelog]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1992169-InsulinLispro100UNT/MLInjectableSolution[Admelog]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1986830-0.5MLVaricellazostervirusglycoproteinE,recombinant0.1MG/MLInjection[Shingrix]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1797888-Nicotine0.5MG/ACTUATMeteredDoseNasalSpray[Nicotrol]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1736863-3MLInsulinGlargine100UNT/MLPenInjector[Basaglar]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1731317-3MLinsulin,regular,human500UNT/MLPenInjector[HumulinR]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1723478-dabigatranetexilate110MGOralCapsule[Pradaxa]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1667882-60ACTUATtiotropium0.00125MG/ACTUATInhalationSpray[Spiriva]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1658472-0.5MLStreptococcuspneumoniaetype1capsularpolysaccharideantigen0.05MG/ML/Streptococcuspneumoniaetype10Acapsularpolysac|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1658157-1MLHepatitisBSurfaceAntigenVaccine0.02MG/MLInjection[Engerix-B]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1658155-0.5MLHepatitisBSurfaceAntigenVaccine0.01MG/MLInjection[Recombivax]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1658150-1MLHepatitisBSurfaceAntigenVaccine0.01MG/MLInjection[Recombivax]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1658106-0.5MLhepatitisAvirusstrainCR326Fantigen,inactivated50UNT/MLInjection[Vaqta]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1658102-1MLhepatitisAvirusstrainCR326Fantigen,inactivated50UNT/MLInjection[Vaqta]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1658060-1MLHepatitisAVaccine(Inactivated)StrainHM1751440UNT/MLInjection[Havrix]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1656356-sacubitril97MG/valsartan103MGOralTablet[Entresto]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1656351-sacubitril49MG/valsartan51MGOralTablet[Entresto]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1656346-sacubitril24MG/valsartan26MGOralTablet[Entresto]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1601407-0.5MLmeningococcalgroupBvaccine0.1MG/ML/NeisseriameningitidisserogroupBrecombinantFHBPfusionproteinantigen0.1MG/ML/Ne|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1597103-0.5MLL1protein,Humanpapillomavirustype11Vaccine0.08MG/ML/L1protein,Humanpapillomavirustype16Vaccine0.12MG/ML/L1protei|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1597099-0.5MLL1protein,Humanpapillomavirustype11Vaccine0.08MG/ML/L1protein,Humanpapillomavirustype16Vaccine0.12MG/ML/L1protei|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1596445-7ACTUATumeclidinium0.0625MG/ACTUATDryPowderInhaler[Incruse]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1593140-0.5MLNeisseriameningitidisserogroupBrecombinantLP2086A05proteinvariantantigen0.12MG/ML/Neisseriameningitidisserogroup|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1549683-Xarelto30-DayStarterPackKit|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1547950-CarboxymethylcelluloseSodium2.5MG/MLOphthalmicSolution[TheraTears]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1547672-30ACTUATfluticasonefuroate0.2MG/ACTUATDryPowderInhaler[Arnuity]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1547664-14ACTUATfluticasonefuroate0.1MG/ACTUATDryPowderInhaler[Arnuity]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1547582-0.5MLStreptococcuspneumoniaetype1capsularpolysaccharideantigen0.05MG/ML/Streptococcuspneumoniaetype10Acapsularpolysac|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1364447-apixaban5MGOralTablet[Eliquis]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1364441-apixaban2.5MGOralTablet[Eliquis]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1363484-hypromellose0.003MG/MGOphthalmicGel[SystaneOvernightTherapy]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1300468-0.5MLHaemophilusinfluenzaetypebstrain1482,capsularpolysaccharideinactivatedtetanustoxoidconjugatevaccine0.068MG/MLInj|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1300378-0.5MLBordetellapertussisfilamentoushemagglutininvaccine,inactivated0.016MG/ML/Bordetellapertussispertactinvaccine,ina|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1300370-0.5MLBordetellapertussisfilamentoushemagglutininvaccine,inactivated0.016MG/ML/Bordetellapertussispertactinvaccine,ina|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1300206-0.5MLBordetellapertussisfilamentoushemagglutininvaccine,inactivated0.01MG/ML/Bordetellapertussisfimbriae2/3vaccine,in|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1292459-0.5MLVaricella-ZosterVirusVaccineLive(Oka-Merck)strain2700UNT/MLInjection[Varivax]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1190919-0.5MLdiphtheriatoxoidvaccine,inactivated4UNT/ML/tetanustoxoidvaccine,inactivated10UNT/MLPrefilledSyringe[Tenivac]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1190916-0.5MLdiphtheriatoxoidvaccine,inactivated4UNT/ML/tetanustoxoidvaccine,inactivated10UNT/MLInjection[Tenivac]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1115892-MineralOil0.15MG/MG/Petrolatum0.85MG/MGOphthalmicOintment[Puralube]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|106892-insulinisophane,human70UNT/ML/insulin,regular,human30UNT/MLInjectableSuspension[Humulin]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1049216-Acetaminophen325MG/OxycodoneHydrochloride10MGOralTablet[Endocet]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1046920-Nicotine4MGInhalationSolution[Nicotrol]|EXPANSION PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1037181-dabigatranetexilate75MGOralCapsule[Pradaxa]|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|999613-SulfacetamideSodium100MG/ML/Sulfur50MG/MLMedicatedLiquidSoap|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|997501-Fexofenadinehydrochloride60MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|997491-Fexofenadinehydrochloride6MG/MLOralSuspension|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|997420-Fexofenadinehydrochloride180MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|997229-Donepezilhydrochloride5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|997226-Donepezilhydrochloride5MGDisintegratingOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|997223-Donepezilhydrochloride10MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|997220-Donepezilhydrochloride10MGDisintegratingOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|996824-MethylergonovineMaleate0.2MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|996572-{21(Memantinehydrochloride10MGOralTablet)/28(Memantinehydrochloride5MGOralTablet)}Pack|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|996571-Memantinehydrochloride5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|996561-Memantinehydrochloride10MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|996520-DextromethorphanHydrobromide2MG/ML/Guaifenesin20MG/MLOralSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|995666-MeclizineHydrochloride25MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|995632-MeclizineHydrochloride25MGChewableTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|995624-MeclizineHydrochloride12.5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|995607-EthambutolHydrochloride400MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|995599-EthambutolHydrochloride100MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|995281-HydroxyzineHydrochloride50MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|995278-HydroxyzinePamoate50MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|995258-HydroxyzineHydrochloride25MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|995253-HydroxyzinePamoate25MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|995241-HydroxyzineHydrochloride2MG/MLOralSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|995232-HydroxyzinePamoate100MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|995218-HydroxyzineHydrochloride10MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|993943-Acetaminophen325MG/butalbital50MG/Caffeine40MG/CodeinePhosphate30MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|993691-BupropionHydrochloride75MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|993687-BupropionHydrochloride100MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|993557-24HRBupropionHydrochloride300MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|993541-24HRBupropionHydrochloride150MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|993536-12HRBupropionHydrochloride200MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|993518-12HRBupropionHydrochloride150MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|993503-12HRBupropionHydrochloride100MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|992780-MiconazoleNitrate100MGVaginalInsert|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|992775-{1(MiconazoleNitrate1200MGVaginalInsert)/1(9000MG)(MiconazoleNitrate20MG/MLVaginalCream)}Pack|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|992528-Terbinafinehydrochloride10MG/MLTopicalCream|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|992475-PromethazineHydrochloride50MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|992454-PromethazineHydrochloride25MGRectalSuppository|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|992447-PromethazineHydrochloride25MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|992441-PromethazineHydrochloride12.5MGRectalSuppository|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|992438-PromethazineHydrochloride12.5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|992432-PromethazineHydrochloride1.25MG/MLOralSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|992184-methenaminemandelate500MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|992153-methenaminemandelate1000MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|991086-DicyclomineHydrochloride20MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|991061-DicyclomineHydrochloride10MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|979492-LosartanPotassium50MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|979485-LosartanPotassium25MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|979480-LosartanPotassium100MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|979475-MetaproterenolSulfate20MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|979471-Hydrochlorothiazide25MG/LosartanPotassium100MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|979468-Hydrochlorothiazide12.5MG/LosartanPotassium50MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|979464-Hydrochlorothiazide12.5MG/LosartanPotassium100MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|979444-MetaproterenolSulfate2MG/MLOralSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|979409-MetaproterenolSulfate10MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|979092-HydroxychloroquineSulfate200MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|978006-LoperamideHydrochloride2MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|966920-POLYETHYLENEGLYCOL3350236000MG/PotassiumChloride2970MG/SodiumBicarbonate6740MG/SodiumChloride5860MG/sodiumsulfate22740|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|966914-POLYETHYLENEGLYCOL3350240000MG/PotassiumChloride2980MG/SodiumBicarbonate6720MG/SodiumChloride5840MG/sodiumsulfate22720|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|966270-LevothyroxineSodium0.137MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|966253-LevothyroxineSodium0.088MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|966249-LevothyroxineSodium0.175MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|966248-LevothyroxineSodium0.112MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|966225-LevothyroxineSodium0.15MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|966224-LevothyroxineSodium0.125MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|966222-LevothyroxineSodium0.075MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|966221-LevothyroxineSodium0.05MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|966220-LevothyroxineSodium0.025MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|905395-HydralazineHydrochloride50MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|905225-HydralazineHydrochloride25MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|905222-HydralazineHydrochloride100MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|905199-HydralazineHydrochloride10MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|905158-Sirolimus0.5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|904932-ibandronicacid150MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|904481-PravastatinSodium80MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|904475-PravastatinSodium40MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|904467-PravastatinSodium20MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|904458-PravastatinSodium10MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|904431-Alendronicacid70MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|904396-Alendronicacid35MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|904170-PrimaquinePhosphate26.3MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|903891-FluvoxamineMaleate50MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|903887-FluvoxamineMaleate25MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|903884-FluvoxamineMaleate100MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|903703-liothyroninesodium0.05MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|903697-liothyroninesodium0.025MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|903456-liothyroninesodium0.005MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|898723-Benazeprilhydrochloride5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|898690-Benazeprilhydrochloride20MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|898687-Benazeprilhydrochloride10MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|898378-Benazeprilhydrochloride5MG/Hydrochlorothiazide6.25MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|898372-Benazeprilhydrochloride20MG/Hydrochlorothiazide25MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|898367-Benazeprilhydrochloride20MG/Hydrochlorothiazide12.5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|898359-Amlodipine5MG/Benazeprilhydrochloride40MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|898356-Amlodipine5MG/Benazeprilhydrochloride20MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|898353-Amlodipine5MG/Benazeprilhydrochloride10MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|898350-Amlodipine2.5MG/Benazeprilhydrochloride10MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|898346-Amlodipine10MG/Benazeprilhydrochloride40MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|898342-Amlodipine10MG/Benazeprilhydrochloride20MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|897722-Verapamilhydrochloride40MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|897683-Verapamilhydrochloride80MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|897666-Verapamilhydrochloride120MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|897649-Verapamilhydrochloride240MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|897624-24HRVerapamilhydrochloride240MGExtendedReleaseOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|897596-24HRVerapamilhydrochloride300MGExtendedReleaseOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|897590-24HRVerapamilhydrochloride200MGExtendedReleaseOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|897584-24HRVerapamilhydrochloride100MGExtendedReleaseOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|896766-Labetalolhydrochloride300MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|896762-Labetalolhydrochloride200MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|896758-Labetalolhydrochloride100MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|896209-60ACTUATFluticasonepropionate0.25MG/ACTUAT/salmeterol0.05MG/ACTUATDryPowderInhaler|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|895987-Fluticasonepropionate0.5MG/MLTopicalCream|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|895487-Fluticasonepropionate0.00005MG/MGTopicalOintment|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|892255-LevothyroxineSodium0.3MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|892251-LevothyroxineSodium0.2MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|892246-LevothyroxineSodium0.1MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|886671-FlecainideAcetate150MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|886666-FlecainideAcetate100MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|886662-FlecainideAcetate50MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|885857-Balsalazidedisodium750MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|884707-Estradiol0.01MGVaginalInsert|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|884308-Nystatin100UNT/MGTopicalOintment|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|884189-ClonidineHydrochloride0.3MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|884185-ClonidineHydrochloride0.2MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|884173-ClonidineHydrochloride0.1MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|876193-POLYETHYLENEGLYCOL335017000MGPowderforOralSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|866924-MetoprololTartrate25MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|866514-MetoprololTartrate50MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|866511-MetoprololTartrate100MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|866436-24HRmetoprololsuccinate50MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|866427-24HRmetoprololsuccinate25MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|866419-24HRmetoprololsuccinate200MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|866412-24HRmetoprololsuccinate100MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|866144-Cyproheptadinehydrochloride4MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|866111-buspironehydrochloride7.5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|866094-buspironehydrochloride5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|866090-buspironehydrochloride30MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|866083-buspironehydrochloride10MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|866018-buspironehydrochloride15MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|863669-Tamsulosinhydrochloride0.4MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|863664-Oxybutyninchloride5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|863636-24HROxybutyninchloride5MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|863628-24HROxybutyninchloride15MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|863619-24HROxybutyninchloride10MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|861753-Glyburide5MG/Metforminhydrochloride500MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|861748-Glyburide2.5MG/Metforminhydrochloride500MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|861743-Glyburide1.25MG/Metforminhydrochloride250MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|861657-24HRNitroglycerin0.1MG/HRTransdermalSystem|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|861495-ClobetasolPropionate0.5MG/MLTopicalCream|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|861487-ClobetasolPropionate0.5MG/MLTopicalSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|861448-ClobetasolPropionate0.0005MG/MGTopicalOintment|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|861430-PropafenoneHydrochloride300MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|861427-PropafenoneHydrochloride225MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|861424-PropafenoneHydrochloride150MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|861416-Azithromycin1000MGPowderforOralSuspension|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|861200-Brimonidinetartrate2MG/MLOphthalmicSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|861171-12HRPropafenoneHydrochloride425MGExtendedReleaseOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|861164-12HRPropafenoneHydrochloride325MGExtendedReleaseOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|861156-12HRPropafenoneHydrochloride225MGExtendedReleaseOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|861132-24HRAlfuzosinhydrochloride10MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|861064-Sertraline20MG/MLOralSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|861010-Metforminhydrochloride850MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|861007-Metforminhydrochloride500MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|861004-Metforminhydrochloride1000MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|860981-24HRMetforminhydrochloride750MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|860975-24HRMetforminhydrochloride500MGExtendedReleaseOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|860805-Azelastinehydrochloride0.5MG/MLOphthalmicSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|860225-MegestrolAcetate40MG/MLOralSuspension|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|860221-MegestrolAcetate40MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|860215-MegestrolAcetate20MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|860107-KetorolacTromethamine5MG/MLOphthalmicSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|859751-Rosuvastatincalcium20MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|859747-Rosuvastatincalcium10MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|859424-Rosuvastatincalcium5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|859419-Rosuvastatincalcium40MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|859193-selegilinehydrochloride5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|859186-selegilinehydrochloride5MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|859052-Pramipexoledihydrochloride1MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|859048-Pramipexoledihydrochloride1.5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|859044-Pramipexoledihydrochloride0.5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|859040-Pramipexoledihydrochloride0.25MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|859033-Pramipexoledihydrochloride0.125MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|858828-EnalaprilMaleate10MG/Hydrochlorothiazide25MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|858824-EnalaprilMaleate5MG/Hydrochlorothiazide12.5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|858817-EnalaprilMaleate10MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|858813-EnalaprilMaleate5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|858810-EnalaprilMaleate20MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|858804-EnalaprilMaleate2.5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|858747-Ursodiol300MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|858625-Pramipexoledihydrochloride0.75MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|858616-Nicardipinehydrochloride30MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|858613-Nicardipinehydrochloride20MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|857683-TerbutalineSulfate5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|857677-TerbutalineSulfate2.5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|857461-ClemastineFumarate2.68MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|857340-BethanecholChloride50MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|857336-BethanecholChloride5MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|857328-BethanecholChloride25MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|857321-BethanecholChloride10MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|857305-ClomipramineHydrochloride75MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|857301-ClomipramineHydrochloride50MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|857297-ClomipramineHydrochloride25MGOralCapsule|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|857187-FosinoprilSodium40MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|857183-FosinoprilSodium20MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|857169-FosinoprilSodium10MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|856853-AmitriptylineHydrochloride75MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|856845-AmitriptylineHydrochloride50MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|856840-AmitriptylineHydrochloride50MG/Perphenazine4MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|856834-AmitriptylineHydrochloride25MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|856825-AmitriptylineHydrochloride25MG/Perphenazine4MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|856797-AmitriptylineHydrochloride25MG/Perphenazine2MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|856783-AmitriptylineHydrochloride10MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|856773-AmitriptylineHydrochloride150MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|856762-AmitriptylineHydrochloride100MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|856733-PropranololHydrochloride8MG/MLOralSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|856724-PropranololHydrochloride4MG/MLOralSolution|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|856720-AmitriptylineHydrochloride10MG/Perphenazine4MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|856706-AmitriptylineHydrochloride10MG/Perphenazine2MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|856578-PropranololHydrochloride80MGOralTablet|EXPANSION PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|856519-PropranololHydrochloride40MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|856457-PropranololHydrochloride20MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|856448-PropranololHydrochloride10MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|856429-Hydrochlorothiazide25MG/PropranololHydrochloride80MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|856422-Hydrochlorothiazide25MG/PropranololHydrochloride40MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|856377-TrazodoneHydrochloride50MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|856373-TrazodoneHydrochloride100MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|856364-TrazodoneHydrochloride150MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|855926-DiclofenacSodium75MGDelayedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|855911-2MLPhenytoinsodium50MG/MLCartridge|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|855906-DiclofenacSodium50MGDelayedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|855873-Phenytoinsodium300MGExtendedReleaseOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|855861-Phenytoinsodium200MGExtendedReleaseOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|855818-prasugrel5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|855812-prasugrel10MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|855671-Phenytoinsodium100MGExtendedReleaseOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|855664-DiclofenacSodium25MGDelayedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|855480-alclometasonedipropionate0.0005MG/MGTopicalOintment|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|855474-alclometasonedipropionate0.5MG/MLTopicalCream|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|855344-WarfarinSodium7.5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|855338-WarfarinSodium6MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|855332-WarfarinSodium5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|855324-WarfarinSodium4MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|855318-WarfarinSodium3MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|855312-WarfarinSodium2.5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|855302-WarfarinSodium2MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|855296-WarfarinSodium10MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|855288-WarfarinSodium1MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|855172-levocetirizinedihydrochloride5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|855168-levocetirizinedihydrochloride0.5MG/MLOralSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|854905-BisoprololFumarate5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|854901-BisoprololFumarate10MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|854801-DiclofenacSodium1MG/MLOphthalmicSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|852913-QuinidineSulfate300MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|852877-QuinidineSulfate200MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|849515-DesmopressinAcetate0.1MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|849506-DesmopressinAcetate0.01MG/ACTUATNasalSpray|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|848943-CholestyramineResin4000MGPowderforOralSuspension|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|848176-AugmentedBetamethasone0.5MG/MLTopicalCream|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|847121-CalciumCitrate1500MG/Cholecalciferol250UNTOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|836358-IpratropiumBromide0.2MG/MLInhalationSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|835925-cyclosporine,modified50MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|835913-MefloquineHydrochloride250MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|835894-cyclosporine,modified25MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|835886-cyclosporine,modified100MG/MLOralSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|835593-ImipramineHydrochloride10MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|835568-ImipramineHydrochloride50MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|835564-ImipramineHydrochloride25MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|834127-chlorhexidinegluconate1.2MG/MLMouthwash|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|834102-PenicillinVPotassium500MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|834061-PenicillinVPotassium250MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|834046-PenicillinVPotassium25MG/MLOralSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|834040-PenicillinVPotassium50MG/MLOralSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|833528-Amiodaronehydrochloride200MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|833217-DiltiazemHydrochloride30MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|833008-DesmopressinAcetate0.2MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|832909-CalciumCarbonate1250MG/Cholecalciferol100UNTChewableTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|831261-CromolynSodium20MG/MLOralSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|831109-CromolynSodium40MG/MLOphthalmicSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|831103-DiltiazemHydrochloride60MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|831102-DiltiazemHydrochloride90MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|831054-DiltiazemHydrochloride120MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|830882-24HRDiltiazemHydrochloride300MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|828348-Cyclobenzaprinehydrochloride10MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|828320-Cyclobenzaprinehydrochloride5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|801054-POLYETHYLENEGLYCOL3350420000MG/PotassiumChloride1480MG/SodiumBicarbonate5720MG/SodiumChloride11200MGPowderforOralSolut|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|763185-{21(Prednisone10MGOralTablet)}Pack|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|763181-{21(Prednisone5MGOralTablet)}Pack|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|762675-{21(Methylprednisolone4MGOralTablet)}Pack|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|756209-Zidovudine10MG/MLOralSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|755497-Albuterol0.4MG/MLOralSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|751901-{84(EthinylEstradiol0.03MG/Levonorgestrel0.15MGOralTablet)/7(InertIngredients1MGOralTablet)}Pack|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|749860-{21(EthinylEstradiol0.035MG/norgestimate0.25MGOralTablet)/7(InertIngredients1MGOralTablet)}Pack|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|749784-{7(EthinylEstradiol0.035MG/norgestimate0.18MGOralTablet)/7(EthinylEstradiol0.035MG/norgestimate0.215MGOralTablet)/7(Et|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|749783-{6(Azithromycin250MGOralTablet)}Pack|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|749780-{3(Azithromycin500MGOralTablet)}Pack|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|749157-{7(EthinylEstradiol0.025MG/norgestimate0.18MGOralTablet)/7(EthinylEstradiol0.025MG/norgestimate0.215MGOralTablet)/7(Et|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|748961-{28(Norethindrone0.35MGOralTablet)}Pack|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|748868-{21(EthinylEstradiol0.02MG/Levonorgestrel0.1MGOralTablet)/7(InertIngredients1MGOralTablet)}Pack|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|748800-{21(drospirenone3MG/EthinylEstradiol0.03MGOralTablet)/7(InertIngredients1MGOralTablet)}Pack|