Customer_ID|Client_ID|Prior_Authorization_Required|Step_Therapy_Required|Quantity_Limit_Required|Plan_Id|Drug_Tier|RxCUI_Descr|Member_Benefit_Group
636|1003|N|N|N||Preferred Brand|1000487-Premphase28DayPack|IHSS
636|1003|Y|N|N||Preferred Brand|2122657-Mavenclad5TabletPack|IHSS
636|1003|N|Y|Y||Preferred Generic|284201-zolmitriptan2.5MGDisintegratingOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|197853-Ketoconazole200MGOralTablet|IHSS
636|1003|N|N|N||Preferred Brand|1000499-Prempro0.625/2.528DayPack|IHSS
636|1003|Y|N|N||Preferred Brand|2122655-Mavenclad6TabletPack|IHSS
636|1003|N|N|N||Preferred Brand|1000500-Prempro0.625/528DayPack|IHSS
636|1003|N|Y|Y||Preferred Generic|200194-zolmitriptan5MGOralTablet|IHSS
636|1003|N|N|N||Preferred Brand|1005928-ulipristalacetate30MGOralTablet[Ella]|IHSS
636|1003|N|Y|N||Preferred Generic|197984-Minocycline100MGOralCapsule|IHSS
636|1003|N|N|Y||Preferred Generic|198250-tetracyclinehydrochloride250MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Brand|1048452-ColestipolHydrochloride5000MGGranulesforOralSuspension[Colestid]|IHSS
636|1003|Y|N|N||Preferred Generic|1592279-pirfenidone267MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|895999-120ACTUATFluticasonepropionate0.11MG/ACTUATMeteredDoseInhaler|IHSS
636|1003|Y|N|N||Preferred Brand|2122648-Mavenclad8TabletPack|IHSS
636|1003|N|N|N||Preferred Brand|105553-Chlorambucil2MGOralTablet[Leukeran]|IHSS
636|1003|N|N|N||Preferred Generic|617310-atorvastatin20MGOralTablet|IHSS
636|1003|N|N|N||Preferred Brand|105590-Thioguanine40MGOralTablet[Tabloid]|IHSS
636|1003|N|Y|Y||Preferred Generic|197979-Metolazone2.5MGOralTablet|IHSS
636|1003|N|N|N||Preferred Brand|108396-20MLZidovudine10MG/MLInjection[Retrovir]|IHSS
636|1003|N|N|N||Preferred Generic|313583-24HRvenlafaxine37.5MGExtendedReleaseOralCapsule|IHSS
636|1003|N|N|Y||Preferred Generic|830845-24HRDiltiazemHydrochloride180MGExtendedReleaseOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|314238-Tropicamide10MG/MLOphthalmicSolution|IHSS
636|1003|N|N|Y||Preferred Generic|311207-Ivermectin3MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|198242-Temazepam30MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|198046-Nortriptyline50MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Brand|1111011-Etonogestrel68MGDrugImplant[Nexplanon]|IHSS
636|1003|Y|N|N||Preferred Generic|597747-sorafenib200MGOralTablet|IHSS
636|1003|N|N|N||Preferred Brand|1113046-amylase15000UNT/lipase3000UNT/protease9500UNTDelayedReleaseOralCapsule[Creon]|IHSS
636|1003|Y|N|N||Preferred Generic|1591943-ledipasvir90MG/sofosbuvir400MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|897126-3MLliraglutide6MG/MLPenInjector[Victoza]|IHSS
636|1003|N|N|N||Preferred Generic|896004-120ACTUATFluticasonepropionate0.22MG/ACTUATMeteredDoseInhaler|IHSS
636|1003|Y|N|N||Preferred Brand|2475860-vericiguat5MGOralTablet[Verquvo]|IHSS
636|1003|Y|N|N||Preferred Brand|2121100-siponimod2MGOralTablet[Mayzent]|IHSS
636|1003|N|N|N||Preferred Brand|1190225-120ACTUATAlbuterol0.1MG/ACTUAT/IpratropiumBromide0.02MG/ACTUATInhalationSpray[Combivent]|IHSS
636|1003|N|N|N||Preferred Generic|749761-{7(EthinylEstradiol0.01MGOralTablet)/84(EthinylEstradiol0.03MG/Levonorgestrel0.15MGOralTablet)}Pack|IHSS
636|1003|N|N|N||Preferred Brand|1235591-raltegravir100MGChewableTablet[ISENTRESS]|IHSS