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|727316-NDA0194300.3MLEpinephrine0.5MG/MLAuto-Injector|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|722137-Amlodipine5MG/valsartan320MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|722134-Amlodipine5MG/valsartan160MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|722131-Amlodipine10MG/valsartan320MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|722126-Amlodipine10MG/valsartan160MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|702519-Phenobarbital4MG/MLOralSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|702249-ferroussulfate44MG/MLOralSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|692783-Loratadine1MG/MLOralSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|686924-carvedilol3.125MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|686418-ErythromycinEthylsuccinate80MG/MLOralSuspension|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|686405-ErythromycinEthylsuccinate400MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|686400-ErythromycinEthylsuccinate40MG/MLOralSuspension|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|647121-5MLLevetiracetam100MG/MLInjection|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|646456-Nystatin100UNT/MGTopicalPowder|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|646333-Capsaicin1MG/MLTopicalCream|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|643102-Ibuprofen200MGOralTablet[Wal-Profen]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|639566-VitaminB650MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|628953-PotassiumChloride10MEQExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|617993-Amoxicillin120MG/ML/Clavulanate8.58MG/MLOralSuspension|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|617430-Amoxicillin80MG/ML/Clavulanate11.4MG/MLOralSuspension|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|617423-Amoxicillin40MG/ML/Clavulanate5.7MG/MLOralSuspension|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|617322-Amoxicillin50MG/ML/Clavulanate12.5MG/MLOralSuspension|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|617316-Amoxicillin400MG/Clavulanate57MGChewableTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|617312-atorvastatin10MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|617311-atorvastatin40MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|617310-atorvastatin20MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|617309-Amoxicillin200MG/Clavulanate28.5MGChewableTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|617296-Amoxicillin500MG/Clavulanate125MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|598025-Amoxicillin250MGChewableTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|598006-Erythromycin250MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|597852-anagrelide1MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|596843-lansoprazole15MGDelayedReleaseOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|583170-Salsalate750MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|582926-podofilox5MG/MLTopicalSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|577040-CalciumCarbonate648MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|562704-ropinirole4MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|562524-12HRAcetazolamide500MGExtendedReleaseOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|562510-SodiumFluoride2MG/MLMouthwash|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|562508-Amoxicillin875MG/Clavulanate125MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|562251-Amoxicillin250MG/Clavulanate125MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|544455-Lactulose667MG/MLOralSolution[Generlac]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|543546-Nystatin100000UNT/MLTopicalCream|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|486152-24HRNitroglycerin0.4MG/HRTransdermalSystem|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|486148-24HRNitroglycerin0.2MG/HRTransdermalSystem|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|486146-24HRNitroglycerin0.6MG/HRTransdermalSystem|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|486131-BenzoylPeroxide0.1MG/MGTopicalGel|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|476809-Mirtazapine7.5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|476576-cefdinir50MG/MLOralSuspension|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|432402-cinacalcet30MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|432401-cinacalcet60MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|432400-cinacalcet90MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|429503-Hydrochlorothiazide12.5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|403967-zonisamide50MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|403966-zonisamide25MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|403855-Hydrochlorothiazide25MG/Olmesartanmedoxomil40MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|403854-Hydrochlorothiazide12.5MG/Olmesartanmedoxomil40MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|403853-Hydrochlorothiazide12.5MG/Olmesartanmedoxomil20MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|402698-24HRFelodipine2.5MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|402696-24HRFelodipine5MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|402695-24HRFelodipine10MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|393245-Digoxin0.05MG/MLOralSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|391937-Lactulose667MG/MLOralSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|387003-Levetiracetam1000MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|381056-IsosorbideDinitrate10MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|360110-Sirolimus2MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|359601-Guaifenesin400MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|359296-calciumacetate667MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|353538-24HRIsosorbideMononitrate60MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|351250-Escitalopram20MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|351249-Escitalopram5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|351172-Dutasteride0.5MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|351137-Albuterol0.21MG/MLInhalationSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|351136-Albuterol0.417MG/MLInhalationSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|349420-desloratadine5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|349405-Olmesartanmedoxomil40MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|349401-Olmesartanmedoxomil20MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|349373-Olmesartanmedoxomil5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|349332-Escitalopram10MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|349208-Sirolimus1MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|348472-Theophylline600MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|343033-Dexamethasone0.75MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|328161-Methylprednisolone16MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|328160-Cyclosporine100MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|318272-Aspirin81MGChewableTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|317769-Theophylline300MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|317573-pioglitazone15MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|317173-Captopril25MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|317136-Nortriptyline25MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|317128-Misoprostol0.2MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|317110-24HRIsosorbideMononitrate30MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|315187-Prednisone1MG/MLOralSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|315183-PotassiumChloride8MEQExtendedReleaseOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|315134-Levocarnitine100MG/MLOralSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|315107-24HRGlipizide10MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|315102-SodiumFluoride1.1MG/MLOralSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|315090-Erythromycin333MGDelayedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|314277-venlafaxine50MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|314241-Theophylline450MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|314238-Tropicamide10MG/MLOphthalmicSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|314234-Sucralfate1000MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|314231-Simvastatin10MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|314208-ropinirole1MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|314203-quinapril40MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|314182-PotassiumChloride2.67MEQ/MLOralSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|314165-prednisolone10MG/MLOphthalmicSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|314131-Niacin250MGExtendedReleaseOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|314111-Mirtazapine30MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|314106-Metronidazole250MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|314077-Lisinopril20MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|314076-Lisinopril10MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|314072-latanoprost0.05MG/MLOphthalmicSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|314055-IsosorbideDinitrate5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|314006-24HRGlipizide5MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|314000-Glyburide1.5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|313989-Fluoxetine40MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|313988-Furosemide40MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|313979-fludrocortisoneacetate0.1MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|313919-salmoncalcitonin200UNT/ACTUATNasalSpray|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|313888-Cefaclor50MG/MLOralSuspension|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|313850-Amoxicillin40MG/MLOralSuspension|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|313797-Amoxicillin25MG/MLOralSuspension|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|313786-AceticAcid20MG/ML/Hydrocortisone10MG/MLOticSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|313586-venlafaxine75MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|313585-24HRvenlafaxine75MGExtendedReleaseOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|313584-venlafaxine37.5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|313583-24HRvenlafaxine37.5MGExtendedReleaseOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|313582-venlafaxine25MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|313581-24HRvenlafaxine150MGExtendedReleaseOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|313580-venlafaxine100MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|313565-valacyclovir500MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|313564-valacyclovir1000MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|313521-Tropicamide5MG/MLOphthalmicSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|313477-Trifluridine10MG/MLOphthalmicSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|313428-Toremifene60MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|313423-Tolnaftate10MG/MLTopicalSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|313306-Theophylline5.33MG/MLOralSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|313291-Theophylline400MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|313227-terconazole8MG/MLVaginalCream|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|313226-terconazole4MG/MLVaginalCream|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|313219-Terazosin5MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|313217-Terazosin2MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|313215-Terazosin1MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|313195-Tamoxifen20MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|313190-Tacrolimus0.5MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|313142-Sulfasalazine500MGDelayedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|313134-Sulfamethoxazole40MG/ML/Trimethoprim8MG/MLOralSuspension|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|313123-Sucralfate100MG/MLOralSuspension|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|313096-Spironolactone25MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|313092-Sorbitol700MG/MLOralSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|312997-SodiumChloride9MG/MLInhalationSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|312962-Simvastatin5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|312961-Simvastatin20MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|312941-Sertraline50MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|312940-Sertraline25MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|312938-Sertraline100MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|312899-Salsalate500MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|312849-ropinirole5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|312847-ropinirole2MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|312846-ropinirole0.5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|312845-ropinirole0.25MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|312750-quinapril5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|312749-quinapril20MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|312748-quinapril10MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|312641-Progesterone200MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|312635-Prochlorperazine5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|312617-Prednisone5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|312615-Prednisone20MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|312594-Prazosin2MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|312593-Prazosin1MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|312529-PotassiumChloride8MEQExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|312515-PotassiumChloride1.33MEQ/MLOralSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|312504-PotassiumChloride10MEQExtendedReleaseOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|312441-pioglitazone45MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|312440-pioglitazone30MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|312362-Phenobarbital30MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|312357-Phenobarbital15MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|312301-Pentoxifylline400MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|312289-Naloxone0.5MG/Pentazocine50MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|312138-oxcarbazepine600MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|312137-oxcarbazepine300MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|312136-oxcarbazepine150MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|312059-Nystatin500000UNTOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|312055-Nystatin100000UNT/MLOralSuspension|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|312036-Nortriptyline2MG/MLOralSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|312013-Nitroglycerin2.5MGExtendedReleaseOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|311995-NITROFURANTOIN,MACROCRYSTALS50MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|311994-NITROFURANTOIN,MACROCRYSTALS25MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|311989-Nitrofurantoin5MG/MLOralSuspension|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|311963-Niacin750MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|311960-Niacin500MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|311955-Niacin250MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|311893-nabumetone750MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|311892-nabumetone500MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|311727-Misoprostol0.1MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|311726-Mirtazapine45MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|311725-Mirtazapine15MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|311681-Metronidazole500MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|311679-Metronidazole0.0075MG/MGTopicalGel|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|311678-Metronidazole7.5MG/MLTopicalCream|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|311668-Metoclopramide5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|311666-Metoclopramide10MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|311665-Metipranolol3MG/MLOphthalmicSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|311486-meloxicam7.5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|311376-Lorazepam2MG/MLOralSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|311372-Loratadine10MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|311354-Lisinopril5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|311353-Lisinopril2.5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|311296-Levofloxacin750MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|311290-Levetiracetam750MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|311289-Levetiracetam500MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|311288-Levetiracetam250MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|311277-lansoprazole30MGDelayedReleaseOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|311264-lamotrigine25MGChewableTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|311197-IsosorbideMononitrate20MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|311196-24HRIsosorbideMononitrate120MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|311194-IsosorbideDinitrate40MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|311192-IsosorbideMononitrate10MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|311166-isoniazid100MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310982-imiquimod50MG/MLTopicalCream|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310965-Ibuprofen200MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310964-Ibuprofen200MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310891-Hydrocortisone25MG/MLTopicalCream|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310818-Hydrochlorothiazide50MG/Triamterene75MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310812-Hydrochlorothiazide25MG/Triamterene37.5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310809-Hydrochlorothiazide25MG/quinapril20MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310798-Hydrochlorothiazide25MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310797-Hydrochlorothiazide12.5MG/quinapril20MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310796-Hydrochlorothiazide12.5MG/quinapril10MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310687-Hydrocortisone10MG/ML/Neomycin3.5MG/ML/PolymyxinB10000UNT/MLOticSuspension|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310594-Gramicidin0.025MG/ML/Neomycin1.75MG/ML/PolymyxinB10000UNT/MLOphthalmicSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310539-Glyburide6MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310537-Glyburide5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310536-Glyburide3MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310534-Glyburide2.5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310490-Glipizide5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310489-24HRGlipizide2.5MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310488-Glipizide10MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310459-Gemfibrozil600MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310442-Ganciclovir500MGInjection|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310434-gabapentin800MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310433-gabapentin600MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310432-gabapentin400MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310431-gabapentin300MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310430-gabapentin100MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310429-Furosemide20MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310410-FolicAcid1MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310386-Fluoxetine4MG/MLOralSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310385-Fluoxetine20MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310384-Fluoxetine10MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310380-Fluorouracil50MG/MLTopicalSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310379-Fluorouracil20MG/MLTopicalSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310377-Fluorometholone1MG/MLOphthalmicSuspension|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310364-Fluocinonide0.5MG/MLTopicalSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310362-Fluocinonide0.0005MG/MGTopicalGel|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310353-Fluconazole40MG/MLOralSuspension|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310352-Fluconazole10MG/MLOralSuspension|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310346-Finasteride5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310325-ferroussulfate325MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310324-ferroussulfate325MGDelayedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310273-Famotidine20MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310261-exemestane25MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310169-Estradiol0.1MG/MLVaginalCream|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310157-Erythromycin500MGDelayedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310155-Erythromycin250MGDelayedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310154-Erythromycin250MGDelayedReleaseOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|310015-dorzolamide20MG/MLOphthalmicSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|309955-Dipyridamole75MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|309952-Dipyridamole25MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|309686-Dexamethasone0.1MG/MLOralSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|309680-Dexamethasone1MG/ML/Neomycin3.5MG/ML/PolymyxinB10000UNT/MLOphthalmicSuspension|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|309679-Dexamethasone0.001MG/MG/Neomycin0.0035MG/MG/PolymyxinB10UNT/MGOphthalmicOintment|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|309594-vitaminB121MG/MLInjectableSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|309371-Clotrimazole10MGOralLozenge|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|309370-Clotrimazole10MG/MLTopicalSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|309367-Clotrimazole10MG/MLTopicalCream|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|309362-clopidogrel75MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|309337-Clindamycin20MG/MLVaginalCream|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|309313-Citalopram2MG/MLOralSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|309291-ciclopirox80MG/MLTopicalSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|309290-ciclopirox7.7MG/MLTopicalLotion|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|309273-cholinesalicylate58.6MG/ML/MagnesiumSalicylate72.4MG/MLOralSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|309115-Cephalexin250MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|309114-Cephalexin500MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|309113-Cephalexin50MG/MLOralSuspension|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|309112-Cephalexin250MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|309110-Cephalexin25MG/MLOralSuspension|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|309098-Cefuroxime500MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|309054-cefdinir25MG/MLOralSuspension|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|309045-Cefaclor250MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|309044-Cefaclor25MG/MLOralSuspension|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|308989-Carbidopa50MG/Levodopa200MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|308988-Carbidopa25MG/Levodopa100MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|308979-Carbamazepine200MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|308976-Carbamazepine20MG/MLOralSuspension|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|308973-Carbamazepine100MGChewableTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|308964-Captopril50MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|308963-Captopril12.5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|308962-Captopril100MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|308891-CalciumCarbonate250MG/MLOralSuspension|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|308868-Calcitriol0.0005MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|308867-Calcitriol0.00025MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|308725-bexarotene75MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|308714-Betamethasone0.5MG/ML/Clotrimazole10MG/MLTopicalCream|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|308696-BenzoylPeroxide50MG/MLMedicatedLiquidSoap|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|308694-BenzoylPeroxide0.05MG/MGTopicalGel|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|308689-BenzoylPeroxide0.025MG/MGTopicalGel|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|308512-Bacitracin0.5UNT/MG/PolymyxinB10UNT/MGTopicalOintment|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|308508-Bacitracin0.5UNT/MGOphthalmicOintment|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|308493-Bacitracin0.4UNT/MG/Neomycin0.0035MG/MG/PolymyxinB10UNT/MGOphthalmicOintment|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|308459-Azithromycin20MG/MLOralSuspension|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|308416-Aspirin81MGDelayedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|308345-apraclonidine5MG/MLOphthalmicSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|308212-Ampicillin500MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|308194-Amoxicillin875MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|308191-Amoxicillin500MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|308189-Amoxicillin80MG/MLOralSuspension|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|308182-Amoxicillin250MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|308177-Amoxicillin125MGChewableTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|308136-Amlodipine2.5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|308135-Amlodipine10MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|308078-AluminumHydroxide64MG/MLOralSuspension|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|307730-Acyclovir40MG/MLOralSuspension|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|307719-Acetylcysteine200MG/MLInhalationSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|307718-Acetylcysteine100MG/MLInhalationSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|307675-Acetaminophen32MG/MLOralSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|284988-Didanosine400MGDelayedReleaseOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|284245-Famotidine40MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|284215-Clindamycin300MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|284185-Didanosine200MGDelayedReleaseOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|284184-Didanosine250MGDelayedReleaseOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|283858-ropinirole3MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|283672-Citalopram10MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|283523-gabapentin50MG/MLOralSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|283485-Mirtazapine45MGDisintegratingOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|283433-Melatonin10MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|283406-Mirtazapine15MGDisintegratingOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|283077-prednisolone3MG/MLOralSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|282755-telmisartan20MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|282401-lamotrigine25MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|260376-Terazosin10MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|260243-Progesterone100MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|259966-Methylprednisolone4MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|259255-atorvastatin80MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|2532159-PMDDfluoxetine10MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|253059-Levocarnitine500MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|253039-Melatonin1MG/MLOralSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|252732-Melatonin5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|251322-Ethosuximide50MG/MLOralSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|251156-ferroussulfate75MG/MLOralSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|248420-mesalamine1000MGRectalSuppository|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|248109-Ribavirin200MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|245314-Albuterol5MG/MLInhalationSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|244967-PolymyxinB10000UNT/ML/Trimethoprim1MG/MLOphthalmicSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|242590-ferrousgluconate240MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|242446-Ofloxacin3MG/MLOticSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|241834-cyclosporine,modified100MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|240209-Betamethasone0.5MG/MLTopicalLotion|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|240029-Cholecalciferol0.125MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|239238-Griseofulvin25MG/MLOralSuspension|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|239191-Amoxicillin50MG/MLOralSuspension|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|238920-Betamethasone0.5MG/MLTopicalCream|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|238600-seleniumsulfide25MG/MLMedicatedShampoo|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|238154-Acetaminophen325MG/butalbital50MG/Caffeine40MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|238151-mesalamine66.7MG/MLEnema|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|238006-Estrogens,Esterified(USP)0.625MG/Methyltestosterone1.25MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|237776-vitaminB121MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|237723-Ergocalciferol0.2MG/MLOralSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|237420-CalciumCarbonate1500MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|226343-Dexamethasonephosphate1MG/MLOphthalmicSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|211365-chlorhexidinegluconate40MG/MLMedicatedLiquidSoap|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|2101899-Sodiumpolystyrenesulfonate15000MGPowderforOralSuspension|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|209890-Acetaminophen500MGOralCapsule[Mapap]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|206842-IsosorbideDinitrate20MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|205326-Lisinopril30MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|205305-telmisartan80MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|205304-telmisartan40MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|205285-leflunomide20MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|205284-leflunomide10MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|204844-Azithromycin600MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|204423-Hydrocortisone10MG/ML/Neomycin3.5MG/ML/PolymyxinB10000UNT/MLOticSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|204135-Desonide0.0005MG/MGTopicalOintment|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|200371-Citalopram20MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|200346-cefdinir300MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|200257-repaglinide0.5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|200256-repaglinide1MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|200133-12HRCarbamazepine200MGExtendedReleaseOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|200132-Acarbose25MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|200131-12HRCarbamazepine300MGExtendedReleaseOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|200064-letrozole2.5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|200060-mycophenolatemofetil500MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|200033-carvedilol25MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|200032-carvedilol12.5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|200031-carvedilol6.25MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|199903-Hydrochlorothiazide12.5MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|199890-topiramate200MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|199889-topiramate100MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|199888-topiramate25MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|199885-Levofloxacin500MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