636|1003|N|N|N||Preferred Generic|198045-Nortriptyline10MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Brand|1235595-raltegravir25MGChewableTablet[ISENTRESS]|IHSS
636|1003|Y|N|N||Preferred Brand|1310138-everolimus2MGTabletforOralSuspension[Afinitor]|IHSS
636|1003|N|N|N||Preferred Brand|1236632-darunavir100MG/MLOralSuspension[Prezista]|IHSS
636|1003|N|Y|Y||Preferred Brand|2601776-0.5MLtirzepatide25MG/MLAuto-Injector[Mounjaro]|IHSS
636|1003|N|N|N||Preferred Brand|1250723-etravirine25MGOralTablet[Intelence]|IHSS
636|1003|N|N|N||Preferred Generic|314234-Sucralfate1000MGOralTablet|IHSS
636|1003|N|N|N||Preferred Brand|1293864-ErgotamineTartrate2MGSublingualTablet[Ergomar]|IHSS
636|1003|N|N|N||Preferred Generic|197754-Haloperidol20MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|861223-24HRAmphetamineaspartate3.75MG/AmphetamineSulfate3.75MG/Dextroamphetaminesaccharate3.75MG/DextroamphetamineSulfate3.75|IHSS
636|1003|N|N|Y||Preferred Generic|830837-24HRDiltiazemHydrochloride240MGExtendedReleaseOralCapsule|IHSS
636|1003|N|Y|N||Preferred Brand|2395785-0.5MLdulaglutide9MG/MLAuto-Injector[Trulicity]|IHSS
636|1003|N|N|N||Preferred Generic|315107-24HRGlipizide10MGExtendedReleaseOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|313777-ziprasidone60MGOralCapsule|IHSS
636|1003|N|N|Y||Preferred Generic|310793-Hydrochlorothiazide12.5MG/irbesartan300MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|197942-Methimazole5MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|198189-Ramipril5MGOralCapsule|IHSS
636|1003|Y|N|N||Preferred Brand|1488667-12HRTreprostinil0.125MGExtendedReleaseOralTablet[Orenitram]|IHSS
636|1003|Y|N|N||Preferred Brand|1599797-1MLsecukinumab150MG/MLPrefilledSyringe[Cosentyx]|IHSS
636|1003|N|N|Y||Preferred Brand|2605106-0.7MLinfluenzaAvirusA/Darwin/9/2021(H3N2)antigen0.0857MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.0857MG/|IHSS
636|1003|N|N|N||Preferred Brand|1359031-Loestrin1.5/3021DayPack|IHSS
636|1003|Y|N|N||Preferred Generic|860771-Trimethobenzamidehydrochloride300MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Brand|1359271-darunavir800MGOralTablet[Prezista]|IHSS
636|1003|Y|N|N||Preferred Generic|579148-Galantamine12MGOralTablet|IHSS
636|1003|N|N|N||Preferred Brand|1366339-Levonorgestrel0.000583MG/HRIntrauterineSystem[Skyla]|IHSS
636|1003|N|N|N||Preferred Generic|237776-vitaminB121MGExtendedReleaseOralTablet|IHSS
636|1003|N|N|N||Preferred Brand|1373327-amylase180000UNT/lipase36000UNT/protease114000UNTDelayedReleaseOralCapsule[Creon]|IHSS
636|1003|Y|N|N||Preferred Generic|1547565-Isotretinoin35MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Brand|1373504-Quartette91-DayPack|IHSS
636|1003|Y|N|N||Preferred Brand|903855-2MLPyridostigmineBromide5MG/MLInjection[Regonol]|IHSS
636|1003|Y|N|N||Preferred Brand|795749-RebifTitrationPack|IHSS
636|1003|N|N|N||Preferred Generic|896758-Labetalolhydrochloride100MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|2613759-1.2MLrisankizumab-rzaa150MG/MLCartridge[Skyrizi]|IHSS
636|1003|Y|N|N||Preferred Brand|2475856-vericiguat2.5MGOralTablet[Verquvo]|IHSS
636|1003|Y|N|N||Preferred Generic|403878-imatinib100MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|2107351-prucalopride1MGOralTablet[Motegrity]|IHSS