|199884-Levofloxacin250MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|199703-cabergoline0.5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|199425-Melatonin1MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|199390-Etodolac500MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|199353-trandolapril1MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|199352-trandolapril4MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|199351-trandolapril2MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|199246-glimepiride2MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|199245-glimepiride1MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1992303-12HRTimolol5MG/MLOphthalmicSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|199224-anastrozole1MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|199193-famciclovir250MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|199192-famciclovir125MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|199168-Phenobarbital64.8MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|199167-Phenobarbital32.4MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|199164-Phenobarbital97.2MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|199163-Melatonin3MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|199159-Tretinoin10MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|199150-Acarbose100MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|199149-Acarbose50MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|199143-Niacin250MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|199058-mycophenolatemofetil250MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|199047-Famotidine10MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198861-SodiumBicarbonate650MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198857-Simethicone66.7MG/MLOralSuspension|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198760-Niacin50MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198759-Niacin100MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198741-MagnesiumOxide400MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198707-Hydrocortisone5MG/MLTopicalCream|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198630-ferrousgluconate324MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198555-Capsaicin0.25MG/MLTopicalCream|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198546-CalciumGluconate500MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198509-Bisacodyl10MGRectalSuppository|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198440-Acetaminophen500MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198429-lamotrigine200MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198428-lamotrigine150MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198427-lamotrigine100MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198382-famciclovir500MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198380-tioconazole0.065MG/MGVaginalOintment|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198378-Tacrolimus5MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198377-Tacrolimus1MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198372-torsemide5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198371-torsemide20MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198370-torsemide100MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198369-torsemide10MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198365-Prochlorperazine10MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198352-Zidovudine100MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198335-Sulfamethoxazole800MG/Trimethoprim160MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198334-Sulfamethoxazole400MG/Trimethoprim80MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198332-Trimethoprim100MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198316-Hydrochlorothiazide25MG/Triamterene37.5MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198293-Tolazamide500MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198292-Tolazamide250MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198240-Tamoxifen10MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198239-Sulindac200MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198238-Sulindac150MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198232-Sulfasalazine500MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198224-Hydrochlorothiazide25MG/Spironolactone25MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198223-Spironolactone50MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198222-Spironolactone100MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198211-Simvastatin40MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198202-Rifampin300MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198201-Rifampin150MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198181-Pyrazinamide500MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198175-Propylthiouracil50MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198165-Propantheline15MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198153-Colchicine0.5MG/Probenecid500MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198152-Probenecid500MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198148-Prednisone50MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198146-Prednisone2.5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198145-Prednisone10MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198144-Prednisone1MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198141-Prazosin5MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198116-PotassiumChloride20MEQExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198108-Piroxicam20MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198107-Piroxicam10MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198105-Pindolol5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198104-Pindolol10MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198102-vitaminK15MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198089-Phenobarbital60MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198086-Phenobarbital16.2MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198083-Phenobarbital100MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198049-Ofloxacin300MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198047-Nortriptyline75MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198046-Nortriptyline50MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198045-Nortriptyline10MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198040-Nitroglycerin0.6MGSublingualTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198039-Nitroglycerin0.4MGSublingualTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198038-Nitroglycerin0.3MGSublingualTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198033-Nifedipine20MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198032-Nifedipine10MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198024-Niacin500MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198014-Naproxen500MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198013-Naproxen250MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|198012-Naproxen375MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197987-Minoxidil2.5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197986-Minoxidil10MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197973-Methylprednisolone8MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197971-Methylprednisolone32MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197963-Hydrochlorothiazide15MG/Methyldopa250MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197960-Hydrochlorothiazide25MG/Methyldopa250MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197958-Methyldopa500MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197956-Methyldopa250MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197944-Methocarbamol750MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197943-Methocarbamol500MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197942-Methimazole5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197941-Methimazole10MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197940-Methazolamide50MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197939-Methazolamide25MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197931-mercaptopurine50MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197919-Melphalan2MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197905-Lovastatin40MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197904-Lovastatin20MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197903-Lovastatin10MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197887-Hydrochlorothiazide25MG/Lisinopril20MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197886-Hydrochlorothiazide12.5MG/Lisinopril20MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197885-Hydrochlorothiazide12.5MG/Lisinopril10MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197884-Lisinopril40MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197863-Leucovorin5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197862-Leucovorin25MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197861-Leucovorin15MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197860-Leucovorin10MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197856-Ketoprofen75MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197855-Ketoprofen50MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197854-Ketoprofen25MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197853-Ketoconazole200MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197839-IsosorbideDinitrate30MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197832-isoniazid300MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197818-Indomethacin50MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197817-Indomethacin25MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197816-Indapamide2.5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197815-Indapamide1.25MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197807-Ibuprofen800MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197806-Ibuprofen600MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197805-Ibuprofen400MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197803-Ibuprofen20MG/MLOralSuspension|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197797-hydroxyurea500MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197787-Hydrocortisone5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197785-Hydrocortisone25MG/MLTopicalLotion|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197783-Hydrocortisone20MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197782-Hydrocortisone10MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197770-Hydrochlorothiazide50MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197746-Guanfacine2MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197745-Guanfacine1MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197741-Guaifenesin200MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197737-Glyburide1.25MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197732-Furosemide80MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197726-Flutamide125MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197701-Fluconazole50MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197700-Fluconazole200MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197699-Fluconazole150MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197698-Fluconazole100MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197686-Etodolac400MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197685-Etodolac300MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197684-Etodolac200MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197682-Ethosuximide250MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197670-Estrogens,Esterified(USP)1.25MG/Methyltestosterone2.5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197659-Estradiol2MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197658-Estradiol1MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|Y||Preferred Generic|892646-MorphineSulfate200MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|Y||Preferred Generic|891893-MorphineSulfate60MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197657-Estradiol0.5MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|Y||Preferred Generic|891888-MorphineSulfate30MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|Y||Preferred Generic|891881-MorphineSulfate15MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197650-Erythromycin500MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|Y||Preferred Generic|891874-MorphineSulfate100MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|Y||Preferred Generic|883826-TranexamicAcid650MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197628-Doxazosin8MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|Y||Preferred Generic|835809-testosteroneenanthate200MG/MLInjectableSolution|SPD PARTIAL DUALS 632|2002|Y|N|Y||Preferred Generic|577033-sildenafil20MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197627-Doxazosin4MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|Y||Preferred Generic|313451-Tretinoin0.00025MG/MGTopicalGel|SPD PARTIAL DUALS 632|2002|Y|N|Y||Preferred Generic|313450-Tretinoin0.0001MG/MGTopicalGel|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197626-Doxazosin2MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|Y||Preferred Generic|312084-Ondansetron24MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|Y||Preferred Generic|310140-eprosartan600MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197625-Doxazosin1MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|Y||Preferred Generic|245723-Tretinoin0.0005MG/MGTopicalGel|SPD PARTIAL DUALS 632|2002|Y|N|Y||Preferred Generic|198300-Tretinoin1MG/MLTopicalCream|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197624-Disulfiram500MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|Y||Preferred Generic|197636-dronabinol5MGOralCapsule|SPD PARTIAL DUALS 632|2002|Y|N|Y||Preferred Generic|197635-dronabinol2.5MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197623-Disulfiram250MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|Y||Preferred Generic|197634-dronabinol10MGOralCapsule|SPD PARTIAL DUALS 632|2002|Y|N|Y||Preferred Generic|106303-Tretinoin0.5MG/MLTopicalCream|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197622-Dipyridamole50MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|Y||Preferred Generic|106302-Tretinoin0.25MG/MLTopicalCream|SPD PARTIAL DUALS 632|2002|Y|N|Y||Preferred Brand|861821-Metforminhydrochloride500MG/sitagliptin50MGOralTablet[Janumet]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197606-Digoxin0.25MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|Y||Preferred Brand|861771-Metforminhydrochloride1000MG/sitagliptin50MGOralTablet[Janumet]|SPD PARTIAL DUALS 632|2002|Y|N|Y||Preferred Brand|804547-difluprednate0.5MG/MLOphthalmicSuspension[Durezol]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197604-Digoxin0.125MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|Y||Preferred Brand|665044-sitagliptin50MGOralTablet[Januvia]|SPD PARTIAL DUALS 632|2002|Y|N|Y||Preferred Brand|665040-sitagliptin25MGOralTablet[Januvia]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197596-Dicloxacillin500MGOralCapsule|SPD PARTIAL DUALS 632|2002|Y|N|Y||Preferred Brand|665036-sitagliptin100MGOralTablet[Januvia]|SPD PARTIAL DUALS 632|2002|Y|N|Y||Preferred Brand|1292435-0.65MLVaricella-ZosterVirusVaccineLive(Oka-Merck)strain29800UNT/MLInjection[Zostavax]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197595-Dicloxacillin250MGOralCapsule|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|999996-Amlodipine5MG/Hydrochlorothiazide12.5MG/Olmesartanmedoxomil40MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|999991-Amlodipine10MG/Hydrochlorothiazide25MG/Olmesartanmedoxomil40MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197583-Dexamethasone6MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|999986-Amlodipine10MG/Hydrochlorothiazide12.5MG/Olmesartanmedoxomil40MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|999967-Amlodipine5MG/Hydrochlorothiazide12.5MG/Olmesartanmedoxomil20MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197582-Dexamethasone4MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|998189-everolimus2.5MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|992395-gatifloxacin5MG/MLOphthalmicSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197581-Dexamethasone2MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|990982-2MLphysostigminesalicylate1MG/MLInjection|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|968766-PhentermineHydrochloride15MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197580-Dexamethasone1.5MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|904952-3MLibandronicacid1MG/MLPrefilledSyringe|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|903857-PyridostigmineBromide60MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197579-Dexamethasone1MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|903847-PyridostigmineBromide180MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|903843-PyridostigmineBromide12MG/MLOralSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197577-Dexamethasone0.5MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|900164-24HRlamotrigine25MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|900156-24HRlamotrigine200MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197575-Desoximetasone0.0025MG/MGTopicalOintment|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|900038-PhentermineHydrochloride30MGOralCapsule|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|898715-pregabalin20MG/MLOralSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197558-Dapsone25MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|897021-12HRdalfampridine10MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|892349-24HRMorphineSulfate60MGExtendedReleaseOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197557-Dapsone100MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|892342-24HRMorphineSulfate30MGExtendedReleaseOralCapsule|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|886634-ButorphanolTartrate1MG/ACTUATMeteredDoseNasalSpray|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197553-Cyclosporine25MGOralCapsule|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|881341-adefovirdipivoxil10MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|876529-Amlodipine5MG/telmisartan80MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197518-Clindamycin150MGOralCapsule|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|876524-Amlodipine5MG/telmisartan40MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|876519-Amlodipine10MG/telmisartan80MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197517-Clarithromycin500MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|876514-Amlodipine10MG/telmisartan40MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|864978-MethadoneHydrochloride40MGTabletforOralSuspension|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197516-Clarithromycin250MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|864769-MethadoneHydrochloride2MG/MLOralSolution|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|864761-MethadoneHydrochloride1MG/MLOralSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197500-Chlorthalidone50MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|864718-MethadoneHydrochloride5MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|864706-MethadoneHydrochloride10MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197499-Chlorthalidone25MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|864681-Atovaquone62.5MG/proguanilhydrochloride25MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|864675-Atovaquone250MG/proguanilhydrochloride100MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197454-Cephalexin500MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|863038-bepotastinebesilate15MG/MLOphthalmicSolution|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|861960-armodafinil200MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197449-Cefaclor500MGOralCapsule|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|861375-sevelamercarbonate800MGPowderforOralSuspension|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|861370-sevelamercarbonate2400MGPowderforOralSuspension|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197448-Levocarnitine330MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|860901-galantaminehydrobromide4MG/MLOralSolution|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|860715-24HRgalantaminehydrobromide8MGExtendedReleaseOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197445-Carbidopa25MG/Levodopa250MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|860707-24HRgalantaminehydrobromide24MGExtendedReleaseOralCapsule|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|860695-24HRgalantaminehydrobromide16MGExtendedReleaseOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197444-Carbidopa25MG/Levodopa100MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|860103-KetorolacTromethamine4MG/MLOphthalmicSolution|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|857700-DiclofenacSodium15MG/MLTopicalSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197443-Carbidopa10MG/Levodopa100MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|857224-Sevelamerhydrochloride800MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|857216-Sevelamerhydrochloride400MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197433-calciumacetate667MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|855642-DiclofenacSodium0.03MG/MGTopicalGel|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|855626-Twice-Dailydiclofenacepolamine0.013MG/MGMedicatedPatch|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197411-Bromocriptine2.5MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|854894-Zolpidemtartrate6.25MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|854880-Zolpidemtartrate12.5MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197409-Betamethasone0.001MG/MGTopicalOintment|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|850091-24HRlamotrigine50MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|850087-24HRlamotrigine100MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197408-Betamethasone1MG/MLTopicalLotion|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|848151-Amlodipine10MG/Hydrochlorothiazide25MG/valsartan160MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|848145-Amlodipine5MG/Hydrochlorothiazide25MG/valsartan160MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197407-Betamethasone1MG/MLTopicalCream|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|848140-Amlodipine5MG/Hydrochlorothiazide12.5MG/valsartan160MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|848135-Amlodipine10MG/Hydrochlorothiazide25MG/valsartan320MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197405-Betamethasone0.0005MG/MGTopicalOintment|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|848131-Amlodipine10MG/Hydrochlorothiazide12.5MG/valsartan160MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|845515-everolimus5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197392-Baclofen20MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|834241-febuxostat80MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|834235-febuxostat40MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197391-Baclofen10MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|833234-mesalamine800MGDelayedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|824301-rufinamide400MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197388-Azathioprine50MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|824295-rufinamide200MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|810096-{7(EthinylEstradiol0.01MGOralTablet)/84(EthinylEstradiol0.02MG/Levonorgestrel0.1MGOralTablet)}Pack|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197383-Atenolol50MG/Chlorthalidone25MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|803353-PhentermineHydrochloride37.5MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|802749-candesartancilexetil32MG/Hydrochlorothiazide25MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197382-Atenolol100MG/Chlorthalidone25MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|794639-lubiprostone0.008MGOralCapsule|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|754508-{1(aprepitant125MGOralCapsule)/2(aprepitant80MGOralCapsule)}Pack|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197381-Atenolol50MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|728231-12HRranolazine1000MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|727339-0.5MLSumatriptan12MG/MLPrefilledSyringe|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197380-Atenolol25MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|725023-24HRrivastigmine0.396MG/HRTransdermalSystem|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|725021-24HRrivastigmine0.192MG/HRTransdermalSystem|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197379-Atenolol100MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|724863-armodafinil50MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|724861-armodafinil250MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197362-ammoniumlactate120MG/MLTopicalLotion|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|724859-armodafinil150MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|722122-ambrisentan5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197361-Amlodipine5MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|722116-ambrisentan10MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|705824-100MLzoledronicacid0.05MG/MLInjection|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197320-Allopurinol300MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|700885-temozolomide180MGOralCapsule|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|700883-temozolomide140MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197319-Allopurinol100MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|672149-lapatinib250MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|656659-bosentan125MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197318-Albuterol4MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|644088-aprepitant40MGOralCapsule|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|642452-lanthanumcarbonate750MGChewableTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197316-Albuterol2MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|639537-candesartancilexetil32MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|616749-12HRranolazine500MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197313-Acyclovir800MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|616578-lubiprostone0.024MGOralCapsule|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|603208-erlotinib25MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197311-Acyclovir400MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|603206-erlotinib150MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|603203-erlotinib100MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197310-Acyclovir200MGOralCapsule|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|602635-lanthanumcarbonate1000MGChewableTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|597772-deferasirox500MGTabletforOralSuspension|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197305-AceticAcid20MG/MLOticSolution|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|597770-deferasirox250MGTabletforOralSuspension|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|597768-deferasirox125MGTabletforOralSuspension|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197304-Acetazolamide250MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|579148-Galantamine12MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|578330-candesartancilexetil32MG/Hydrochlorothiazide12.5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|197303-Acetazolamide125MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|578325-candesartancilexetil16MG/Hydrochlorothiazide12.5MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|578018-bromfenac0.9MG/MLOphthalmicSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1946772-Methotrexate25MG/MLInjectableSolution|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|577776-candesartancilexetil16MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|577348-ramelteon8MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1923809-thyroid(USP)120MGOralTablet[NPThyroid]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|577208-Omega-3AcidEthylEsters(USP)1000MGOralCapsule|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|577057-72HRFentanyl0.012MG/HRTransdermalSystem|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1923432-dorzolamide20MG/ML/Timolol5MG/MLOphthalmicSolution|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|545835-LeuprolideAcetate5MG/MLInjectableSolution|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|543218-1MLGranisetron0.1MG/MLInjection|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1923428-Timolol2.5MG/MLOphthalmicSolution|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|485489-Temazepam22.5MGOralCapsule|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|485436-entecavir1MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1923426-SotalolHydrochloride80MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|485434-entecavir0.5MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|485423-24HRdarifenacin7.5MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1923424-SotalolHydrochloride160MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|485421-24HRdarifenacin15MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|477372-solifenacinsuccinate10MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1923422-SotalolHydrochloride120MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|477367-solifenacinsuccinate5MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|477347-lanthanumcarbonate500MGChewableTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1870230-NDA0208000.3MLEpinephrine1MG/MLAuto-Injector|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|477130-Hydrochlorothiazide25MG/telmisartan80MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|465355-voriconazole40MG/MLOralSuspension|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1860100-ferroussulfate324MGDelayedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|403930-Isotretinoin30MGOralCapsule|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|403879-imatinib400MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1855086-thyroid(USP)15MGOralTablet[NPThyroid]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|403878-imatinib100MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|403818-moxifloxacin5MG/MLOphthalmicSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1806189-30/70Release24HRMethylphenidateHydrochloride30MGExtendedReleaseOralCapsule|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|403811-aprepitant125MGOralCapsule|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|402506-12HRCarbamazepine400MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1806187-30/70Release24HRMethylphenidateHydrochloride20MGExtendedReleaseOralCapsule|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|402505-12HRCarbamazepine200MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|351114-5MLzoledronicacid0.8MG/MLInjection|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1806181-30/70Release24HRMethylphenidateHydrochloride10MGExtendedReleaseOralCapsule|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|349435-voriconazole50MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|349434-voriconazole200MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1801298-MicroencapsulatedPotassiumChloride10MEQExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|349410-Treprostinil5MG/MLInjectableSolution|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|349409-Treprostinil2.5MG/MLInjectableSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1801294-MicroencapsulatedPotassiumChloride20MEQExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|349408-Treprostinil10MG/MLInjectableSolution|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|349407-Treprostinil1MG/MLInjectableSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1801289-SmokingCessation12HRBupropionHydrochloride150MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|349253-bosentan62.5MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|348719-Tobramycin60MG/MLInhalationSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1797913-TriamcinoloneAcetonide0.055MG/ACTUATMeteredDoseNasalSpray|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|317160-temozolomide100MGOralCapsule|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|313472-Trientinehydrochloride250MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1797907-Fluticasonepropionate0.05MG/ACTUATMeteredDoseNasalSpray|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|313211-temozolomide5MGOralCapsule|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|313210-temozolomide250MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1797867-Azelastinehydrochloride0.137MG/ACTUATMeteredDoseNasalSpray|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|313209-temozolomide20MGOralCapsule|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|313165-0.5MLSumatriptan12MG/MLInjection|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1797851-CromolynSodium5.2MG/ACTUATMeteredDoseNasalSpray|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|312835-rivastigmine3MGOralCapsule|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|311204-Itraconazole100MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1738511-ParoxetineHydrochloride40MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|310599-Granisetron1MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|310437-Galantamine8MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1738503-ParoxetineHydrochloride30MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|310436-Galantamine4MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|283317-Hydrochlorothiazide12.5MG/telmisartan80MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1738495-ParoxetineHydrochloride20MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|283316-Hydrochlorothiazide12.5MG/telmisartan40MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|260218-modafinil100MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1738483-ParoxetineHydrochloride10MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|245136-72HRFentanyl0.1MG/HRTransdermalSystem|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|245135-72HRFentanyl0.05MG/HRTransdermalSystem|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1731350-deferoxaminemesylate500MGInjection|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|245134-72HRFentanyl0.025MG/HRTransdermalSystem|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|240912-Granisetron1MG/MLInjectableSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1731345-deferoxaminemesylate2000MGInjection|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|2198370-pretomanid200MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|2123194-PulmonaryHypertensiontadalafil20MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1724481-thyroid(USP)60MGOralTablet[NPThyroid]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|205324-modafinil200MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|205316-topiramate15MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1724439-thyroid(USP)30MGOralTablet[NPThyroid]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|205315-topiramate25MGOralCapsule|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|200328-capecitabine500MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1724437-thyroid(USP)90MGOralTablet[NPThyroid]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|200327-capecitabine150MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|200220-tolcapone100MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1665188-1MLLorazepam2MG/MLInjection|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|199521-Vigabatrin500MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|199378-12HRCarbamazepine100MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1665050-Cefazolin1000MGInjection|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1988980-24HRpregabalin82.5MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1988977-24HRpregabalin330MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1659263-1MLheparinsodium,porcine5000UNT/MLInjection|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1988974-24HRpregabalin165MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|198243-Temazepam7.5MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1655968-8MLMethotrexate25MG/MLInjection|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|198200-Rifabutin150MGOralCapsule|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|198071-Penicillamine250MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1648759-NITROFURANTOIN,MACROCRYSTALS100MGOralCapsule|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|198070-Penicillamine250MGOralCapsule|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|197845-Isotretinoin40MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1648755-NITROFURANTOIN,MACROCRYSTALS25MG/Nitrofurantoin,Monohydrate75MGOralCapsule|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|197844-Isotretinoin20MGOralCapsule|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|197843-Isotretinoin10MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1547771-Tetracainehydrochloride5MG/MLOphthalmicSolution|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|197730-Furosemide10MG/MLOralSolution|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|197696-72HRFentanyl0.075MG/HRTransdermalSystem|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|152695-meloxicam15MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1923828-deferasirox180MGOralGranules|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1923826-deferasirox360MGOralGranules|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|151226-topiramate50MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1923822-deferasirox90MGOralGranules|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1918042-abirateroneacetate500MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1440184-hydrocortisoneacetate0.01MG/MGTopicalOintment|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1874559-24HRdesvenlafaxinesuccinate50MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1874553-24HRdesvenlafaxinesuccinate100MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1437702-Albuterol0.833MG/ML/IpratropiumBromide0.167MG/MLInhalationSolution|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1860157-Abuse-Deterrent12HROxycodoneHydrochloride10MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1860154-Abuse-Deterrent12HROxycodoneHydrochloride15MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|142034-BenzoylPeroxide100MG/MLMedicatedLiquidSoap|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1860151-Abuse-Deterrent12HROxycodoneHydrochloride30MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1860148-Abuse-Deterrent12HROxycodoneHydrochloride80MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|141963-Azithromycin40MG/MLOralSuspension|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1860137-Abuse-Deterrent12HROxycodoneHydrochloride40MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1860129-Abuse-Deterrent12HROxycodoneHydrochloride20MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1376336-prednisoloneacetate10MG/MLOphthalmicSuspension|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1860127-Abuse-Deterrent12HROxycodoneHydrochloride60MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1799212-sofosbuvir400MG/velpatasvir100MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1367436-21DAYEthinylEstradiol0.000625MG/HR/Etonogestrel0.005MG/HRVaginalSystem|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1796690-1MLhydroxyprogesteronecaproate(USP)250MG/MLInjection|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1793916-0.5MLSumatriptan8MG/MLAuto-Injector|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1367410-Ergocalciferol1.25MGOralCapsule|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1745091-Lidocaine0.05MG/MGMedicatedPatch|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1737461-PamidronateDisodium90MGInjection|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1366116-bacitracinzinc0.5UNT/MGTopicalOintment|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1737459-PamidronateDisodium30MGInjection|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1734399-1MLGranisetron1MG/MLInjection|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1363309-ChlorpheniramineMaleate4MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1728055-5MLpalonosetron0.05MG/MLInjection|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1657173-0.5MLSumatriptan8MG/MLCartridge|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1362720-MexiletineHydrochloride250MGOralCapsule|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1657160-0.5MLSumatriptan12MG/MLCartridge|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1607990-{24(EthinylEstradiol0.025MG/Norethindrone0.8MGChewableTablet)/4(Ferrousfumarate75MGChewableTablet)}Pack|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1362712-MexiletineHydrochloride200MGOralCapsule|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1607796-deferasirox90MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1607792-deferasirox360MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1362706-MexiletineHydrochloride150MGOralCapsule|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1607784-deferasirox180MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1607617-24HRdesvenlafaxinesuccinate25MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1359858-Fluticasonepropionate0.5MG/ACTUAT/salmeterol0.05MG/ACTUATDryPowderInhaler|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1599949-60ACTUATTestosterone30MG/ACTUATTopicalSolution|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1597129-5000MGTestosterone0.01MG/MGTopicalGel|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1359779-Fluticasonepropionate0.1MG/ACTUAT/salmeterol0.05MG/ACTUATDryPowderInhaler|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1597123-2500MGTestosterone0.01MG/MGTopicalGel|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1591943-ledipasvir90MG/sofosbuvir400MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1359117-{24(EthinylEstradiol0.02MG/norethindroneacetate1MGOralTablet)/4(Ferrousfumarate75MGOralTablet)}Pack|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1547565-Isotretinoin35MGOralCapsule|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1547561-Isotretinoin25MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1313885-Phenytoin50MGChewableTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|153823-candesartancilexetil8MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|153822-candesartancilexetil4MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1313112-Phenytoin25MG/MLOralSuspension|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1490065-RaloxifeneHydrochloride60MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1487361-1MLglatirameracetate40MG/MLPrefilledSyringe|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1298072-Cyclopentolatehydrochloride5MG/MLOphthalmicSolution|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1435115-28ACTUATTeriparatide0.02MG/ACTUATPenInjector|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1426600-{24(EthinylEstradiol0.02MG/norethindroneacetate1MGChewableTablet)/4(Ferrousfumarate75MGOralTablet)}Pack|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1298070-Cyclopentolatehydrochloride20MG/MLOphthalmicSolution|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1373503-{7(EthinylEstradiol0.01MGOralTablet)/42(EthinylEstradiol0.02MG/Levonorgestrel0.15MGOralTablet)/21(EthinylEstradiol0.0|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1373497-{14(dimethylfumarate120MGDelayedReleaseOralCapsule)/46(dimethylfumarate240MGDelayedReleaseOralCapsule)}Pack|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1298066-Cyclopentolatehydrochloride10MG/MLOphthalmicSolution|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1373491-dimethylfumarate240MGDelayedReleaseOralCapsule|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1373483-dimethylfumarate120MGDelayedReleaseOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1291082-hydrocortisoneacetate25MGRectalSuppository|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1366550-24HRBudesonide9MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1360304-Budesonide0.08MG/ACTUAT/formoterolfumarate0.0045MG/ACTUATMeteredDoseInhaler|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1250490-hydrocortisoneacetate5MG/MLTopicalCream|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1359861-Budesonide0.16MG/ACTUAT/formoterolfumarate0.0045MG/ACTUATMeteredDoseInhaler|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1308569-24HRrivastigmine0.554MG/HRTransdermalSystem|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1245919-Marlissa28DayPack|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1307427-sildenafil10MG/MLOralSuspension|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1304979-icosapentethyl1000MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1245468-DocusateSodium250MGOralCapsule|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1299917-Tiagabinehydrochloride4MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1299911-Tiagabinehydrochloride2MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1245230-chlorhexidinegluconate20MG/MLMedicatedLiquidSoap|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1299909-Tiagabinehydrochloride16MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1299903-Tiagabinehydrochloride12MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1243585-Flurbiprofensodium0.3MG/MLOphthalmicSolution|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1146690-24HRlamotrigine250MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1119400-everolimus7.5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1242787-Alyacen7/7/7Kit|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1111641-1MLglatirameracetate20MG/MLPrefilledSyringe|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1100075-abirateroneacetate250MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1242786-Alyacen1/3528-DayKit|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1098608-24HRlamotrigine300MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1095229-FlavoxateHydrochloride100MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1234571-PhenylephrineHydrochloride100MG/MLOphthalmicSolution|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1092357-rufinamide40MG/MLOralSuspension|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1087964-hydroxyprogesteronecaproate(USP)250MG/MLInjectableSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1193362-100MLLevetiracetam5MG/MLInjection|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1050493-{21(drospirenone3MG/EthinylEstradiol0.03MG/levomefolatecalcium0.451MGOralTablet)/7(levomefolatecalcium0.451MGOralTabl|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1013629-{24(drospirenone3MG/EthinylEstradiol0.02MG/levomefolatecalcium0.451MGOralTablet)/4(levomefolatecalcium0.451MGOralTabl|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1193360-100MLLevetiracetam15MG/MLInjection|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1011739-aliskiren300MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1011736-aliskiren150MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1193358-100MLLevetiracetam10MG/MLInjection|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Generic|1000001-Amlodipine5MG/Hydrochlorothiazide25MG/Olmesartanmedoxomil40MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|995156-lacosamide10MG/MLOralSolution[Vimpat]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1191315-FluocinoloneAcetonide0.25MG/MLTopicalCream|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|993456-1MLdenosumab60MG/MLPrefilledSyringe[Prolia]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|979115-0.6MLMethylnaltrexonebromide20MG/MLInjection[Relistor]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1191310-FluocinoloneAcetonide0.1MG/MLTopicalSolution|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|978950-Natazia28DayPack|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|903855-2MLPyridostigmineBromide5MG/MLInjection[Regonol]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1191256-FluocinoloneAcetonide0.00025MG/MGTopicalOintment|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|902626-dexlansoprazole60MGDelayedReleaseOralCapsule[Dexilant]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|902624-dexlansoprazole30MGDelayedReleaseOralCapsule[Dexilant]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1191013-Proparacainehydrochloride5MG/MLOphthalmicSolution|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|901614-Aztreonam75MG/MLInhalationSolution[Cayston]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|897126-3MLliraglutide6MG/MLPenInjector[Victoza]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1190655-AtropineSulfate10MG/MLOphthalmicSolution|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|896273-120ACTUATFluticasonepropionate0.23MG/ACTUAT/salmeterol0.021MG/ACTUATMeteredDoseInhaler[Advair]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|896245-120ACTUATFluticasonepropionate0.115MG/ACTUAT/salmeterol0.021MG/ACTUATMeteredDoseInhaler[Advair]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1190572-AtropineSulfate0.025MG/DiphenoxylateHydrochloride2.5MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|896237-120ACTUATFluticasonepropionate0.045MG/ACTUAT/salmeterol0.021MG/ACTUATMeteredDoseInhaler[Advair]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|884619-eltrombopag75MGOralTablet[Promacta]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1190570-AtropineSulfate0.01MG/MGOphthalmicOintment|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|867506-pazopanib200MGOralTablet[Votrient]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|864820-Oxybutyninchloride0.1MG/MGTopicalGel[Gelnique]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1190568-AtropineSulfate0.005MG/ML/DiphenoxylateHydrochloride0.5MG/MLOralSolution|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|861966-Iloprost0.02MG/MLInhalationSolution[Ventavis]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|861045-1.5MLpramlintideacetate1MG/MLPenInjector[Symlin]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1150836-LevobunololHydrochloride5MG/MLOphthalmicSolution|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|861043-2.7MLpramlintideacetate1MG/MLPenInjector[Symlin]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|860898-Vigabatrin500MGPowderforOralSolution[Sabril]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1116758-chloroquinephosphate500MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|860244-interferonbeta-1b0.3MGInjection[Extavia]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|858366-KetorolacTromethamine4.5MG/MLOphthalmicSolution[Acuvail]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1116150-bacitracinzinc0.4UNT/MG/hydrocortisoneacetate0.01MG/MG/NeomycinSulfate0.0035MG/MG/PolymyxinBSulfate10UNT/MGOphthalmic|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|858044-saxagliptin2.5MGOralTablet[Onglyza]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|858040-saxagliptin5MGOralTablet[Onglyza]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1115005-DocusateSodium100MGOralCapsule|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|857799-Treprostinil0.6MG/MLInhalationSolution[Tyvaso]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|854852-lisdexamfetaminedimesylate50MGOralCapsule[Vyvanse]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1100457-PyridoxineHydrochloride25MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|854848-lisdexamfetaminedimesylate60MGOralCapsule[Vyvanse]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|854844-lisdexamfetaminedimesylate70MGOralCapsule[Vyvanse]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1099870-DivalproexSodium500MGDelayedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|854840-lisdexamfetaminedimesylate40MGOralCapsule[Vyvanse]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|854836-lisdexamfetaminedimesylate30MGOralCapsule[Vyvanse]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1099687-ValproicAcid50MG/MLOralSolution|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|854832-lisdexamfetaminedimesylate20MGOralCapsule[Vyvanse]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|853356-1MLustekinumab90MG/MLPrefilledSyringe[Stelara]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1099681-ValproicAcid250MGOralCapsule|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|853354-0.5MLustekinumab90MG/MLPrefilledSyringe[Stelara]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|849599-1MLcertolizumabpegol200MG/MLPrefilledSyringe[Cimzia]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1099678-DivalproexSodium250MGDelayedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|848164-0.5MLgolimumab100MG/MLPrefilledSyringe[Simponi]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|847917-60ACTUATexenatide0.005MG/ACTUATPenInjector[Byetta]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1099648-5MLValproicAcid100MG/MLInjection|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|847913-60ACTUATexenatide0.01MG/ACTUATPenInjector[Byetta]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|845512-everolimus10MGOralTablet[Afinitor]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1099625-DivalproexSodium125MGDelayedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|836649-Zolpidemtartrate5MGSublingualTablet[Edluar]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|836645-Zolpidemtartrate10MGSublingualTablet[Edluar]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1099596-DivalproexSodium125MGDelayedReleaseOralCapsule|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|828703-1.2MLPlerixafor20MG/MLInjection[Mozobil]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|828696-Zolpidemtartrate5MG/ACTUATOralSpray[Zolpimist]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1099569-24HRDivalproexSodium500MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|828364-hydrocortisoneacetate10MG/ML/Pramoxinehydrochloride10MG/MLRectalFoam[Proctofoam-HC]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|825429-eltrombopag50MGOralTablet[Promacta]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1099563-24HRDivalproexSodium250MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|825425-eltrombopag25MGOralTablet[Promacta]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|825170-HumiraPen40MG/0.8ML-Crohn'sDiseaseStarterPack|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1099316-DesipramineHydrochloride75MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|810079-24HRFesoterodineFumarate8MGExtendedReleaseOralTablet[Toviaz]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|810075-24HRFesoterodineFumarate4MGExtendedReleaseOralTablet[Toviaz]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1099304-DesipramineHydrochloride50MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|810002-lacosamide50MGOralTablet[Vimpat]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|809998-lacosamide200MGOralTablet[Vimpat]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1099300-DesipramineHydrochloride25MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|809994-lacosamide150MGOralTablet[Vimpat]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|809990-lacosamide100MGOralTablet[Vimpat]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1099296-DesipramineHydrochloride150MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|809159-0.5MLEtanercept50MG/MLPrefilledSyringe[Enbrel]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|802652-1MLEtanercept50MG/MLPrefilledSyringe[Enbrel]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1099292-DesipramineHydrochloride100MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|799830-dasatinib100MGOralTablet[Sprycel]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|795749-RebifTitrationPack|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1099288-DesipramineHydrochloride10MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|795085-certolizumabpegol200MGInjection[Cimzia]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|763565-0.4MLadalimumab50MG/MLPrefilledSyringe[Humira]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1098134-24HRNiacin1000MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|758032-0.5MLInterferonbeta-1a0.044MG/MLPrefilledSyringe[Rebif]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|758027-0.5MLInterferonbeta-1a0.088MG/MLPrefilledSyringe[Rebif]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1095725-ClemastineFumarate1.34MGOralTablet[Dayhist-1]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|753443-9HRMethylphenidate3.33MG/HRTransdermalSystem[Daytrana]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|753442-9HRMethylphenidate2.22MG/HRTransdermalSystem[Daytrana]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1094543-Briellyn28DayPack|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|753437-9HRMethylphenidate1.11MG/HRTransdermalSystem[Daytrana]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|748740-Topotecan1MGOralCapsule[Hycamtin]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1094107-Phenazopyridinehydrochloride100MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|748738-Topotecan0.25MGOralCapsule[Hycamtin]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|746609-nilotinib200MGOralCapsule[Tasigna]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1094104-Phenazopyridinehydrochloride200MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|731250-0.3MLdarbepoetinalfa0.2MG/MLPrefilledSyringe[Aranesp]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|731245-0.42MLdarbepoetinalfa0.06MG/MLPrefilledSyringe[Aranesp]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1085745-TriamcinoloneAcetonide1MG/MLTopicalLotion|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|731241-1MLdarbepoetinalfa0.5MG/MLPrefilledSyringe[Aranesp]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|731235-0.4MLdarbepoetinalfa0.5MG/MLPrefilledSyringe[Aranesp]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1085741-TriamcinoloneAcetonide0.25MG/MLTopicalLotion|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|731231-0.3MLdarbepoetinalfa0.5MG/MLPrefilledSyringe[Aranesp]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|731229-0.6MLdarbepoetinalfa0.5MG/MLPrefilledSyringe[Aranesp]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1085686-TriamcinoloneAcetonide5MG/MLTopicalCream|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|731227-0.4MLdarbepoetinalfa0.1MG/MLPrefilledSyringe[Aranesp]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|730046-0.5MLdarbepoetinalfa0.2MG/MLPrefilledSyringe[Aranesp]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1085644-TriamcinoloneAcetonide0.25MG/MLTopicalCream|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|727816-0.5MLInterferonbeta-1a0.06MG/MLPrefilledSyringe[Avonex]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|727714-0.67MLanakinra149MG/MLPrefilledSyringe[Kineret]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1085640-TriamcinoloneAcetonide0.005MG/MGTopicalOintment|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|727705-0.8MLadalimumab50MG/MLPrefilledSyringe[Humira]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|723846-orlistat60MGOralCapsule[Alli]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1085636-TriamcinoloneAcetonide0.001MG/MGTopicalOintment|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|706872-Azithromycin10MG/MLOphthalmicSolution[AzaSite]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|700418-Thalidomide150MGOralCapsule[Thalomid]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1085633-TriamcinoloneAcetonide0.00025MG/MGTopicalOintment|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|668606-Vorinostat100MGOralCapsule[Zolinza]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|643722-lenalidomide25MGOralCapsule[Revlimid]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|106387-Permethrin50MG/MLTopicalCream|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|643714-lenalidomide15MGOralCapsule[Revlimid]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|643488-Isotretinoin30MGOralCapsule[Claravis]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|106351-SilverSulfadiazine10MG/MLTopicalCream|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|643177-dasatinib70MGOralTablet[Sprycel]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|643175-dasatinib50MGOralTablet[Sprycel]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|106336-Ketoconazole20MG/MLMedicatedShampoo|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|643173-dasatinib20MGOralTablet[Sprycel]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|616292-sunitinib50MGOralCapsule[Sutent]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|106258-Hydrocortisone10MG/MLTopicalCream|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|616287-sunitinib25MGOralCapsule[Sutent]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|616283-sunitinib12.5MGOralCapsule[Sutent]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|105585-Methotrexate2.5MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|616116-lenalidomide5MGOralCapsule[Revlimid]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|616114-lenalidomide10MGOralCapsule[Revlimid]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|105583-Fluorouracil50MG/MLTopicalCream|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|616018-abatacept250MGInjection[Orencia]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|615979-sorafenib200MGOralTablet[Nexavar]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1053753-Nystatin100000UNT/ML/TriamcinoloneAcetonide1MG/MLTopicalCream|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|607579-entecavir0.05MG/MLOralSolution[Baraclude]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|603978-nepafenac1MG/MLOphthalmicSuspension[Nevanac]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1053697-Nystatin100UNT/MG/TriamcinoloneAcetonide0.001MG/MGTopicalOintment|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|602862-magnesiumaminoacidchelate133MGOralTablet[MGPlusProtein]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|582595-Iloprost0.01MG/MLInhalationSolution[Ventavis]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|105292-isoniazid10MG/MLOralSolution|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|580286-mesalamine500MGExtendedReleaseOralCapsule[Pentasa]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|540181-alosetron0.5MGOralTablet[Lotronex]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1052760-magnesiumcitrate58.2MG/MLOralSolution|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|404450-Thalidomide200MGOralCapsule[Thalomid]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|404449-Thalidomide100MGOralCapsule[Thalomid]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1050077-DiphenhydramineHydrochloride20MG/MLTopicalCream|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|404065-Isotretinoin40MGOralCapsule[Claravis]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|404062-Isotretinoin20MGOralCapsule[Claravis]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1049909-DiphenhydramineHydrochloride25MGOralCapsule|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|404059-Isotretinoin10MGOralCapsule[Claravis]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|352262-1MLdarbepoetinalfa0.3MG/MLInjection[Aranesp]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1049906-DiphenhydramineHydrochloride2.5MG/MLOralSolution|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|352047-1MLdarbepoetinalfa0.1MG/MLInjection[Aranesp]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|352046-1MLdarbepoetinalfa0.06MG/MLInjection[Aranesp]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1049630-DiphenhydramineHydrochloride25MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|352045-1MLdarbepoetinalfa0.04MG/MLInjection[Aranesp]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|352044-1MLdarbepoetinalfa0.025MG/MLInjection[Aranesp]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1049167-PseudoephedrineHydrochloride60MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|261362-alosetron1MGOralTablet[Lotronex]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|261105-Etanercept25MG/MLInjectableSolution[Enbrel]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|104884-Metoclopramide1MG/MLOralSolution|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2559707-1.14MLdupilumab175MG/MLAuto-Injector[Dupixent]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2557216-trikafta50MG/37.5MG/25MGand75MGPack|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1047905-HyoscyamineSulfate0.125MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2550713-0.5MLsecukinumab150MG/MLPrefilledSyringe[Cosentyx]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2536758-24HRviloxazine200MGExtendedReleaseOralCapsule[Qelbree]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1047895-HyoscyamineSulfate0.125MG/MLOralSolution|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2536752-24HRviloxazine150MGExtendedReleaseOralCapsule[Qelbree]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2536554-24HRviloxazine100MGExtendedReleaseOralCapsule[Qelbree]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1047881-HyoscyamineSulfate0.025MG/MLOralSolution|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2531134-HumiraPen80MG/0.8ML-StarterPackageforPediatricUlcerativeColitis(4count)|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2475860-vericiguat5MGOralTablet[Verquvo]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1046985-HyoscyamineSulfate0.125MGDisintegratingOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2475856