636|1003|N|N|N||Preferred Brand|150840-Estrogens,Conjugated(USP)0.625MGOralTablet[Premarin]|IHSS
636|1003|N|N|N||Preferred Generic|284245-Famotidine40MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1870950-deflazacort6MGOralTablet[Emflaza]|IHSS
636|1003|N|N|N||Preferred Generic|198116-PotassiumChloride20MEQExtendedReleaseOralTablet|IHSS
636|1003|N|N|N||Preferred Brand|153183-adapalene0.001MG/MGTopicalGel[Differin]|IHSS
636|1003|Y|N|N||Preferred Brand|1655934-ivacaftor125MG/lumacaftor200MGOralTablet[ORKAMBI]|IHSS
636|1003|N|N|N||Preferred Brand|1546894-abacavir600MG/dolutegravir50MG/Lamivudine300MGOralTablet[Triumeq]|IHSS
636|1003|N|N|N||Preferred Brand|2584356-bictegravir30MG/emtricitabine120MG/tenofoviralafenamide15MGOralTablet[Biktarvy]|IHSS
636|1003|N|N|N||Preferred Brand|1547664-14ACTUATfluticasonefuroate0.1MG/ACTUATDryPowderInhaler[Arnuity]|IHSS
636|1003|Y|N|N||Preferred Brand|1486977-dapagliflozin10MGOralTablet[Farxiga]|IHSS
636|1003|N|N|N||Preferred Brand|1547672-30ACTUATfluticasonefuroate0.2MG/ACTUATDryPowderInhaler[Arnuity]|IHSS
636|1003|Y|N|N||Preferred Brand|1307635-bosutinib500MGOralTablet[Bosulif]|IHSS
636|1003|N|N|N||Preferred Brand|1594673-amylase105000UNT/lipase25000UNT/protease79000UNTDelayedReleaseOralCapsule[Zenpep]|IHSS
636|1003|N|N|N||Preferred Generic|1053697-Nystatin100UNT/MG/TriamcinoloneAcetonide0.001MG/MGTopicalOintment|IHSS
636|1003|N|N|N||Preferred Brand|1595292-amylase14000UNT/lipase3000UNT/protease10000UNTDelayedReleaseOralCapsule[Zenpep]|IHSS
636|1003|N|Y|Y||Preferred Brand|1716223-patiromer25200MGPowderforOralSuspension[Veltassa]|IHSS
636|1003|N|N|N||Preferred Brand|1595457-amylase24000UNT/lipase5000UNT/protease17000UNTDelayedReleaseOralCapsule[Zenpep]|IHSS
636|1003|N|N|N||Preferred Generic|328161-Methylprednisolone16MGOralTablet|IHSS
636|1003|N|N|N||Preferred Brand|1595462-amylase42000UNT/lipase10000UNT/protease32000UNTDelayedReleaseOralCapsule[Zenpep]|IHSS
636|1003|N|N|N||Preferred Generic|197839-IsosorbideDinitrate30MGOralTablet|IHSS
636|1003|N|N|N||Preferred Brand|1595473-amylase63000UNT/lipase15000UNT/protease47000UNTDelayedReleaseOralCapsule[Zenpep]|IHSS
636|1003|N|Y|N||Preferred Brand|213307-Ciprofloxacin0.003MG/MGOphthalmicOintment[Ciloxan]|IHSS
636|1003|N|N|N||Preferred Brand|1595478-amylase84000UNT/lipase20000UNT/protease63000UNTDelayedReleaseOralCapsule[Zenpep]|IHSS
636|1003|N|N|N||Preferred Brand|212957-Cyclosporine100MG/MLOralSolution[Sandimmune]|IHSS
636|1003|N|N|N||Preferred Brand|1598658-Levonorgestrel1.5MGOralTablet[Aftera]|IHSS
636|1003|N|N|Y||Preferred Generic|861221-24HRAmphetamineaspartate2.5MG/AmphetamineSulfate2.5MG/Dextroamphetaminesaccharate2.5MG/DextroamphetamineSulfate2.5MGEx|IHSS
636|1003|N|N|N||Preferred Generic|313428-Toremifene60MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|810000-lacosamide50MGOralTablet|IHSS
636|1003|N|Y|N||Preferred Brand|1243843-24HRMetforminhydrochloride1000MG/sitagliptin50MGExtendedReleaseOralTablet[Janumet]|IHSS
636|1003|N|N|N||Preferred Generic|197807-Ibuprofen800MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|483444-pregabalin300MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|315213-SodiumFluoride2.2MGChewableTablet|IHSS
636|1003|N|N|Y||Preferred Generic|349198-Clonazepam0.5MGDisintegratingOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|313776-ziprasidone40MGOralCapsule|IHSS