-vericiguat2.5MGOralTablet[Verquvo]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2475852-vericiguat10MGOralTablet[Verquvo]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1043690-hydrocortisoneacetate10MG/MLTopicalCream|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2475406-voclosporin7.9MGOralCapsule[Lupkynis]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2473042-ponatinib10MGOralTablet[Iclusig]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|103951-Tolnaftate10MG/MLTopicalCream|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2463737-epoetinalfa-epbx20000UNT/MLInjectableSolution[Retacrit]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2463733-epoetinalfa-epbx10000UNT/MLInjectableSolution[Retacrit]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|103457-Fluocinonide0.0005MG/MGTopicalOintment|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2395775-30ACTUATfluticasonefuroate0.2MG/ACTUAT/umeclidinium0.0625MG/ACTUAT/vilanterol0.025MG/ACTUATDryPowderInhaler[Trelegy]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2392142-0.5MLetanercept50MG/MLInjection[Enbrel]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|103456-Fluocinonide0.5MG/MLTopicalCream|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2387331-120ACTUATbudesonide0.16MG/ACTUAT/formoterolfumarate0.0048MG/ACTUAT/glycopyrrolate0.009MG/ACTUATMeteredDoseInhaler[Bre|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2373941-bedaquiline20MGOralTablet[Sirturo]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|103403-Hydrocortisone10MG/MLTopicalLotion|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2371768-Oriahnn28DayKit|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2359358-24HRempagliflozin5MG/linagliptin2.5MG/metforminhydrochloride1000MGExtendedReleaseOralTablet[Trijardy]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|103401-Hydrocortisone0.025MG/MGTopicalOintment|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2359353-24HRempagliflozin25MG/linagliptin5MG/metforminhydrochloride1000MGExtendedReleaseOralTablet[Trijardy]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2359290-24HRempagliflozin12.5MG/linagliptin2.5MG/metforminhydrochloride1000MGExtendedReleaseOralTablet[Trijardy]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1020477-DiphenhydramineHydrochloride50MGOralCapsule|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2359285-24HRempagliflozin10MG/linagliptin5MG/metforminhydrochloride1000MGExtendedReleaseOralTablet[Trijardy]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2287905-1.5MLfremanezumab-vfrm150MG/MLAuto-Injector[Ajovy]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1014678-cetirizinehydrochloride10MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2283236-bempedoicacid180MG/ezetimibe10MGOralTablet[Nexlizet]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2282414-bempedoicacid180MGOralTablet[Nexletol]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1014676-cetirizinehydrochloride5MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2282320-Rimegepant75MGDisintegratingOralTablet[Nurtec]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2273115-24HRtofacitinib22MGExtendedReleaseOralTablet[Xeljanz]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1014673-cetirizinehydrochloride1MG/MLOralSolution|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|226917-orlistat120MGOralCapsule[Xenical]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2268231-ubrogepant50MGOralTablet[Ubrelvy]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1014571-12HRcetirizinehydrochloride5MG/PseudoephedrineHydrochloride120MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2268227-ubrogepant100MGOralTablet[Ubrelvy]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2265689-Voxelotor500MGOralTablet[Oxbryta]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1014314-TriamcinoloneAcetonide1MG/MLTopicalCream|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2262731-MicronizedIsotretinoin8MGOralCapsule[Absorica]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2262727-MicronizedIsotretinoin32MGOralCapsule[Absorica]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1012021-Prednisolonesodiumphosphate2.5MG/ML/SulfacetamideSodium100MG/MLOphthalmicSolution|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2262719-MicronizedIsotretinoin24MGOralCapsule[Absorica]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2262713-MicronizedIsotretinoin16MGOralCapsule[Absorica]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1011852-LidocaineHydrochloride0.02MG/MGTopicalGel|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2257013-trikafta100MG/50MG/75MGand150MGPack|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2256947-lasmiditan50MGOralTablet[Reyvow]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1010878-LidocaineHydrochloride40MG/MLMucousMembraneTopicalSolution|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2256943-lasmiditan100MGOralTablet[Reyvow]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2205634-1MLbenralizumab30MG/MLAuto-Injector[Fasenra]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1006688-SulfacetamideSodium100MG/MLTopicalLotion|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2203897-ledipasvir45MG/sofosbuvir200MGOralTablet[Harvoni]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2203893-sofosbuvir200MGOralTablet[Sovaldi]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1006120-SulfacetamideSodium100MG/MLOphthalmicSolution|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2201540-romiplostim0.125MGInjection[Nplate]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2196592-120ACTUATformoterolfumarate0.005MG/ACTUAT/mometasonefuroate0.05MG/ACTUATMeteredDoseInhaler[Dulera]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1005856-SulfacetamideSodium100MG/ML/Sulfur50MG/MLTopicalLotion|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2182340-1MLEtanercept50MG/MLCartridge[Enbrel]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2174390-symdeko50MG/75MGand75MGPack|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1000897-PilocarpineHydrochloride40MG/MLOphthalmicSolution|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2173822-1MLmepolizumab100MG/MLPrefilledSyringe[Nucala]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2170993-1MLmepolizumab100MG/MLAuto-Injector[Nucala]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1000862-PilocarpineHydrochloride20MG/MLOphthalmicSolution|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2170613-1MLgalcanezumab-gnlm100MG/MLPrefilledSyringe[Emgality]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2166401-ivacaftor25MGOralGranules[Kalydeco]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1000673-SulfacetamideSodium0.1MG/MGOphthalmicOintment|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|213475-1MLEpoetinAlfa40000UNT/MLInjection[Procrit]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|213360-Thalidomide50MGOralCapsule[Thalomid]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1000647-PilocarpineHydrochloride10MG/MLOphthalmicSolution|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2123314-Mayzent0.25MGStarterPack|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|212219-EpoetinAlfa20000UNT/MLInjectableSolution[Procrit]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1000141-medroxyprogesteroneacetate5MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|212218-EpoetinAlfa20000UNT/MLInjectableSolution[Epogen]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2121100-siponimod2MGOralTablet[Mayzent]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1000135-medroxyprogesteroneacetate2.5MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2121096-siponimod0.25MGOralTablet[Mayzent]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2120195-1MLerenumab-aooe140MG/MLAuto-Injector[Aimovig]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1000114-medroxyprogesteroneacetate10MGOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2119391-Spravato56MGDoseKit|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2119389-Spravato84MGDoseKit|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1000097-DoxepinHydrochloride75MGOralCapsule|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2107355-prucalopride2MGOralTablet[Motegrity]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2107351-prucalopride1MGOralTablet[Motegrity]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1000076-DoxepinHydrochloride50MGOralCapsule|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2106362-rifamycinSV194MGDelayedReleaseOralTablet[Aemcolo]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2106075-0.9MLtocilizumab180MG/MLAuto-Injector[Actemra]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1000070-DoxepinHydrochloride25MGOralCapsule|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2102705-0.6MLpegfilgrastim-cbqv10MG/MLPrefilledSyringe[Udenyca]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|208083-sargramostim0.25MG/MLInjectableSolution[Leukine]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1000064-DoxepinHydrochloride150MGOralCapsule|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|207059-interferonbeta-1b0.3MGInjection[Betaseron]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|206791-mesalamine250MGExtendedReleaseOralCapsule[Pentasa]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1000058-DoxepinHydrochloride100MGOralCapsule|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|205924-1MLEpoetinAlfa4000UNT/MLInjection[Procrit]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|205923-1MLEpoetinAlfa4000UNT/MLInjection[Epogen]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1000054-DoxepinHydrochloride10MG/MLOralSolution|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|205922-1MLEpoetinAlfa3000UNT/MLInjection[Procrit]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|205921-1MLEpoetinAlfa3000UNT/MLInjection[Epogen]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|1000048-DoxepinHydrochloride10MGOralCapsule|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2059189-amikacinliposomal70.3MG/MLInhalationSuspension[Arikayce]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|205918-1MLEpoetinAlfa2000UNT/MLInjection[Procrit]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|993804-Gianvi28-DayPack|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|205917-1MLEpoetinAlfa2000UNT/MLInjection[Epogen]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|205913-EpoetinAlfa10000UNT/MLInjectableSolution[Procrit]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|992759-Homatropinehydrobromide50MG/MLOphthalmicSolution[Homatropaire]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|205912-EpoetinAlfa10000UNT/MLInjectableSolution[Epogen]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2058950-0.5MLomalizumab150MG/MLPrefilledSyringe[Xolair]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|992481-PromethazineHydrochloride50MGRectalSuppository[Promethegan]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2058946-1MLomalizumab150MG/MLPrefilledSyringe[Xolair]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2058906-cannabidiol100MG/MLOralSolution[Epidiolex]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|991233-bexarotene0.01MG/MGTopicalGel[Targretin]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2058887-1MLgalcanezumab-gnlm120MG/MLPrefilledSyringe[Emgality]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2058877-1MLgalcanezumab-gnlm120MG/MLAuto-Injector[Emgality]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|967012-POLYETHYLENEGLYCOL3350236000MG/PotassiumChloride2970MG/SodiumBicarbonate6740MG/SodiumChloride5860MG/sodiumsulfate22740|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2057216-0.8MLfilgrastim-aafi0.6MG/MLPrefilledSyringe[Nivestym]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2057205-0.5MLfilgrastim-aafi0.6MG/MLPrefilledSyringe[Nivestym]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|905379-HydralazineHydrochloride37.5MG/IsosorbideDinitrate20MGOralTablet[Bidil]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2056700-1.5MLfremanezumab-vfrm150MG/MLPrefilledSyringe[Ajovy]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2056670-AimovigAutoinjector2-Pack(140MGDose)|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|896031-28ACTUATFluticasonepropionate0.1MG/ACTUATDryPowderInhaler[Flovent]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|205532-DornaseAlfa1MG/MLInhalationSolution[Pulmozyme]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2054995-lusutrombopag3MGOralTablet[Mulpleta]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|896019-60ACTUATFluticasonepropionate0.05MG/ACTUATDryPowderInhaler[Flovent]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2053519-ivacaftor188MG/lumacaftor150MGOralGranules[ORKAMBI]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2053512-ivacaftor125MG/lumacaftor100MGOralGranules[ORKAMBI]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|896006-120ACTUATFluticasonepropionate0.22MG/ACTUATMeteredDoseInhaler[Flovent]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2048568-tofacitinib10MGOralTablet[Xeljanz]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2048025-0.6MLpegfilgrastim-jmdb10MG/MLPrefilledSyringe[Fulphila]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|896001-120ACTUATFluticasonepropionate0.11MG/ACTUATMeteredDoseInhaler[Flovent]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2047623-1MLepoetinalfa-epbx40000UNT/MLInjection[Retacrit]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2047614-1MLepoetinalfa-epbx4000UNT/MLInjection[Retacrit]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|895996-120ACTUATFluticasonepropionate0.044MG/ACTUATMeteredDoseInhaler[Flovent]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2047608-1MLepoetinalfa-epbx3000UNT/MLInjection[Retacrit]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2047602-1MLepoetinalfa-epbx2000UNT/MLInjection[Retacrit]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|890786-Butoconazolenitrate20MG/MLVaginalCream[Gynazole-1]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2047596-1MLepoetinalfa-epbx10000UNT/MLInjection[Retacrit]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2045961-Doptelet60MGDailyDoseCartonPack|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|866049-60ACTUATsalmeterol0.05MG/ACTUATDryPowderInhaler[Serevent]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2045959-Doptelet40MGDailyDoseCartonPack|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2045638-1MLerenumab-aooe70MG/MLAuto-Injector[Aimovig]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|864010-ammoniumlactate120MG/MLTopicalLotion[Geri-Hydrolac]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2003767-1.14MLsarilumab175MG/MLAuto-Injector[Kevzara]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2003757-1.14MLsarilumab132MG/MLAuto-Injector[Kevzara]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|863841-amylase60000UNT/lipase12000UNT/protease38000UNTDelayedReleaseOralCapsule[Creon]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2001321-Roflumilast0.25MGOralTablet[Daliresp]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|2000013-1.1MLhydroxyprogesteronecaproate(USP)250MG/MLAuto-Injector[Makena]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|863836-amylase30000UNT/lipase6000UNT/protease19000UNTDelayedReleaseOralCapsule[Creon]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1999389-symdeko100MG/150MGand150MGPack|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1990869-0.85MLexenatide2.35MG/MLAuto-Injector[Bydureon]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|863829-amylase120000UNT/lipase24000UNT/protease76000UNTDelayedReleaseOralCapsule[Creon]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1989109-1MLbenralizumab30MG/MLPrefilledSyringe[Fasenra]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1989085-bosentan32MGTabletforOralSuspension[Tracleer]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|861834-amylase82000UNT/lipase15000UNT/protease51000UNTDelayedReleaseOralCapsule[Zenpep]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1946522-4-Month1.5MLLeuprolideAcetate20MG/MLPrefilledSyringe[Lupron]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1946520-3-Month1.5MLLeuprolideAcetate20MG/MLPrefilledSyringe[Lupron]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|856467-Tri-Lo-Sprintec28DayPack|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1945048-30ACTUATfluticasonefuroate0.1MG/ACTUAT/umeclidinium0.0625MG/ACTUAT/vilanterol0.025MG/ACTUATDryPowderInhaler[Trelegy]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1927290-infliximab-abda100MGInjection[Renflexis]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|855871-Phenytoinsodium30MGExtendedReleaseOralCapsule[Dilantin]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1925257-0.7MLabatacept125MG/MLPrefilledSyringe[Orencia]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1925255-0.4MLabatacept125MG/MLPrefilledSyringe[Orencia]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|855205-docosanol100MG/MLTopicalCream[Abreva]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1923347-1.14MLsarilumab175MG/MLPrefilledSyringe[Kevzara]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1923338-1.14MLsarilumab132MG/MLPrefilledSyringe[Kevzara]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|854921-BisoprololFumarate5MG/Hydrochlorothiazide6.25MGOralTablet[Ziac]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1921468-HumiraPen80MG/0.8MLand40MG/0.4ML-Psoriasis/UveitisStarterPackage(3count)|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1921245-HumiraPen80MG/0.8ML-StarterPackageforCrohn'sDisease,UlcerativeColitisorHidradenitisSuppurativa(3count)|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|854918-BisoprololFumarate2.5MG/Hydrochlorothiazide6.25MGOralTablet[Ziac]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1921240-0.8MLadalimumab100MG/MLAuto-Injector[Humira]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1921081-1.56MLabaloparatide2MG/MLPenInjector[Tymlos]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|854910-BisoprololFumarate10MG/Hydrochlorothiazide6.25MGOralTablet[Ziac]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1921017-0.2MLadalimumab100MG/MLPrefilledSyringe[Humira]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1921010-0.1MLadalimumab100MG/MLPrefilledSyringe[Humira]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|845305-Nonoxynol-90.04MG/MGVaginalGel[Conceptrol]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1876609-naldemedine0.2MGOralTablet[Symproic]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1873765-plecanatide3MGOralTablet[Trulance]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|836368-200ACTUATIpratropiumBromide0.017MG/ACTUATMeteredDoseInhaler[Atrovent]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1873704-Mibelas24FeChewable28DayPack|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1873087-HumiraPrefilledSyringe80MG/0.8MLStarterPack-PediatricCrohn'sDisease(3count)|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|830470-1MLrabiesvirusvaccinewistarstrainPM-1503-3M(Human),Inactivated2.5UNT/MLInjection[Imovax]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1872980-0.4MLadalimumab100MG/MLAuto-Injector[Humira]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1871469-lisdexamfetaminedimesylate50MGChewableTablet[Vyvanse]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|830463-1MLrabiesvirusvaccineflury-lepstrain2.5UNT/MLInjection[RabAvert]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1871467-lisdexamfetaminedimesylate60MGChewableTablet[Vyvanse]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1871465-lisdexamfetaminedimesylate10MGChewableTablet[Vyvanse]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|827713-MineralOil0.03MG/MG/Petrolatum0.94MG/MGOphthalmicOintment[SystaneNighttime]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1871463-lisdexamfetaminedimesylate20MGChewableTablet[Vyvanse]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1871461-lisdexamfetaminedimesylate30MGChewableTablet[Vyvanse]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|808118-prednisolone5MGOralTablet[MILLIPRED]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1871459-lisdexamfetaminedimesylate40MGChewableTablet[Vyvanse]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1870968-deflazacort22.75MG/MLOralSuspension[Emflaza]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|797023-DexPakTaperPak13DayPack|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1870960-deflazacort36MGOralTablet[Emflaza]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1870956-deflazacort18MGOralTablet[Emflaza]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|762663-Jolessa91DayPack|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1870952-deflazacort30MGOralTablet[Emflaza]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1870950-deflazacort6MGOralTablet[Emflaza]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|762334-Velivet28DayPack|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1868020-pirfenidone801MGOralTablet[Esbriet]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1868016-pirfenidone267MGOralTablet[Esbriet]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|762007-Nortrel7/7/728DayPack|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1858833-12HRTreprostinil5MGExtendedReleaseOralTablet[Orenitram]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1855527-HumiraPediatricCrohn'sDiseaseStarterPackage(2count)|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|762001-Kariva28DayPack|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1813112-Rajani28DayPack|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1812470-ivacaftor125MG/lumacaftor100MGOralTablet[ORKAMBI]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|759473-20ACTUATZanamivir5MG/ACTUATDryPowderInhaler[Relenza]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1811182-icosapentethyl500MGOralCapsule[Vascepa]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1806942-carfilzomib60MGInjection[Kyprolis]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|759469-Quasense91DayPack|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1801519-Methylnaltrexonebromide150MGOralTablet[Relistor]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1801322-3.5MLevolocumab120MG/MLCartridge[Repatha]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|754766-Metronidazole0.0075MG/MGVaginalGel[MetroGel]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1801278-HumiraPsoriasisStarterPack40MG/0.8MLPen(4count)|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1799230-1MLabatacept125MG/MLAuto-Injector[Orencia]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|753543-Reclipsen28DayPack|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1796096-24HRLinagliptin5MG/Metforminhydrochloride1000MGExtendedReleaseOralTablet[Jentadueto]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1796091-24HRLinagliptin2.5MG/Metforminhydrochloride1000MGExtendedReleaseOralTablet[Jentadueto]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|753482-Apri28DayPack|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1790546-infliximab-dyyb100MGInjection[Inflectra]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1747194-0.4MLMethotrexate56.3MG/MLAuto-Injector[Otrexup]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|751890-Portia28DayPack|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1747187-0.4MLMethotrexate43.8MG/MLAuto-Injector[Otrexup]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1747181-0.4MLMethotrexate31.3MG/MLAuto-Injector[Otrexup]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|751884-Lutera28DayPack|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1746898-10MLreslizumab10MG/MLInjection[Cinqair]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1745114-1MLixekizumab80MG/MLPrefilledSyringe[Taltz]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|751875-Necon0.5/3528DayPack|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1745108-1MLixekizumab80MG/MLAuto-Injector[Taltz]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1741049-24HRtofacitinib11MGExtendedReleaseOralTablet[Xeljanz]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|751871-Nortrel1/3521DayPack|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1734642-elbasvir50MG/grazoprevir100MGOralTablet[Zepatier]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1732165-incobotulinumtoxinA200UNTInjection[Xeomin]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|751870-Nortrel1/3528DayPack|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1732161-incobotulinumtoxinA100UNTInjection[Xeomin]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1732157-incobotulinumtoxinA50UNTInjection[Xeomin]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|750839-erythromycinstearate250MGOralTablet[ErythrocinStearate]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1729076-UptraviTitrationPack|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1729065-selexipag0.8MGOralTablet[Uptravi]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|750264-Necon7/7/728DayPack|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1729061-selexipag0.6MGOralTablet[Uptravi]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1729057-selexipag0.4MGOralTablet[Uptravi]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|750244-Low-Ogestrel28DayPack|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1729053-selexipag0.2MGOralTablet[Uptravi]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1729047-selexipag1.6MGOralTablet[Uptravi]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|750243-Ogestrel28DayPack|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1729033-selexipag1.4MGOralTablet[Uptravi]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1729029-selexipag1.2MGOralTablet[Uptravi]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|749151-Tri-Norinyl28DayPack|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1729013-selexipag1MGOralTablet[Uptravi]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1728099-romiplostim0.5MGInjection[Nplate]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|748865-Trivora28DayPack|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1728095-romiplostim0.25MGInjection[Nplate]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1726846-0.4MLadalimumab100MG/MLPrefilledSyringe[Humira]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|748859-Zovia1/35E28DayPack|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1726639-ponatinib30MGOralTablet[Iclusig]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1721690-1MLEpoetinAlfa10000UNT/MLInjection[Procrit]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|707333-SodiumChloride0.111MEQ/MLNasalSolution[AyrSalineNasal]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1721685-1MLEpoetinAlfa10000UNT/MLInjection[Epogen]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1720606-mepolizumab100MGInjection[Nucala]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|705008-Cefixime40MG/MLOralSuspension[Suprax]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1666334-Ticagrelor60MGOralTablet[Brilinta]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1665906-1MLevolocumab140MG/MLPrefilledSyringe[Repatha]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|692694-thyroid(USP)65MGOralTablet[Westhroid]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1665900-1MLevolocumab140MG/MLAuto-Injector[Repatha]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1663728-Isotretinoin30MGOralCapsule[Myorisan]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|688242-Estrogens,Conjugated(USP)0.625MG/MLVaginalCream[Premarin]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1661567-TOBIPodhalerDailyKit,8|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1660938-60ACTUATformoterolfumarate0.005MG/ACTUAT/mometasonefuroate0.2MG/ACTUATMeteredDoseInhaler[Dulera]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|644304-Tamoxifen2MG/MLOralSolution[Soltamox]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1660934-60ACTUATformoterolfumarate0.005MG/ACTUAT/mometasonefuroate0.1MG/ACTUATMeteredDoseInhaler[Dulera]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1657982-20MLtocilizumab20MG/MLInjection[Actemra]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|630475-SodiumFluoride5.56MG/MLOralSolution[FluoraDay]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1657980-10MLtocilizumab20MG/MLInjection[Actemra]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1657976-4MLtocilizumab20MG/MLInjection[Actemra]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|617333-Amoxicillin25MG/ML/Clavulanate6.25MG/MLOralSuspension[Augmentin]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1657212-omalizumab150MGInjection[Xolair]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1655934-ivacaftor125MG/lumacaftor200MGOralTablet[ORKAMBI]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|616450-MycophenolicAcid180MGDelayedReleaseOralTablet[Myfortic]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1654955-1MLdarbepoetinalfa0.2MG/MLInjection[Aranesp]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1654630-1MLglatirameracetate20MG/MLPrefilledSyringe[Glatopa]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|616449-MycophenolicAcid360MGDelayedReleaseOralTablet[Myfortic]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1654079-0.5MLustekinumab90MG/MLInjection[Stelara]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1653243-1MLsecukinumab150MG/MLAuto-Injector[Cosentyx]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|616444-mycophenolatemofetil200MG/MLOralSuspension[Cellcept]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1653225-1MLEtanercept50MG/MLAuto-Injector[Enbrel]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1653166-1MLgolimumab100MG/MLAuto-Injector[Simponi]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|544597-PotassiumIodide1000MG/MLOralSolution[SSKIbrandofPotassiumIodide]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1653144-0.5MLgolimumab100MG/MLAuto-Injector[Simponi]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1650901-0.5MLInterferonbeta-1a0.06MG/MLAuto-Injector[Avonex]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|542059-Didanosine10MG/MLOralSolution[Videx]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1650282-RebifRebidoseTitrationPack|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1650004-0.5MLInterferonbeta-1a0.088MG/MLAuto-Injector[Rebif]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|404550-Estrogens,Conjugated(USP)0.45MGOralTablet[Premarin]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1649996-0.5MLInterferonbeta-1a0.044MG/MLAuto-Injector[Rebif]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1649605-PlegridyPenStarterPack|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|404509-CalciumCarbonate1000MG/Simethicone60MGChewableTablet[MaaloxMaxQuickDissolve]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1649593-0.5MLpeginterferonbeta-1a0.25MG/MLAuto-Injector[Plegridy]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1649495-ivabradine7.5MGOralTablet[Corlanor]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|404492-5MLLaronidase0.58MG/MLInjection[Aldurazyme]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1649491-ivabradine5MGOralTablet[Corlanor]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1648789-30ACTUATfluticasonefuroate0.2MG/ACTUAT/vilanterol0.025MG/ACTUATDryPowderInhaler[Breo]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|404476-Azathioprine100MGOralTablet[Azasan]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1606870-ivacaftor75MGOralGranules[Kalydeco]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1606866-ivacaftor50MGOralGranules[Kalydeco]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|404475-Azathioprine75MGOralTablet[Azasan]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1605455-Otezla28-DayStarterPack|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1605172-0.4MLdarbepoetinalfa0.025MG/MLPrefilledSyringe[Aranesp]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|352210-Mesna400MGOralTablet[Mesnex]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1605075-0.8MLFILGRASTIM-SNDZ0.6MG/MLPrefilledSyringe[Zarxio]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1605071-0.5MLFILGRASTIM-SNDZ0.6MG/MLPrefilledSyringe[Zarxio]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|351901-Sirolimus1MG/MLOralSolution[Rapamune]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1601373-naloxegol25MGOralTablet[Movantik]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1599797-1MLsecukinumab150MG/MLPrefilledSyringe[Cosentyx]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|351750-podofilox0.005MG/MGTopicalGel[Condylox]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1596778-14ACTUATBudesonide2MG/ACTUATRectalFoam[Uceris]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1596023-ferriccitrate1000MGOralTablet[Auryxia]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|351487-thyroid(USP)130MGOralTablet[Westhroid]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1594358-HumiraPediatricCrohn'sDiseaseStarterPackage(3count)|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1593858-lisdexamfetaminedimesylate10MGOralCapsule[Vyvanse]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|312020-Nitroglycerin9MGExtendedReleaseOralCapsule|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1593835-24HRdapagliflozin10MG/Metforminhydrochloride500MGExtendedReleaseOralTablet[Xigduo]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1593833-24HRdapagliflozin5MG/Metforminhydrochloride1000MGExtendedReleaseOralTablet[Xigduo]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|312018-Nitroglycerin6.5MGExtendedReleaseOralCapsule|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1593831-24HRdapagliflozin5MG/Metforminhydrochloride500MGExtendedReleaseOralTablet[Xigduo]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1593775-24HRdapagliflozin10MG/Metforminhydrochloride1000MGExtendedReleaseOralTablet[Xigduo]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|284551-nilutamide150MGOralTablet[Nilandron]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1592752-nintedanib150MGOralCapsule[Ofev]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1592748-nintedanib100MGOralCapsule[Ofev]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|261353-Trimethoprim10MG/MLOralSolution[Primsol]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1592285-pirfenidone267MGOralCapsule[Esbriet]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1551923-naloxegol12.5MGOralTablet[Movantik]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|260409-prednisolone1MG/MLOralSolution[Pediapred]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1551888-0.2MLadalimumab50MG/MLPrefilledSyringe[Humira]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1551886-lanthanumcarbonate750MGOralPowder[Fosrenol]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|2564406-influenzaAvirusA/Tasmania/503/2020(H3N2)antigen158000000UNT/ML/influenzaAvirusA/Victoria/1/2020(H1N1)antigen158000000|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1546198-PlegridyStarterPack|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1546189-0.5MLpeginterferonbeta-1a0.25MG/MLPrefilledSyringe[Plegridy]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|2564038-influenzaAvirusA/Cambodia/e0826360/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.03MG/|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1545174-hydrocortisoneacetate100MG/MLRectalFoam[Cortifoam]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1544918-0.65MLexenatide3.08MG/MLPenInjector[Bydureon]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|2564021-0.5MLinfluenzaAvirusA/Cambodia/e0826360/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1544404-0.15MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1544402-0.6MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|2563039-0.5MLinfluenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.03MG/|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1544398-0.5MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1544396-0.45MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|2563032-0.5MLinfluenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.03MG/|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1544394-0.4MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1544390-0.35MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|2563031-influenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.03MG/ML/in|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1544388-0.3MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1544386-0.25MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|2563020-influenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Washington/19/2020(H1N1)antigen0.03MG/ML/in|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1544383-0.2MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1541928-sunitinib37.5MGOralCapsule[Sutent]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|2563004-0.7MLinfluenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.0857MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.085|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1539893-30ACTUATfluticasonefuroate0.1MG/ACTUAT/vilanterol0.025MG/ACTUATDryPowderInhaler[Breo]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|153324-Interferonbeta-1a0.03MGInjection[Avonex]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|2563002-0.5MLinfluenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.09MG/ML/influenzaAvirusA/Wisconsin/588/2019(H1N1)antigen0.09MG/|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1492746-apremilast30MGOralTablet[Otezla]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1488679-12HRTreprostinil2.5MGExtendedReleaseOralTablet[Orenitram]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|2562996-0.5MLinfluenzaAvirusA/Cambodia/e0826360/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1488675-12HRTreprostinil1MGExtendedReleaseOralTablet[Orenitram]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1488671-12HRTreprostinil0.25MGExtendedReleaseOralTablet[Orenitram]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|2562995-0.5MLinfluenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Washington/19/2020(H1N1)antigen0.03MG/|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1488667-12HRTreprostinil0.125MGExtendedReleaseOralTablet[Orenitram]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1487076-DiclofenacSodium20MG/MLTopicalSolution[Pennsaid]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|2561275-0.5MLinfluenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.03MG/|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1486981-dapagliflozin5MGOralTablet[Farxiga]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1486977-dapagliflozin10MGOralTablet[Farxiga]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|2561270-0.5MLinfluenzaAvirusA/Tasmania/503/2020(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.03MG/|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1484296-sucroferricoxyhydroxide500MGChewableTablet[Velphoro]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1482814-1MLgolimumab100MG/MLPrefilledSyringe[Simponi]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|2178792-0.3MLEpinephrine0.5MG/MLPrefilledSyringe[Symjepi]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1482513-eslicarbazepineacetate200MGOralTablet[Aptiom]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1442143-Macitentan10MGOralTablet[Opsumit]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|2173508-Nonoxynol-91000MGVaginalSponge[TodaySponge]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1441530-0.9MLtocilizumab180MG/MLPrefilledSyringe[Actemra]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1441424-0.4MLMethotrexate62.5MG/MLAuto-Injector[Otrexup]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|213621-Bacitracin0.5UNT/MG/PolymyxinB10UNT/MGOphthalmicOintment[Polycin]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1441418-0.4MLMethotrexate50MG/MLAuto-Injector[Otrexup]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1441413-0.4MLMethotrexate37.5MG/MLAuto-Injector[Otrexup]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|213510-Auranofin3MGOralCapsule[Ridaura]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1441407-0.4MLMethotrexate25MG/MLAuto-Injector[Otrexup]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1439903-riociguat2.5MGOralTablet[Adempas]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|213291-ParoxetineHydrochloride2MG/MLOralSuspension[Paxil]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1439901-riociguat2MGOralTablet[Adempas]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1439899-riociguat1.5MGOralTablet[Adempas]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|213284-hydroxyurea400MGOralCapsule[Droxia]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1439896-riociguat1MGOralTablet[Adempas]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1439894-riociguat0.5MGOralTablet[Adempas]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|213283-hydroxyurea300MGOralCapsule[Droxia]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1431647-4MLgolimumab12.5MG/MLInjection[Simponi]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1429367-lenalidomide20MGOralCapsule[Revlimid]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|213282-hydroxyurea200MGOralCapsule[Droxia]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1429284-NeostigmineMethylsulfate1MG/MLInjectableSolution[Bloxiverz]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1429282-NeostigmineMethylsulfate0.5MG/MLInjectableSolution[Bloxiverz]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|212373-Estrogens,Esterified(USP)1.25MGOralTablet[Menest]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1375922-bromfenac0.7MG/MLOphthalmicSolution[Prolensa]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1374574-TOBIPodhalerKit,224|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|212232-Estrogens,Esterified(USP)0.625MGOralTablet[Menest]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1373337-Isotretinoin40MGOralCapsule[Zenatane]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1373335-Isotretinoin20MGOralCapsule[Zenatane]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|212039-Estrogens,Esterified(USP)0.3MGOralTablet[Menest]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1373333-Isotretinoin10MGOralCapsule[Zenatane]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1365866-nepafenac3MG/MLOphthalmicSuspension[Ilevro]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|211633-AluminumHydroxide200MG/MagnesiumHydroxide200MG/Simethicone25MGChewableTablet[Gelusil]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1364515-Bedaquiline100MGOralTablet[Sirturo]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1364477-teduglutide5MGInjection[Gattex]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|2110516-60ACTUATFluticasonepropionate0.5MG/ACTUAT/salmeterol0.05MG/ACTUATDryPowderInhaler[Wixela]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1364362-ponatinib45MGOralTablet[Iclusig]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1364358-ponatinib15MGOralTablet[Iclusig]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|2110513-60ACTUATFluticasonepropionate0.25MG/ACTUAT/salmeterol0.05MG/ACTUATDryPowderInhaler[Wixela]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1357547-tofacitinib5MGOralTablet[Xeljanz]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1313061-24HRPhentermine11.25MG/topiramate69MGExtendedReleaseOralCapsule[Qsymia]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|2110510-60ACTUATFluticasonepropionate0.1MG/ACTUAT/salmeterol0.05MG/ACTUATDryPowderInhaler[Wixela]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1310535-teriflunomide7MGOralTablet[Aubagio]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1310531-teriflunomide14MGOralTablet[Aubagio]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|210000-AluminumHydroxide80MG/ML/MagnesiumHydroxide80MG/ML/Simethicone8MG/MLOralSuspension[Almacone]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1310147-everolimus5MGTabletforOralSuspension[Afinitor]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1310144-everolimus3MGTabletforOralSuspension[Afinitor]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|209531-Acetaminophen80MGRectalSuppository[Feverall]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1310138-everolimus2MGTabletforOralSuspension[Afinitor]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1307635-bosutinib500MGOralTablet[Bosulif]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|209360-Acetaminophen325MGRectalSuppository[Acephen]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1307630-bosutinib100MGOralTablet[Bosulif]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1302856-24HRPhentermine15MG/topiramate92MGExtendedReleaseOralCapsule[Qsymia]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|209002-prednisolone1.2MG/MLOphthalmicSuspension[PredMild]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1302845-24HRPhentermine3.75MG/topiramate23MGExtendedReleaseOralCapsule[Qsymia]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1302833-24HRPhentermine7.5MG/topiramate46MGExtendedReleaseOralCapsule[Qsymia]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|208949-Estrogens,Conjugated(USP)0.9MGOralTablet[Premarin]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1300803-24HRmirabegron50MGExtendedReleaseOralTablet[Myrbetriq]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1300797-24HRmirabegron25MGExtendedReleaseOralTablet[Myrbetriq]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|208551-thyroid(USP)300MGOralTablet[ArmourThyroid]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1291092-hydrocortisoneacetate30MGRectalSuppository[Proctocort]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1245003-eltrombopag12.5MGOralTablet[Promacta]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|208549-thyroid(USP)240MGOralTablet[ArmourThyroid]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1244632-AmethiaLo91DayPack|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1244064-0.4MLMethylnaltrexonebromide20MG/MLPrefilledSyringe[Relistor]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|208547-thyroid(USP)180MGOralTablet[ArmourThyroid]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1244062-0.6MLMethylnaltrexonebromide20MG/MLPrefilledSyringe[Relistor]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1243848-24HRMetforminhydrochloride500MG/sitagliptin50MGExtendedReleaseOralTablet[Janumet]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|208513-Estrogens,Conjugated(USP)0.3MGOralTablet[Premarin]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1243843-24HRMetforminhydrochloride1000MG/sitagliptin50MGExtendedReleaseOralTablet[Janumet]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1243833-24HRMetforminhydrochloride1000MG/sitagliptin100MGExtendedReleaseOralTablet[Janumet]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|207949-Succimer100MGOralCapsule[Chemet]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1243052-ivacaftor150MGOralTablet[Kalydeco]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1243040-Linagliptin2.5MG/Metforminhydrochloride850MGOralTablet[Jentadueto]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|207864-crotamiton100MG/MLTopicalCream[Eurax]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1243033-Linagliptin2.5MG/Metforminhydrochloride500MGOralTablet[Jentadueto]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1243026-Linagliptin2.5MG/Metforminhydrochloride1000MGOralTablet[Jentadueto]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|207588-Procarbazine50MGOralCapsule[Matulane]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1242968-exenatide2MGInjection[Bydureon]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1242615-Isotretinoin40MGOralCapsule[Myorisan]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|207478-Primidone50MGOralTablet[Mysoline]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1242613-Isotretinoin20MGOralCapsule[Myorisan]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1242611-Isotretinoin10MGOralCapsule[Myorisan]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|207373-Mitotane500MGOralTablet[Lysodren]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1242233-lenalidomide2.5MGOralCapsule[Revlimid]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1235267-CamreseLo91DayPack|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|207273-Nitroglycerin0.02MG/MGTopicalOintment[Nitro-Bid]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1235157-azilsartanmedoxomil40MG/Chlorthalidone25MGOralTablet[Edarbyclor]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1235150-azilsartanmedoxomil40MG/Chlorthalidone12.5MGOralTablet[Edarbyclor]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|207136-Methylprednisolone2MGOralTablet[Medrol]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1232204-Zolpidemtartrate3.5MGSublingualTablet[Intermezzo]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1232200-Zolpidemtartrate1.75MGSublingualTablet[Intermezzo]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|206978-Ketoconazole20MG/MLMedicatedShampoo[Nizoral]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1232190-asparaginaseErwiniachrysanthemi10000UNTInjection[Erwinaze]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1191128-EdrophoniumChloride10MG/MLInjectableSolution[Enlon]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|206961-Nadolol20MGOralTablet[Corgard]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1149667-Camrese91DayPack|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1149617-COLLAGENASE0.25UNT/MGTopicalOintment[Santyl]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|206314-Hydrocortisone0.01MG/MGTopicalOintment[Cortizone]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1148506-crizotinib250MGOralCapsule[Xalkori]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1148502-crizotinib200MGOralCapsule[Xalkori]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|206216-2MLIron-DextranComplex50MG/MLInjection[InFed]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1145932-1MLabatacept125MG/MLPrefilledSyringe[Orencia]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1116639-Ticagrelor90MGOralTablet[Brilinta]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|206208-aluminumchloride200MG/MLTopicalSolution[Drysol]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1115473-1.5MLLeuprolideAcetate7.5MG/MLPrefilledSyringe[Lupron]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1115468-1.5MLLeuprolideAcetate15MG/MLPrefilledSyringe[Lupron]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|205669-Dexamethasone1MG/MLOphthalmicSuspension[Maxidex]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1115464-1MLLeuprolideAcetate7.5MG/MLPrefilledSyringe[Lupron]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1115459-1MLLeuprolideAcetate3.75MG/MLPrefilledSyringe[Lupron]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|205562-Estramustine140MGOralCapsule[Emcyt]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1115456-1MLLeuprolideAcetate15MG/MLPrefilledSyringe[Lupron]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1115449-1MLLeuprolideAcetate11.25MG/MLPrefilledSyringe[Lupron]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|2045958-avatrombopag20MGOralTablet[Doptelet]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1115259-1.5MLLeuprolideAcetate30MG/MLPrefilledSyringe[Lupron]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1114096-Vandetanib300MGOralTablet[Caprelsa]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|202301-Estrogens,Conjugated(USP)1.25MGOralTablet[Premarin]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1114074-Vandetanib100MGOralTablet[Caprelsa]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1112687-Amethia91DayPack|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|201747-Primidone250MGOralTablet[Mysoline]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1100706-Linagliptin5MGOralTablet[Tradjenta]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1091843-Roflumilast0.5MGOralTablet[Daliresp]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|201338-Nadolol80MGOralTablet[Corgard]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1091654-azilsartanmedoxomil80MGOralTablet[Edarbi]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1091650-azilsartanmedoxomil40MGOralTablet[Edarbi]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|201337-Nadolol40MGOralTablet[Corgard]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1046402-1.7MLdenosumab70MG/MLInjection[Xgeva]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1045408-dasatinib80MGOralTablet[Sprycel]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1998774-Breath-Actuated120ACTUATBeclomethasoneDipropionate0.04MG/ACTUATMeteredDoseInhaler[Qvar]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1045404-dasatinib140MGOralTablet[Sprycel]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1043582-24HRMetforminhydrochloride500MG/saxagliptin5MGExtendedReleaseOralTablet[Kombiglyze]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1998772-Breath-Actuated120ACTUATBeclomethasoneDipropionate0.08MG/ACTUATMeteredDoseInhaler[Qvar]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1043574-24HRMetforminhydrochloride1000MG/saxagliptin5MGExtendedReleaseOralTablet[Kombiglyze]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1043567-24HRMetforminhydrochloride1000MG/saxagliptin2.5MGExtendedReleaseOralTablet[Kombiglyze]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1995479-amylase168000UNT/lipase40000UNT/protease126000UNTDelayedReleaseOralCapsule[Zenpep]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1040058-DextromethorphanHydrobromide20MG/QuinidineSulfate10MGOralCapsule[Nuedexta]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1037185-LoLoestrinFe28DayPack|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1989117-0.3MLEpinephrine1MG/MLPrefilledSyringe[Symjepi]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1012899-fingolimod0.5MGOralCapsule[Gilenya]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1011755-aliskiren300MG/Hydrochlorothiazide25MGOralTablet[TekturnaHCT]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|198467-Aspirin325MGDelayedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1011752-aliskiren300MG/Hydrochlorothiazide12.5MGOralTablet[TekturnaHCT]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1011715-aliskiren150MG/Hydrochlorothiazide25MGOralTablet[TekturnaHCT]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1797880-Nafarelin0.2MG/ACTUATMeteredDoseNasalSpray[Synarel]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1011712-aliskiren150MG/Hydrochlorothiazide12.5MGOralTablet[TekturnaHCT]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1002300-nilotinib150MGOralCapsule[Tasigna]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1667916-5MLIsoproterenolHydrochloride0.2MG/MLInjection[Isuprel]|SPD PARTIAL DUALS 632|2002|Y|N|N||Preferred Brand|1000089-alcaftadine2.5MG/MLOphthalmicSolution[Lastacaft]|SPD PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|998679-168HRClonidine0.0125MG/HRTransdermalSystem|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1595478-amylase84000UNT/lipase20000UNT/protease63000UNTDelayedReleaseOralCapsule[Zenpep]|SPD PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|998675-168HRClonidine0.00833MG/HRTransdermalSystem|SPD PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|998671-168HRClonidine0.00417MG/HRTransdermalSystem|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1595473-amylase63000UNT/lipase15000UNT/protease47000UNTDelayedReleaseOralCapsule[Zenpep]|SPD PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|860654-epinastinehydrochloride0.5MG/MLOphthalmicSolution|SPD PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|856569-24HRPropranololHydrochloride80MGExtendedReleaseOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1595462-amylase42000UNT/lipase10000UNT/protease32000UNTDelayedReleaseOralCapsule[Zenpep]|SPD PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|856535-24HRPropranololHydrochloride60MGExtendedReleaseOralCapsule|SPD PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|856481-24HRPropranololHydrochloride160MGExtendedReleaseOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1595457-amylase24000UNT/lipase5000UNT/protease17000UNTDelayedReleaseOralCapsule[Zenpep]|SPD PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|856460-24HRPropranololHydrochloride120MGExtendedReleaseOralCapsule|SPD PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|854868-Rabeprazolesodium20MGDelayedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1595292-amylase14000UNT/lipase3000UNT/protease10000UNTDelayedReleaseOralCapsule[Zenpep]|SPD PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|798133-Erythromycin20MG/MLMedicatedPad[Ery]|SPD PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|797274-Clindamycin10MG/MLMedicatedPad|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1594673-amylase105000UNT/lipase25000UNT/protease79000UNTDelayedReleaseOralCapsule[Zenpep]|SPD PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|606726-Esomeprazole20MGDelayedReleaseOralCapsule|SPD PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|577127-pregabalin225MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1536586-168HREthinylEstradiol0.00146MG/HR/norelgestromin0.00625MG/HRTransdermalSystem[Xulane]|SPD PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|483450-pregabalin75MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|483448-pregabalin50MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|153473-Altretamine50MGOralCapsule[Hexalen]|SPD PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|483446-pregabalin200MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|483444-pregabalin300MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|153183-adapalene0.001MG/MGTopicalGel[Differin]|SPD PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|483442-pregabalin25MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|483440-pregabalin150MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|152854-Itraconazole10MG/MLOralSolution[Sporanox]|SPD PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|483438-pregabalin100MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|351134-zolmitriptan5MGDisintegratingOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|150840-Estrogens,Conjugated(USP)0.625MGOralTablet[Premarin]|SPD PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|314266-Tacrolimus0.001MG/MGTopicalOintment|SPD PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|314227-Sumatriptan20MG/ACTUATNasalSpray|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1440936-Hydrocortisone25MG/MLTopicalCream[ProctozoneHC]|SPD PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|313189-Tacrolimus0.0003MG/MGTopicalOintment|SPD PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|313159-Sumatriptan5MG/ACTUATNasalSpray|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1426881-Levonorgestrel1.5MGOralTablet[MyWay]|SPD PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|311671-Metolazone5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|309333-Clindamycin10MG/MLTopicalSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1422081-Enskyce28DayPack|SPD PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|309332-Clindamycin0.01MG/MGTopicalGel|SPD PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|284201-zolmitriptan2.5MGDisintegratingOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1373327-amylase180000UNT/lipase36000UNT/protease114000UNTDelayedReleaseOralCapsule[Creon]|SPD PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|244374-BenzoylPeroxide0.05MG/MG/Erythromycin0.03MG/MGTopicalGel|SPD PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|200194-zolmitriptan5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1359135-Tri-LegestFe28DayPack|SPD PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|200193-zolmitriptan2.5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|2001568-BXRating24HRMethylphenidateHydrochloride54MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1359134-TiliaFe28DayPack|SPD PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|2001566-BXRating24HRMethylphenidateHydrochloride36MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|2001565-BXRating24HRMethylphenidateHydrochloride27MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1359032-Microgestin1.5/3021DayPack|SPD PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|2001564-BXRating24HRMethylphenidateHydrochloride18MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|197979-Metolazone2.5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1359030-Junel1.5/3021DayPack|SPD PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|197978-Metolazone10MGOralTablet|SPD PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|197519-Clindamycin10MG/MLTopicalLotion|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1359027-MicrogestinFe1.5/3028DayPack|SPD PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|1806195-50/50Release24HRMethylphenidateHydrochloride10MGExtendedReleaseOralCapsule|SPD PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|1806185-50/50Release24HRMethylphenidateHydrochloride60MGExtendedReleaseOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1359025-JunelFe28DayPack|SPD PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|1797865-mometasonefuroate0.05MG/ACTUATMeteredDoseNasalSpray|SPD PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|1111343-olopatadine2MG/MLOphthalmicSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1359020-Microgestin1/2021DayPack|SPD PARTIAL DUALS 632|2002|N|Y|Y||Preferred Generic|1111339-olopatadine1MG/MLOphthalmicSolution|SPD PARTIAL DUALS 632|2002|N|Y|Y||Preferred Brand|2200658-semaglutide7MGOralTablet[Rybelsus]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1358780-Junel1/2021DayPack|SPD PARTIAL DUALS 632|2002|N|Y|Y||Preferred Brand|2200654-semaglutide3MGOralTablet[Rybelsus]|SPD PARTIAL DUALS 632|2002|N|Y|Y||Preferred Brand|2200650-semaglutide14MGOralTablet[Rybelsus]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1358775-MicrogestinFe1/2028DayPack|SPD PARTIAL DUALS 632|2002|N|Y|Y||Preferred Brand|1716223-patiromer25200MGPowderforOralSuspension[Veltassa]|SPD PARTIAL DUALS 632|2002|N|Y|Y||Preferred Brand|1716219-patiromer16800MGPowderforOralSuspension[Veltassa]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1358765-JunelFe1/2028DayPack|SPD PARTIAL DUALS 632|2002|N|Y|Y||Preferred