636|1003|N|Y|Y||Preferred Brand|2200650-semaglutide14MGOralTablet[Rybelsus]|IHSS
636|1003|N|N|Y||Preferred Generic|310467-Gentamicin3MG/MLOphthalmicSolution|IHSS
636|1003|N|N|N||Preferred Generic|197931-mercaptopurine50MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1148506-crizotinib250MGOralCapsule[Xalkori]|IHSS
636|1003|N|N|Y||Preferred Generic|200284-Hydrochlorothiazide12.5MG/valsartan80MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|198036-24HRNifedipine90MGExtendedReleaseOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1439894-riociguat0.5MGOralTablet[Adempas]|IHSS
636|1003|N|N|N||Preferred Generic|198024-Niacin500MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|1149632-84HREstradiol0.00313MG/HRTransdermalSystem|IHSS
636|1003|N|N|N||Preferred Generic|1085741-TriamcinoloneAcetonide0.25MG/MLTopicalLotion|IHSS
636|1003|N|N|Y||Preferred Brand|797641-0.5MLNeisseriameningitidisserogroupAcapsularpolysaccharidediphtheriatoxoidproteinconjugatevaccine0.104MG/ML/Neisseriam|IHSS
636|1003|N|N|Y||Preferred Brand|2605096-0.5MLinfluenzaAvirusA/Darwin/6/2021(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.03MG/ML/i|IHSS
636|1003|Y|N|N||Preferred Brand|1726639-ponatinib30MGOralTablet[Iclusig]|IHSS
636|1003|N|N|N||Preferred Brand|1856546-Levonorgestrel0.000729MG/HRIntrauterineSystem[Kyleena]|IHSS
636|1003|Y|N|N||Preferred Generic|905168-ProtriptylineHydrochloride10MGOralTablet|IHSS
636|1003|N|N|N||Preferred Brand|1857913-maraviroc25MGOralTablet[Selzentry]|IHSS
636|1003|Y|N|N||Preferred Generic|860103-KetorolacTromethamine4MG/MLOphthalmicSolution|IHSS
636|1003|N|N|N||Preferred Brand|1857917-maraviroc75MGOralTablet[Selzentry]|IHSS
636|1003|N|N|N||Preferred Generic|282401-lamotrigine25MGOralTablet|IHSS
636|1003|N|N|N||Preferred Brand|1924315-raltegravir600MGOralTablet[Isentress]|IHSS
636|1003|Y|N|N||Preferred Generic|578325-candesartancilexetil16MG/Hydrochlorothiazide12.5MGOralTablet|IHSS
636|1003|N|N|N||Preferred Brand|1926069-Ritonavir100MGOralPowder[Norvir]|IHSS
636|1003|N|N|N||Preferred Generic|240209-Betamethasone0.5MG/MLTopicalLotion|IHSS
636|1003|N|N|N||Preferred Brand|1989117-0.3MLEpinephrine1MG/MLPrefilledSyringe[Symjepi]|IHSS
636|1003|N|N|N||Preferred Generic|898378-Benazeprilhydrochloride5MG/Hydrochlorothiazide6.25MGOralTablet|IHSS
636|1003|N|N|N||Preferred Brand|1989506-dolutegravir50MG/Rilpivirine25MGOralTablet[Juluca]|IHSS
636|1003|Y|N|N||Preferred Generic|197363-Amoxapine100MGOralTablet|IHSS
636|1003|N|N|N||Preferred Brand|1995479-amylase168000UNT/lipase40000UNT/protease126000UNTDelayedReleaseOralCapsule[Zenpep]|IHSS
636|1003|Y|N|N||Preferred Generic|1487361-1MLglatirameracetate40MG/MLPrefilledSyringe|IHSS
636|1003|N|N|N||Preferred Brand|1998772-Breath-Actuated120ACTUATBeclomethasoneDipropionate0.08MG/ACTUATMeteredDoseInhaler[Qvar]|IHSS
636|1003|N|N|N||Preferred Generic|200060-mycophenolatemofetil500MGOralTablet|IHSS
636|1003|N|N|N||Preferred Brand|1998774-Breath-Actuated120ACTUATBeclomethasoneDipropionate0.04MG/ACTUATMeteredDoseInhaler[Qvar]|IHSS
636|1003|Y|N|N||Preferred Brand|993456-1MLdenosumab60MG/MLPrefilledSyringe[Prolia]|IHSS
636|1003|Y|N|N||Preferred Brand|853356-1MLustekinumab90MG/MLPrefilledSyringe[Stelara]|IHSS