Brand|1716215-patiromer8400MGPowderforOralSuspension[Veltassa]|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|997406-12HRFexofenadinehydrochloride60MG/PseudoephedrineHydrochloride120MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1293864-ErgotamineTartrate2MGSublingualTablet[Ergomar]|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|996615-24HRMemantinehydrochloride7MGExtendedReleaseOralCapsule|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|996609-24HRMemantinehydrochloride28MGExtendedReleaseOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1293639-Caffeine100MG/ErgotamineTartrate2MGRectalSuppository[Migergot]|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|996603-24HRMemantinehydrochloride21MGExtendedReleaseOralCapsule|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|996594-24HRMemantinehydrochloride14MGExtendedReleaseOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1250090-Nonoxynol-90.03MG/MGVaginalGel[GynolII]|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|857564-24HRtrospiumchloride60MGExtendedReleaseOralCapsule|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|857560-trospiumchloride20MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1233850-Vestura28DayPack|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|855194-tolterodinetartrate2MGOralTablet|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|855189-24HRtolterodinetartrate4MGExtendedReleaseOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1190225-120ACTUATAlbuterol0.1MG/ACTUAT/IpratropiumBromide0.02MG/ACTUATInhalationSpray[Combivent]|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|855182-24HRtolterodinetartrate2MGExtendedReleaseOralCapsule|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|855178-tolterodinetartrate1MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1148646-28ACTUATFluticasonepropionate0.25MG/ACTUATDryPowderInhaler[Flovent]|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|825130-24HRmesalamine375MGExtendedReleaseOralCapsule|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|810090-Carbidopa18.75MG/entacapone200MG/Levodopa75MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1114135-amylase16000UNT/lipase3000UNT/protease10000UNTDelayedReleaseOralCapsule[Zenpep]|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|810083-Carbidopa31.25MG/entacapone200MG/Levodopa125MGOralTablet|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|749206-sevelamercarbonate800MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1114041-DextromethorphanHydrobromide1MG/MLOralSolution[DayQuilCough]|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|745791-200ACTUATLevalbuterol0.045MG/ACTUATMeteredDoseInhaler|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|730988-Carbidopa50MG/entacapone200MG/Levodopa200MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1113046-amylase15000UNT/lipase3000UNT/protease9500UNTDelayedReleaseOralCapsule[Creon]|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|686429-mesalamine1200MGDelayedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|606730-Esomeprazole40MGDelayedReleaseOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1112715-Amethyst28DayPack|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|562806-Pimecrolimus10MG/MLTopicalCream|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|403852-Carbidopa37.5MG/entacapone200MG/Levodopa150MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1101778-Monobasicpotassiumphosphate0.0408MEQ/MLOralSolution[K-Phos]|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|403851-Carbidopa25MG/entacapone200MG/Levodopa100MGOralTablet|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|403850-Carbidopa12.5MG/entacapone200MG/Levodopa50MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1099026-Loryna28DayPack|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|349590-Levalbuterol0.103MG/MLInhalationSolution|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|349556-ezetimibe10MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1098924-SodiumFluoride11MG/MLOralSolution[Flura-Drops]|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|317094-entacapone200MGOralTablet|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|313921-calcipotriene0.05MG/MLTopicalCream|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1095362-Balziva28DayPack|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|311787-moxifloxacin400MGOralTablet|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|311347-linezolid600MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1087012-thyroid(USP)32.5MGOralTablet[Westhroid]|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|311345-linezolid20MG/MLOralSuspension|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|311286-Levalbuterol0.21MG/MLInhalationSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|105590-Thioguanine40MGOralTablet[Tabloid]|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|310600-Griseofulvin500MGOralTablet|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|308865-calcipotriene0.05MG/MLTopicalSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|105553-Chlorambucil2MGOralTablet[Leukeran]|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|284008-travoprost0.04MG/MLOphthalmicSolution|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|242831-Griseofulvin125MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|105551-Busulfan2MGOralTablet[Myleran]|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|242754-Levalbuterol0.417MG/MLInhalationSolution|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|239239-Griseofulvin250MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1048452-ColestipolHydrochloride5000MGGranulesforOralSuspension[Colestid]|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|204119-Malathion5MG/MLTopicalLotion|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|198373-calcipotriene0.00005MG/MGTopicalOintment|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1046771-12HRHyoscyamineSulfate0.375MGExtendedReleaseOralTablet[Levbid]|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|197984-Minocycline100MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|197551-Cycloserine250MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1039273-Hydrocortisone10MG/MLTopicalSolution[ScalpicinItchRelief]|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|197508-Cimetidine800MGOralTablet|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|197507-Cimetidine400MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|102250-Hydrocortisone1.67MG/MLEnema[Cortenema]|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|197506-Cimetidine300MGOralTablet|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|197505-Cimetidine200MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1020155-Introvale91DayPack|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|197419-Bumetanide2MGOralTablet|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|197418-Bumetanide1MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1005928-ulipristalacetate30MGOralTablet[Ella]|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|197417-Bumetanide0.5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|1855389-Levalbuterol2.5MG/MLInhalationSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1000500-Prempro0.625/528DayPack|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|1797863-flunisolide0.025MG/ACTUATMeteredDoseNasalSpray|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|1368954-mesalamine400MGDelayedReleaseOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1000499-Prempro0.625/2.528DayPack|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|1368438-alogliptin25MG/pioglitazone45MGOralTablet|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|1368431-alogliptin25MG/pioglitazone30MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1000497-Prempro0.45/1.528DayPack|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|1368424-alogliptin25MG/pioglitazone15MGOralTablet|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|1368417-alogliptin12.5MG/pioglitazone45MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1000491-Prempro0.3/1.528DayPack|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|1368410-alogliptin12.5MG/pioglitazone30MGOralTablet|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|1368403-alogliptin12.5MG/pioglitazone15MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1000487-Premphase28DayPack|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|1368392-alogliptin12.5MG/Metforminhydrochloride500MGOralTablet|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|1368385-alogliptin12.5MG/Metforminhydrochloride1000MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Brand|1000158-0.65MLmedroxyprogesteroneacetate160MG/MLPrefilledSyringe[depo-subQprovera]|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|1368034-alogliptin12.5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|1368018-alogliptin6.25MGOralTablet|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|1368006-alogliptin25MGOralTablet|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|1246673-Ivermectin5MG/MLTopicalLotion|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Generic|1085816-spinosad9MG/MLMedicatedShampoo|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Brand|996633-NamendaXR28DayTitrationPack|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Brand|856666-rifaximin550MGOralTablet[XIFAXAN]|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Brand|835721-Ethionamide250MGOralTablet[Trecator]|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Brand|833151-Savella4-WeekTitrationPack|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Brand|833149-Milnacipranhydrochloride25MGOralTablet[Savella]|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Brand|833146-Milnacipranhydrochloride50MGOralTablet[Savella]|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Brand|833143-Milnacipranhydrochloride12.5MGOralTablet[Savella]|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Brand|833139-Milnacipranhydrochloride100MGOralTablet[Savella]|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Brand|539789-rifaximin200MGOralTablet[XIFAXAN]|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Brand|402092-Cyclosporine0.5MG/MLOphthalmicSuspension[Restasis]|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Brand|2398842-3MLsemaglutide1.34MG/MLPenInjector[Ozempic]|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Brand|2395785-0.5MLdulaglutide9MG/MLAuto-Injector[Trulicity]|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Brand|2395779-0.5MLdulaglutide6MG/MLAuto-Injector[Trulicity]|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Brand|213307-Ciprofloxacin0.003MG/MGOphthalmicOintment[Ciloxan]|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Brand|212381-aminosalicylicacid4000MGOralGranules[PaserD/R]|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Brand|1992821-ertugliflozin15MGOralTablet[Steglatro]|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Brand|1992816-ertugliflozin5MGOralTablet[Steglatro]|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Brand|1992703-ertugliflozin7.5MG/Metforminhydrochloride500MGOralTablet[Segluromet]|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Brand|1992700-ertugliflozin7.5MG/Metforminhydrochloride1000MGOralTablet[Segluromet]|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Brand|1992695-ertugliflozin2.5MG/Metforminhydrochloride500MGOralTablet[Segluromet]|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Brand|1992691-ertugliflozin2.5MG/Metforminhydrochloride1000MGOralTablet[Segluromet]|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Brand|1991317-1MGDose1.5MLsemaglutide1.34MG/MLPenInjector[Ozempic]|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Brand|1991311-0.25MG,0.5MGDose1.5MLsemaglutide1.34MG/MLPenInjector[Ozempic]|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Brand|1801840-lifitegrast50MG/MLOphthalmicSolution[Xiidra]|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Brand|1551306-0.5MLdulaglutide3MG/MLAuto-Injector[Trulicity]|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Brand|1551300-0.5MLdulaglutide1.5MG/MLAuto-Injector[Trulicity]|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Brand|1356673-BenzylAlcohol0.05ML/MLTopicalLotion[Ulesfia]|SPD PARTIAL DUALS 632|2002|N|Y|N||Preferred Brand|1190334-24HRFexofenadinehydrochloride180MG/PseudoephedrineHydrochloride240MGExtendedReleaseOralTablet[Wal-FexD]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|996757-CodeinePhosphate2MG/ML/PhenylephrineHydrochloride1MG/ML/PromethazineHydrochloride1.25MG/MLOralSolution|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|995868-CodeinePhosphate2MG/ML/Guaifenesin20MG/MLOralSolution|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|993890-Acetaminophen300MG/CodeinePhosphate60MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|993781-Acetaminophen300MG/CodeinePhosphate30MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|993770-Acetaminophen300MG/CodeinePhosphate15MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|993755-Acetaminophen24MG/ML/CodeinePhosphate2.4MG/MLOralSolution|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|993470-midodrinehydrochloride5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|993466-midodrinehydrochloride2.5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|993462-midodrinehydrochloride10MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|992668-homatropinemethylbromide0.3MG/ML/HydrocodoneBitartrate1MG/MLOralSolution|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|991528-DextromethorphanHydrobromide3MG/ML/PromethazineHydrochloride1.25MG/MLOralSolution|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|991486-CodeinePhosphate2MG/ML/PromethazineHydrochloride1.25MG/MLOralSolution|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|977880-AmilorideHydrochloride5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|905516-ChlordiazepoxideHydrochloride5MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|905495-ChlordiazepoxideHydrochloride25MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|905369-ChlordiazepoxideHydrochloride10MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|904589-SotalolHydrochloride240MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|904447-Alendronicacid0.933MG/MLOralSolution|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|904419-Alendronicacid10MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|904405-Alendronicacid40MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|899557-dexmethylphenidatehydrochloride2.5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|899548-dexmethylphenidatehydrochloride10MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|899518-dexmethylphenidatehydrochloride5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|897749-HydromorphoneHydrochloride3MGRectalSuppository|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|897710-HydromorphoneHydrochloride8MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|897702-HydromorphoneHydrochloride4MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|897696-HydromorphoneHydrochloride2MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|897659-Verapamilhydrochloride120MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|897640-Verapamilhydrochloride180MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|897630-24HRVerapamilhydrochloride360MGExtendedReleaseOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|897618-24HRVerapamilhydrochloride180MGExtendedReleaseOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|897612-24HRVerapamilhydrochloride120MGExtendedReleaseOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|894780-MorphineSulfate4MG/MLOralSolution|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|892672-MorphineSulfate30MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|892625-MorphineSulfate20MG/MLOralSolution|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|892589-MorphineSulfate2MG/MLOralSolution|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|892582-MorphineSulfate15MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|884386-DextroamphetamineSulfate5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|884385-DextroamphetamineSulfate10MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|866042-NeomycinSulfate500MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|863559-valganciclovir50MG/MLOralSolution|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|862025-24HRGuanfacine4MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|862019-24HRGuanfacine3MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|862013-24HRGuanfacine2MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|862006-24HRGuanfacine1MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|861237-24HRAmphetamineaspartate1.25MG/AmphetamineSulfate1.25MG/Dextroamphetaminesaccharate1.25MG/DextroamphetamineSulfate1.25|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|861232-24HRAmphetamineaspartate7.5MG/AmphetamineSulfate7.5MG/Dextroamphetaminesaccharate7.5MG/DextroamphetamineSulfate7.5MGEx|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|861227-24HRAmphetamineaspartate6.25MG/AmphetamineSulfate6.25MG/Dextroamphetaminesaccharate6.25MG/DextroamphetamineSulfate6.25|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|861225-24HRAmphetamineaspartate5MG/AmphetamineSulfate5MG/Dextroamphetaminesaccharate5MG/DextroamphetamineSulfate5MGExtendedRe|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|861223-24HRAmphetamineaspartate3.75MG/AmphetamineSulfate3.75MG/Dextroamphetaminesaccharate3.75MG/DextroamphetamineSulfate3.75|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|861221-24HRAmphetamineaspartate2.5MG/AmphetamineSulfate2.5MG/Dextroamphetaminesaccharate2.5MG/DextroamphetamineSulfate2.5MGEx|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|857366-EconazoleNitrate10MG/MLTopicalCream|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|857005-Acetaminophen325MG/HydrocodoneBitartrate7.5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|857002-Acetaminophen325MG/HydrocodoneBitartrate5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|856999-Acetaminophen325MG/HydrocodoneBitartrate10MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|856940-Acetaminophen21.7MG/ML/HydrocodoneBitartrate0.5MG/MLOralSolution|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|855633-DiclofenacSodium0.01MG/MGTopicalGel|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|854876-Zolpidemtartrate5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|854873-Zolpidemtartrate10MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|854252-1MLEnoxaparinsodium150MG/MLPrefilledSyringe|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|854248-1MLEnoxaparinsodium100MG/MLPrefilledSyringe|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|854245-0.8MLEnoxaparinsodium150MG/MLPrefilledSyringe|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|854241-0.8MLEnoxaparinsodium100MG/MLPrefilledSyringe|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|854238-0.6MLEnoxaparinsodium100MG/MLPrefilledSyringe|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|854235-0.4MLEnoxaparinsodium100MG/MLPrefilledSyringe|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|854228-0.3MLEnoxaparinsodium100MG/MLPrefilledSyringe|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|847252-3MLInsulinLispro25UNT/ML/insulinlisproprotamine,human75UNT/MLPenInjector|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|847191-3MLinsulinaspartprotamine,human70UNT/ML/insulinaspart,human30UNT/MLPenInjector|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|846378-24HRLevetiracetam750MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|845488-Ramipril1.25MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|835829-testosteronecypionate100MG/MLInjectableSolution|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|835603-tramadolhydrochloride50MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|834022-KetorolacTromethamine10MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|830861-24HRDiltiazemHydrochloride120MGExtendedReleaseOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|830845-24HRDiltiazemHydrochloride180MGExtendedReleaseOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|830837-24HRDiltiazemHydrochloride240MGExtendedReleaseOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|830801-24HRDiltiazemHydrochloride300MGExtendedReleaseOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|807832-24HRLevetiracetam500MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|801966-4MLDiazepam5MG/MLRectalGel|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|801961-2MLDiazepam5MG/MLRectalGel|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|801957-0.5MLDiazepam5MG/MLRectalGel|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|728113-Oseltamivir45MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|728109-Oseltamivir30MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|687043-Amphetamineaspartate3.125MG/AmphetamineSulfate3.125MG/Dextroamphetaminesaccharate3.125MG/DextroamphetamineSulfate3.125|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|686379-celecoxib50MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|636045-Hydrochlorothiazide25MG/valsartan320MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|636042-Hydrochlorothiazide12.5MG/valsartan320MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|608143-atomoxetine80MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|608139-atomoxetine100MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|596934-duloxetine60MGDelayedReleaseOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|596930-duloxetine30MGDelayedReleaseOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|596926-duloxetine20MGDelayedReleaseOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|577961-Amphetamineaspartate5MG/AmphetamineSulfate5MG/Dextroamphetaminesaccharate5MG/DextroamphetamineSulfate5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|577957-Amphetamineaspartate3.75MG/AmphetamineSulfate3.75MG/Dextroamphetaminesaccharate3.75MG/DextroamphetamineSulfate3.75MGOr|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|541892-Amphetamineaspartate2.5MG/AmphetamineSulfate2.5MG/Dextroamphetaminesaccharate2.5MG/DextroamphetamineSulfate2.5MGOralTa|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|541878-Amphetamineaspartate1.25MG/AmphetamineSulfate1.25MG/Dextroamphetaminesaccharate1.25MG/DextroamphetamineSulfate1.25MGOr|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|541363-Amphetamineaspartate7.5MG/AmphetamineSulfate7.5MG/Dextroamphetaminesaccharate7.5MG/DextroamphetamineSulfate7.5MGOralTa|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|485486-tizanidine2MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|485485-tizanidine4MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|485484-tizanidine6MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|485465-Eszopiclone3MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|485442-Eszopiclone2MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|485440-Eszopiclone1MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|477562-Fenofibrate48MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|477560-Fenofibrate145MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|403923-168HREstradiol0.0025MG/HRTransdermalSystem|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|403922-168HREstradiol0.00156MG/HRTransdermalSystem|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|403884-Levetiracetam100MG/MLOralSolution|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|359818-Nicotine4MGOralLozenge|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|359817-Nicotine2MGOralLozenge|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|351297-insulinaspartprotamine,human70UNT/ML/insulinaspart,human30UNT/MLInjectableSuspension|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|351246-montelukast4MGOralGranules|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|351133-Fenofibrate54MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|351109-Budesonide0.25MG/MLInhalationSuspension|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|349595-atomoxetine60MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|349594-atomoxetine40MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|349593-atomoxetine25MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|349592-atomoxetine18MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|349591-atomoxetine10MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|349514-celecoxib400MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|349483-valsartan40MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|349353-Hydrochlorothiazide25MG/valsartan160MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|349287-Fenofibrate160MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|349201-valsartan160MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|349200-valsartan320MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|349199-valsartan80MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|349198-Clonazepam0.5MGDisintegratingOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|349197-Clonazepam2MGDisintegratingOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|349196-Clonazepam1MGDisintegratingOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|349195-Clonazepam0.25MGDisintegratingOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|349194-Clonazepam0.125MGDisintegratingOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|349094-Budesonide0.125MG/MLInhalationSuspension|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|318202-Erythromycin20MG/MLTopicalSolution|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|315223-Sumatriptan25MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|314285-zonisamide100MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|314209-rizatriptan10MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|314200-pantoprazole40MGDelayedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|314135-naratriptan2.5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|313762-zaleplon5MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|313761-zaleplon10MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|313571-Vancomycin250MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|313570-Vancomycin125MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|313566-valganciclovir450MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|313415-Tobramycin3MG/MLOphthalmicSolution|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|313413-tizanidine4MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|313412-tizanidine2MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|313222-terbinafine250MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|313161-Sumatriptan50MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|313160-Sumatriptan100MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|312840-rizatriptan5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|312087-Ondansetron8MGDisintegratingOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|312086-Ondansetron8MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|312075-Ofloxacin3MG/MLOphthalmicSolution|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|311975-Nicotine4MGChewingGum|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|311918-naratriptan1MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|311759-montelukast4MGChewableTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|311265-lamotrigine5MGChewableTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|311237-Ketotifen0.25MG/MLOphthalmicSolution|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|311207-Ivermectin3MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|310793-Hydrochlorothiazide12.5MG/irbesartan300MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|310792-Hydrochlorothiazide12.5MG/irbesartan150MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|310467-Gentamicin3MG/MLOphthalmicSolution|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|310465-Gentamicin0.001MG/MGTopicalOintment|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|310289-Fenofibrate200MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|310288-Fenofibrate134MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|310191-estradiolvalerate40MG/MLInjectableSolution|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|310190-estradiolvalerate20MG/MLInjectableSolution|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|310152-Erythromycin0.02MG/MGTopicalGel|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|310149-Erythromycin0.005MG/MGOphthalmicOintment|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|309314-Citalopram40MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|309309-Ciprofloxacin500MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|309307-Ciprofloxacin3MG/MLOphthalmicSolution|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|283407-Mirtazapine30MGDisintegratingOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|261962-Ramipril10MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|259081-12HRAspirin25MG/Dipyridamole200MGExtendedReleaseOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|252559-Budesonide0.5MG/MLInhalationSuspension|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|251872-pantoprazole20MGDelayedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|248478-84HREstradiol0.00104MG/HRTransdermalSystem|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|242892-84HREstradiol0.00417MG/HRTransdermalSystem|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|242891-84HREstradiol0.00208MG/HRTransdermalSystem|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|242462-cilostazol50MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|242461-cilostazol100MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|242438-montelukast5MGChewableTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|242333-168HREstradiol0.00104MG/HRTransdermalSystem|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|241946-84HREstradiol0.00156MG/HRTransdermalSystem|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|241527-168HREstradiol0.00312MG/HRTransdermalSystem|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|238004-168HREstradiol0.00417MG/HRTransdermalSystem|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|238003-168HREstradiol0.00208MG/HRTransdermalSystem|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|2123111-NDA020503200ACTUATAlbuterol0.09MG/ACTUATMeteredDoseInhaler|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|205323-celecoxib200MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|205322-celecoxib100MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|2047882-1MLtestosteronecypionate200MG/MLInjection|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|203088-Ketoconazole20MG/MLTopicalCream|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|200345-Simvastatin80MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|200329-Omeprazole40MGDelayedReleaseOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|200311-Fenofibrate67MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|200285-Hydrochlorothiazide12.5MG/valsartan160MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|200284-Hydrochlorothiazide12.5MG/valsartan80MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|200224-montelukast10MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|200096-irbesartan300MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|200095-irbesartan150MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|200094-irbesartan75MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|199381-potassiumcitrate10MEQExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|199376-potassiumcitrate5MEQExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|199370-Ciprofloxacin100MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|199206-Riluzole50MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|198342-Urea400MG/MLTopicalCream|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|198318-Triazolam0.25MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|198317-Triazolam0.125MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|198252-tetracyclinehydrochloride500MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|198250-tetracyclinehydrochloride250MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|198242-Temazepam30MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|198241-Temazepam15MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|198189-Ramipril5MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|198188-Ramipril2.5MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|198052-Ondansetron4MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|198051-Omeprazole20MGDelayedReleaseOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|198036-24HRNifedipine90MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|198035-24HRNifedipine60MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|198034-24HRNifedipine30MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|197902-Lorazepam2MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|197900-Lorazepam0.5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|197877-Lidocaine25MG/ML/Prilocaine25MG/MLTopicalCream|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|197739-Glycopyrrolate2MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|197738-Glycopyrrolate1MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|197735-Gentamicin1MG/MLTopicalCream|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|197591-Diazepam5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|197590-Diazepam2MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|197589-Diazepam10MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|197541-Colchicine0.6MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|197529-Clonazepam2MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|197528-Clonazepam1MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|197527-Clonazepam0.5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|197512-Ciprofloxacin750MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|197511-Ciprofloxacin250MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|1926331-0.5UNTDoses3MLInsulinLispro100UNT/MLPenInjector|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|1918209-60ACTUATfluticasonepropionate0.055MG/ACTUAT/salmeterol0.014MG/ACTUATDryPowderInhaler|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|1918203-60ACTUATfluticasonepropionate0.232MG/ACTUAT/salmeterol0.014MG/ACTUATDryPowderInhaler|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|1918194-60ACTUATfluticasonepropionate0.113MG/ACTUAT/salmeterol0.014MG/ACTUATDryPowderInhaler|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|1812015-Osmotic24HRNifedipine90MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|1812013-Osmotic24HRNifedipine60MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|1812011-Osmotic24HRNifedipine30MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|1806197-30/70Release24HRMethylphenidateHydrochloride60MGExtendedReleaseOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|1806193-30/70Release24HRMethylphenidateHydrochloride50MGExtendedReleaseOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|1806191-30/70Release24HRMethylphenidateHydrochloride40MGExtendedReleaseOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|1650142-DoxycyclineMonohydrate100MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|1649990-DoxycyclineMonohydrate100MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|1649401-DoxycyclineMonohydrate50MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|1596780-60ACTUATTestosterone12.5MG/ACTUATTopicalGel|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|1550940-Colchicine0.6MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|1543069-Lidocaine0.05MG/MGTopicalOintment|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|1298091-FlurazepamHydrochloride30MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|1298088-FlurazepamHydrochloride15MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|1244214-Budesonide3MGDelayedReleaseOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|1149632-84HREstradiol0.00313MG/HRTransdermalSystem|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|1115698-Oseltamivir6MG/MLOralSuspension|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|1091497-MethylphenidateHydrochloride5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|1091392-MethylphenidateHydrochloride20MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|1091225-8HRMethylphenidateHydrochloride20MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|1091150-MethylphenidateHydrochloride10MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|1091145-8HRMethylphenidateHydrochloride10MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|106346-Mupirocin0.02MG/MGTopicalOintment|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|1049225-Acetaminophen325MG/OxycodoneHydrochloride7.5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|1049221-Acetaminophen325MG/OxycodoneHydrochloride5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|1049214-Acetaminophen325MG/OxycodoneHydrochloride10MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|104894-Ondansetron4MGDisintegratingOralTablet|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|1009145-Amphetamineaspartate1.875MG/AmphetamineSulfate1.875MG/Dextroamphetaminesaccharate1.875MG/DextroamphetamineSulfate1.87|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|1000153-1MLmedroxyprogesteroneacetate150MG/MLPrefilledSyringe|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Generic|1000126-1MLmedroxyprogesteroneacetate150MG/MLInjection|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|999965-Glycopyrrolate0.2MG/MLOralSolution[Cuvposa]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|998666-carboxymethylcellulosesodium0.01MG/MGOphthalmicGel[TheraTears]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|901644-0.5MLStreptococcuspneumoniaeserotype1capsularantigendiphtheriaCRM197proteinconjugatevaccine0.0044MG/ML/Streptococcuspn|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|901518-0.5MLNeisseriameningitidisserogroupAoligosaccharidediphtheriaCRM197proteinconjugatevaccine0.02MG/ML/Neisseriameningiti|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|895756-PolyethyleneGlycol4000.004MG/MG/Propyleneglycol0.003MG/MGOphthalmicGel[Systane]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|864650-Ganciclovir0.0015MG/MGOphthalmicGel[Zirgan]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|847213-3MLInsulinLispro50UNT/ML/insulinlisproprotamine,human50UNT/MLPenInjector[HumalogMix]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|847199-3MLinsulinisophane,human100UNT/MLPenInjector[HumulinN]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|847189-3MLinsulinisophane,human70UNT/ML/insulin,regular,human30UNT/MLPenInjector[Humulin]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|836634-1MLhepatitisAvirusstrainCR326Fantigen,inactivated50UNT/MLPrefilledSyringe[Vaqta]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|830263-1MLHepatitisBSurfaceAntigenVaccine0.04MG/MLInjection[Recombivax]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|830253-0.5MLHepatitisBSurfaceAntigenVaccine0.01MG/MLPrefilledSyringe[Recombivax]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|830245-1MLHepatitisBSurfaceAntigenVaccine0.01MG/MLPrefilledSyringe[Recombivax]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|804186-0.5MLMeaslesVirusVaccineLive,Enders'attenuatedEdmonstonstrain2000UNT/ML/MumpsVirusVaccineLive,JerylLynnStrain25000UNT/|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|803371-1MLHepatitisAVaccine(Inactivated)StrainHM175720UNT/ML/HepatitisBSurfaceAntigenVaccine0.02MG/MLPrefilledSyringe[Twinrix|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|798482-0.5MLHepatitisAVaccine(Inactivated)StrainHM1751440UNT/MLPrefilledSyringe[Havrix]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|798479-1MLHepatitisAVaccine(Inactivated)StrainHM1751440UNT/MLPrefilledSyringe[Havrix]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|798428-1MLHepatitisBSurfaceAntigenVaccine0.02MG/MLPrefilledSyringe[Engerix-B]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|797641-0.5MLNeisseriameningitidisserogroupAcapsularpolysaccharidediphtheriatoxoidproteinconjugatevaccine0.104MG/ML/Neisseriam|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|795737-ChantixStartingMonthPAK|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|795735-ChantixContinuingMonthsOfTherapy1MGPack|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|762602-SalmonellatyphiTy21aliveantigen2000000000UNTDelayedReleaseOralCapsule[Vivotif]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|752388-InsulinLispro25UNT/ML/insulinlisproprotamine,human75UNT/MLInjectableSuspension[HumalogMix]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|731281-InsulinLispro50UNT/ML/insulinlisproprotamine,human50UNT/MLInjectableSuspension[HumalogMix]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|707566-PolyethyleneGlycol4004MG/ML/Propyleneglycol3MG/MLOphthalmicSolution[Systane]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|637190-varenicline1MGOralTablet[Chantix]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|637188-varenicline0.5MGOralTablet[Chantix]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|630981-PolyvinylAlcohol27MG/ML/Povidone20MG/MLOphthalmicSolution[Freshkote]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|404448-84HRoxybutynin0.162MG/HRTransdermalSystem[Oxytrol]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|351859-insulin,regular,human500UNT/MLInjectableSolution[HumulinR]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|351433-24HRNicotine0.292MG/HRTransdermalSystem[NicodermC-Q]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|351429-24HRNicotine0.875MG/HRTransdermalSystem[NicodermC-Q]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|351427-24HRNicotine0.583MG/HRTransdermalSystem[NicodermC-Q]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|311036-insulin,regular,human100UNT/MLInjectableSolution[HumulinR]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|311033-insulin,regular,human100UNT/MLInjectableSolution[NovolinR]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|311027-insulinisophane,human100UNT/MLInjectableSuspension[NovolinN]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|311026-insulinisophane,human100UNT/MLInjectableSuspension[HumulinN]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|261315-Oseltamivir75MGOralCapsule[Tamiflu]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|2360588-0.5MLNeisseriameningitidisserogroupAcapsularpolysaccharidetetanustoxoidproteinconjugatevaccine0.02MG/ML/Neisseriameni|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|2166928-10ACTUATolodaterol0.0025MG/ACTUAT/tiotropium0.0025MG/ACTUATInhalationSpray[Stiolto]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|2166204-10ACTUATtiotropium0.0025MG/ACTUATInhalationSpray[Spiriva]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|213442-insulinisophane,human70UNT/ML/insulin,regular,human30UNT/MLInjectableSuspension[Novolin]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|211947-Atovaquone150MG/MLOralSuspension[Mepron]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|211609-hypromellose5MG/MLOphthalmicSolution[IsoptoAlkaline]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|211140-PentosanPolysulfate100MGOralCapsule[Elmiron]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|2106334-0.5MLdiphtheriatoxoidvaccine,inactivated4UNT/ML/tetanustoxoidvaccine,inactivated4UNT/MLInjection[Tdvax]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|208821-Dexamethasone0.001MG/MG/Tobramycin0.003MG/MGOphthalmicOintment[Tobradex]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|2059017-rivaroxaban2.5MGOralTablet[Xarelto]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|2053927-sodiumzirconiumcyclosilicate10000MGPowderforOralSuspension[Lokelma]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|2050059-0.5MLHepatitisBSurfaceAntigenVaccine0.04MG/MLPrefilledSyringe[Heplisav-B]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|2047639-sodiumzirconiumcyclosilicate5000MGPowderforOralSuspension[Lokelma]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|2045382-30ACTUATfluticasonefuroate0.05MG/ACTUATDryPowderInhaler[Arnuity]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|2000136-Vancomycin50MG/MLOralSolution[Firvanq]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|2000133-Vancomycin25MG/MLOralSolution[Firvanq]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1994352-0.5MLHepatitisBSurfaceAntigenVaccine0.04MG/MLInjection[Heplisav-B]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1992428-Eliquis30-DayStarterPack|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1992171-3MLInsulinLispro100UNT/MLPenInjector[Admelog]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1992169-InsulinLispro100UNT/MLInjectableSolution[Admelog]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1986830-0.5MLVaricellazostervirusglycoproteinE,recombinant0.1MG/MLInjection[Shingrix]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1797888-Nicotine0.5MG/ACTUATMeteredDoseNasalSpray[Nicotrol]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1736863-3MLInsulinGlargine100UNT/MLPenInjector[Basaglar]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1731317-3MLinsulin,regular,human500UNT/MLPenInjector[HumulinR]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1723478-dabigatranetexilate110MGOralCapsule[Pradaxa]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1667882-60ACTUATtiotropium0.00125MG/ACTUATInhalationSpray[Spiriva]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1658472-0.5MLStreptococcuspneumoniaetype1capsularpolysaccharideantigen0.05MG/ML/Streptococcuspneumoniaetype10Acapsularpolysac|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1658157-1MLHepatitisBSurfaceAntigenVaccine0.02MG/MLInjection[Engerix-B]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1658155-0.5MLHepatitisBSurfaceAntigenVaccine0.01MG/MLInjection[Recombivax]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1658150-1MLHepatitisBSurfaceAntigenVaccine0.01MG/MLInjection[Recombivax]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1658106-0.5MLhepatitisAvirusstrainCR326Fantigen,inactivated50UNT/MLInjection[Vaqta]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1658102-1MLhepatitisAvirusstrainCR326Fantigen,inactivated50UNT/MLInjection[Vaqta]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1658060-1MLHepatitisAVaccine(Inactivated)StrainHM1751440UNT/MLInjection[Havrix]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1656356-sacubitril97MG/valsartan103MGOralTablet[Entresto]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1656351-sacubitril49MG/valsartan51MGOralTablet[Entresto]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1656346-sacubitril24MG/valsartan26MGOralTablet[Entresto]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1601407-0.5MLmeningococcalgroupBvaccine0.1MG/ML/NeisseriameningitidisserogroupBrecombinantFHBPfusionproteinantigen0.1MG/ML/Ne|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1597103-0.5MLL1protein,Humanpapillomavirustype11Vaccine0.08MG/ML/L1protein,Humanpapillomavirustype16Vaccine0.12MG/ML/L1protei|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1597099-0.5MLL1protein,Humanpapillomavirustype11Vaccine0.08MG/ML/L1protein,Humanpapillomavirustype16Vaccine0.12MG/ML/L1protei|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1596445-7ACTUATumeclidinium0.0625MG/ACTUATDryPowderInhaler[Incruse]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1593140-0.5MLNeisseriameningitidisserogroupBrecombinantLP2086A05proteinvariantantigen0.12MG/ML/Neisseriameningitidisserogroup|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1549683-Xarelto30-DayStarterPackKit|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1547950-CarboxymethylcelluloseSodium2.5MG/MLOphthalmicSolution[TheraTears]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1547672-30ACTUATfluticasonefuroate0.2MG/ACTUATDryPowderInhaler[Arnuity]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1547664-14ACTUATfluticasonefuroate0.1MG/ACTUATDryPowderInhaler[Arnuity]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1547582-0.5MLStreptococcuspneumoniaetype1capsularpolysaccharideantigen0.05MG/ML/Streptococcuspneumoniaetype10Acapsularpolysac|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1364447-apixaban5MGOralTablet[Eliquis]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1364441-apixaban2.5MGOralTablet[Eliquis]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1363484-hypromellose0.003MG/MGOphthalmicGel[SystaneOvernightTherapy]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1300468-0.5MLHaemophilusinfluenzaetypebstrain1482,capsularpolysaccharideinactivatedtetanustoxoidconjugatevaccine0.068MG/MLInj|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1300378-0.5MLBordetellapertussisfilamentoushemagglutininvaccine,inactivated0.016MG/ML/Bordetellapertussispertactinvaccine,ina|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1300370-0.5MLBordetellapertussisfilamentoushemagglutininvaccine,inactivated0.016MG/ML/Bordetellapertussispertactinvaccine,ina|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1300206-0.5MLBordetellapertussisfilamentoushemagglutininvaccine,inactivated0.01MG/ML/Bordetellapertussisfimbriae2/3vaccine,in|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1292459-0.5MLVaricella-ZosterVirusVaccineLive(Oka-Merck)strain2700UNT/MLInjection[Varivax]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1190919-0.5MLdiphtheriatoxoidvaccine,inactivated4UNT/ML/tetanustoxoidvaccine,inactivated10UNT/MLPrefilledSyringe[Tenivac]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1190916-0.5MLdiphtheriatoxoidvaccine,inactivated4UNT/ML/tetanustoxoidvaccine,inactivated10UNT/MLInjection[Tenivac]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1115892-MineralOil0.15MG/MG/Petrolatum0.85MG/MGOphthalmicOintment[Puralube]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|106892-insulinisophane,human70UNT/ML/insulin,regular,human30UNT/MLInjectableSuspension[Humulin]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1049216-Acetaminophen325MG/OxycodoneHydrochloride10MGOralTablet[Endocet]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1046920-Nicotine4MGInhalationSolution[Nicotrol]|SPD PARTIAL DUALS 632|2002|N|N|Y||Preferred Brand|1037181-dabigatranetexilate75MGOralCapsule[Pradaxa]|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|999613-SulfacetamideSodium100MG/ML/Sulfur50MG/MLMedicatedLiquidSoap|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|997501-Fexofenadinehydrochloride60MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|997491-Fexofenadinehydrochloride6MG/MLOralSuspension|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|997420-Fexofenadinehydrochloride180MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|997229-Donepezilhydrochloride5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|997226-Donepezilhydrochloride5MGDisintegratingOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|997223-Donepezilhydrochloride10MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|997220-Donepezilhydrochloride10MGDisintegratingOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|996824-MethylergonovineMaleate0.2MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|996572-{21(Memantinehydrochloride10MGOralTablet)/28(Memantinehydrochloride5MGOralTablet)}Pack|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|996571-Memantinehydrochloride5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|996561-Memantinehydrochloride10MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|996520-DextromethorphanHydrobromide2MG/ML/Guaifenesin20MG/MLOralSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|995666-MeclizineHydrochloride25MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|995632-MeclizineHydrochloride25MGChewableTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|995624-MeclizineHydrochloride12.5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|995607-EthambutolHydrochloride400MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|995599-EthambutolHydrochloride100MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|995281-HydroxyzineHydrochloride50MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|995278-HydroxyzinePamoate50MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|995258-HydroxyzineHydrochloride25MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|995253-HydroxyzinePamoate25MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|995241-HydroxyzineHydrochloride2MG/MLOralSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|995232-HydroxyzinePamoate100MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|995218-HydroxyzineHydrochloride10MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|993943-Acetaminophen325MG/butalbital50MG/Caffeine40MG/CodeinePhosphate30MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|993691-BupropionHydrochloride75MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|993687-BupropionHydrochloride100MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|993557-24HRBupropionHydrochloride300MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|993541-24HRBupropionHydrochloride150MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|993536-12HRBupropionHydrochloride200MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|993518-12HRBupropionHydrochloride150MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|993503-12HRBupropionHydrochloride100MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|992780-MiconazoleNitrate100MGVaginalInsert|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|992775-{1(MiconazoleNitrate1200MGVaginalInsert)/1(9000MG)(MiconazoleNitrate20MG/MLVaginalCream)}Pack|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|992528-Terbinafinehydrochloride10MG/MLTopicalCream|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|992475-PromethazineHydrochloride50MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|992454-PromethazineHydrochloride25MGRectalSuppository|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|992447-PromethazineHydrochloride25MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|992441-PromethazineHydrochloride12.5MGRectalSuppository|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|992438-PromethazineHydrochloride12.5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|992432-PromethazineHydrochloride1.25MG/MLOralSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|992184-methenaminemandelate500MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|992153-methenaminemandelate1000MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|991086-DicyclomineHydrochloride20MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|991061-DicyclomineHydrochloride10MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|979492-LosartanPotassium50MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|979485-LosartanPotassium25MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|979480-LosartanPotassium100MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|979475-MetaproterenolSulfate20MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|979471-Hydrochlorothiazide25MG/LosartanPotassium100MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|979468-Hydrochlorothiazide12.5MG/LosartanPotassium50MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|979464-Hydrochlorothiazide12.5MG/LosartanPotassium100MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|979444-MetaproterenolSulfate2MG/MLOralSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|979409-MetaproterenolSulfate10MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|979092-HydroxychloroquineSulfate200MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|978006-LoperamideHydrochloride2MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|966920-POLYETHYLENEGLYCOL3350236000MG/PotassiumChloride2970MG/SodiumBicarbonate6740MG/SodiumChloride5860MG/sodiumsulfate22740|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|966914-POLYETHYLENEGLYCOL3350240000MG/PotassiumChloride2980MG/SodiumBicarbonate6720MG/SodiumChloride5840MG/sodiumsulfate22720|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|966270-LevothyroxineSodium0.137MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|966253-LevothyroxineSodium0.088MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|966249-LevothyroxineSodium0.175MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|966248-LevothyroxineSodium0.112MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|966225-LevothyroxineSodium0.15MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|966224-LevothyroxineSodium0.125MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|966222-LevothyroxineSodium0.075MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|966221-LevothyroxineSodium0.05MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|966220-LevothyroxineSodium0.025MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|905395-HydralazineHydrochloride50MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|905225-HydralazineHydrochloride25MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|905222-HydralazineHydrochloride100MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|905199-HydralazineHydrochloride10MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|905158-Sirolimus0.5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|904932-ibandronicacid150MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|904481-PravastatinSodium80MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|904475-PravastatinSodium40MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|904467-PravastatinSodium20MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|904458-PravastatinSodium10MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|904431-Alendronicacid70MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|904396-Alendronicacid35MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|904170-PrimaquinePhosphate26.3MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|903891-FluvoxamineMaleate50MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|903887-FluvoxamineMaleate25MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|903884-FluvoxamineMaleate100MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|903703-liothyroninesodium0.05MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|903697-liothyroninesodium0.025MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|903456-liothyroninesodium0.005MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|898723-Benazeprilhydrochloride5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|898690-Benazeprilhydrochloride20MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|898687-Benazeprilhydrochloride10MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|898378-Benazeprilhydrochloride5MG/Hydrochlorothiazide6.25MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|898372-Benazeprilhydrochloride20MG/Hydrochlorothiazide25MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|898367-Benazeprilhydrochloride20MG/Hydrochlorothiazide12.5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|898359-Amlodipine5MG/Benazeprilhydrochloride40MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|898356-Amlodipine5MG/Benazeprilhydrochloride20MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|898353-Amlodipine5MG/Benazeprilhydrochloride10MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|898350-Amlodipine2.5MG/Benazeprilhydrochloride10MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|898346-Amlodipine10MG/Benazeprilhydrochloride40MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|898342-Amlodipine10MG/Benazeprilhydrochloride20MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|897722-Verapamilhydrochloride40MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|897683-Verapamilhydrochloride80MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|897666-Verapamilhydrochloride120MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|897649-Verapamilhydrochloride240MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|897624-24HRVerapamilhydrochloride240MGExtendedReleaseOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|897596-24HRVerapamilhydrochloride300MGExtendedReleaseOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|897590-24HRVerapamilhydrochloride200MGExtendedReleaseOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|897584-24HRVerapamilhydrochloride100MGExtendedReleaseOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|896766-Labetalolhydrochloride300MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|896762-Labetalolhydrochloride200MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|896758-Labetalolhydrochloride100MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|896209-60ACTUATFluticasonepropionate0.25MG/ACTUAT/salmeterol0.05MG/ACTUATDryPowderInhaler|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|895987-Fluticasonepropionate0.5MG/MLTopicalCream|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|895487-Fluticasonepropionate0.00005MG/MGTopicalOintment|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|892255-LevothyroxineSodium0.3MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|892251-LevothyroxineSodium0.2MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|892246-LevothyroxineSodium0.1MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|886671-FlecainideAcetate150MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|886666-FlecainideAcetate100MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|886662-FlecainideAcetate50MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|885857-Balsalazidedisodium750MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|884707-Estradiol0.01MGVaginalInsert|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|884308-Nystatin100UNT/MGTopicalOintment|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|884189-ClonidineHydrochloride0.3MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|884185-ClonidineHydrochloride0.2MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|884173-ClonidineHydrochloride0.1MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|876193-POLYETHYLENEGLYCOL335017000MGPowderforOralSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|866924-MetoprololTartrate25MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|866514-MetoprololTartrate50MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|866511-MetoprololTartrate100MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|866436-24HRmetoprololsuccinate50MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|866427-24HRmetoprololsuccinate25MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|866419-24HRmetoprololsuccinate200MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|866412-24HRmetoprololsuccinate100MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|866144-Cyproheptadinehydrochloride4MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|866111-buspironehydrochloride7.5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|866094-buspironehydrochloride5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|866090-buspironehydrochloride30MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|866083-buspironehydrochloride10MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|866018-buspironehydrochloride15MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|863669-Tamsulosinhydrochloride0.4MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|863664-Oxybutyninchloride5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|863636-24HROxybutyninchloride5MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|863628-24HROxybutyninchloride15MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|863619-24HROxybutyninchloride10MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|861753-Glyburide5MG/Metforminhydrochloride500MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|861748-Glyburide2.5MG/Metforminhydrochloride500MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|861743-Glyburide1.25MG/Metforminhydrochloride250MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|861657-24HRNitroglycerin0.1MG/HRTransdermalSystem|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|861495-ClobetasolPropionate0.5MG/MLTopicalCream|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|861487-ClobetasolPropionate0.5MG/MLTopicalSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|861448-ClobetasolPropionate0.0005MG/MGTopicalOintment|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|861430-PropafenoneHydrochloride300MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|861427-PropafenoneHydrochloride225MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|861424-PropafenoneHydrochloride150MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|861416-Azithromycin1000MGPowderforOralSuspension|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|861200-Brimonidinetartrate2MG/MLOphthalmicSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|861171-12HRPropafenoneHydrochloride425MGExtendedReleaseOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|861164-12HRPropafenoneHydrochloride325MGExtendedReleaseOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|861156-12HRPropafenoneHydrochloride225MGExtendedReleaseOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|861132-24HRAlfuzosinhydrochloride10MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|861064-Sertraline20MG/MLOralSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|861010-Metforminhydrochloride850MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|861007-Metforminhydrochloride500MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|861004-Metforminhydrochloride1000MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|860981-24HRMetforminhydrochloride750MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|860975-24HRMetforminhydrochloride500MGExtendedReleaseOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|860805-Azelastinehydrochloride0.5MG/MLOphthalmicSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|860225-MegestrolAcetate40MG/MLOralSuspension|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|860221-MegestrolAcetate40MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|860215-MegestrolAcetate20MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|860107-KetorolacTromethamine5MG/MLOphthalmicSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|859751-Rosuvastatincalcium20MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|859747-Rosuvastatincalcium10MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|859424-Rosuvastatincalcium5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|859419-Rosuvastatincalcium40MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|859193-selegilinehydrochloride5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|859186-selegilinehydrochloride5MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|859052-Pramipexoledihydrochloride1MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|859048-Pramipexoledihydrochloride1.5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|859044-Pramipexoledihydrochloride0.5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|859040-Pramipexoledihydrochloride0.25MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|859033-Pramipexoledihydrochloride0.125MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|858828-EnalaprilMaleate10MG/Hydrochlorothiazide25MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|858824-EnalaprilMaleate5MG/Hydrochlorothiazide12.5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|858817-EnalaprilMaleate10MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|858813-EnalaprilMaleate5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|858810-EnalaprilMaleate20MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|858804-EnalaprilMaleate2.5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|858747-Ursodiol300MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|858625-Pramipexoledihydrochloride0.75MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|858616-Nicardipinehydrochloride30MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|858613-Nicardipinehydrochloride20MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|857683-TerbutalineSulfate5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|857677-TerbutalineSulfate2.5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|857461-ClemastineFumarate2.68MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|857340-BethanecholChloride50MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|857336-BethanecholChloride5MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|857328-BethanecholChloride25MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|857321-BethanecholChloride10MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|857305-ClomipramineHydrochloride75MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|857301-ClomipramineHydrochloride50MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|857297-ClomipramineHydrochloride25MGOralCapsule|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|857187-FosinoprilSodium40MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|857183-FosinoprilSodium20MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|857169-FosinoprilSodium10MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|856853-AmitriptylineHydrochloride75MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|856845-AmitriptylineHydrochloride50MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|856840-AmitriptylineHydrochloride50MG/Perphenazine4MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|856834-AmitriptylineHydrochloride25MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|856825-AmitriptylineHydrochloride25MG/Perphenazine4MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|856797-AmitriptylineHydrochloride25MG/Perphenazine2MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|856783-AmitriptylineHydrochloride10MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|856773-AmitriptylineHydrochloride150MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|856762-AmitriptylineHydrochloride100MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|856733-PropranololHydrochloride8MG/MLOralSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|856724-PropranololHydrochloride4MG/MLOralSolution|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|856720-AmitriptylineHydrochloride10MG/Perphenazine4MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|856706-AmitriptylineHydrochloride10MG/Perphenazine2MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|856578-PropranololHydrochloride80MGOralTablet|SPD PARTIAL DUALS 632|2002|N|N|N||Preferred Generic|856556-PropranololHydrochloride60MGOralTablet|SPD PARTIAL DUALS