636|1003|Y|N|N||Preferred Brand|795085-certolizumabpegol200MGInjection[Cimzia]|IHSS
636|1003|N|N|N||Preferred Brand|1999673-bictegravir50MG/emtricitabine200MG/tenofoviralafenamide25MGOralTablet[Biktarvy]|IHSS
636|1003|Y|N|N||Preferred Generic|1860129-Abuse-Deterrent12HROxycodoneHydrochloride20MGExtendedReleaseOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|539789-rifaximin200MGOralTablet[XIFAXAN]|IHSS
636|1003|Y|N|N||Preferred Brand|261362-alosetron1MGOralTablet[Lotronex]|IHSS
636|1003|Y|N|N||Preferred Generic|200220-tolcapone100MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|2475406-voclosporin7.9MGOralCapsule[Lupkynis]|IHSS
636|1003|Y|N|N||Preferred Generic|314153-orlistat120MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Brand|1490063-Levonorgestrel1.5MGOralTablet[TakeAction]|IHSS
636|1003|Y|N|N||Preferred Brand|2201540-romiplostim0.125MGInjection[Nplate]|IHSS
636|1003|Y|N|N||Preferred Brand|205913-EpoetinAlfa10000UNT/MLInjectableSolution[Procrit]|IHSS
636|1003|N|N|N||Preferred Brand|2049677-cobicistat150MG/darunavir800MG/emtricitabine200MG/tenofoviralafenamide10MGOralTablet[Symtuza]|IHSS
636|1003|N|N|N||Preferred Generic|283406-Mirtazapine15MGDisintegratingOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|2048568-tofacitinib10MGOralTablet[Xeljanz]|IHSS
636|1003|N|N|N||Preferred Generic|1665188-1MLLorazepam2MG/MLInjection|IHSS
636|1003|Y|N|N||Preferred Brand|1921017-0.2MLadalimumab100MG/MLPrefilledSyringe[Humira]|IHSS
636|1003|Y|N|N||Preferred Brand|1864414-Buprenorphine0.7MG/Naloxone0.18MGSublingualTablet[Zubsolv]|IHSS
636|1003|Y|N|Y||Preferred Generic|883826-TranexamicAcid650MGOralTablet|IHSS
636|1003|N|N|N||Preferred Brand|2598352-abacavir60MG/dolutegravir5MG/lamivudine30MGTabletforOralSuspension[Triumeq]|IHSS
636|1003|N|N|N||Preferred Brand|2055989-273DAYEthinylEstradiol0.000542MG/HR/segesteroneacetate0.00625MG/HRVaginalSystem[Annovera]|IHSS
636|1003|Y|N|N||Preferred Brand|1718936-olanzapine210MGInjection[Zyprexa]|IHSS
636|1003|N|N|N||Preferred Brand|205669-Dexamethasone1MG/MLOphthalmicSuspension[Maxidex]|IHSS
636|1003|Y|N|N||Preferred Brand|1654955-1MLdarbepoetinalfa0.2MG/MLInjection[Aranesp]|IHSS
636|1003|N|N|N||Preferred Brand|206208-aluminumchloride200MG/MLTopicalSolution[Drysol]|IHSS
636|1003|N|N|N||Preferred Generic|1085745-TriamcinoloneAcetonide1MG/MLTopicalLotion|IHSS
636|1003|N|N|N||Preferred Brand|206216-2MLIron-DextranComplex50MG/MLInjection[InFed]|IHSS
636|1003|N|N|N||Preferred Generic|1085644-TriamcinoloneAcetonide0.25MG/MLTopicalCream|IHSS
636|1003|N|N|N||Preferred Brand|207136-Methylprednisolone2MGOralTablet[Medrol]|IHSS
636|1003|Y|N|N||Preferred Brand|1544404-0.15MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|IHSS
636|1003|N|N|N||Preferred Brand|207273-Nitroglycerin0.02MG/MGTopicalOintment[Nitro-Bid]|IHSS
636|1003|Y|N|N||Preferred Brand|1484296-sucroferricoxyhydroxide500MGChewableTablet[Velphoro]|IHSS
636|1003|N|N|N||Preferred Brand|207373-Mitotane500MGOralTablet[Lysodren]|IHSS
636|1003|N|N|N||Preferred Generic|106351-SilverSulfadiazine10MG/MLTopicalCream|IHSS
636|1003|N|N|N||Preferred Brand|207588-Procarbazine50MGOralCapsule[Matulane]|IHSS
636|1003|Y|N|N||Preferred Brand|1302856-24HRPhentermine15MG/topiramate92MGExtendedReleaseOralCapsule[Qsymia]|IHSS
636|1003|N|N|N||Preferred Brand|207864-crotamiton100MG/MLTopicalCream[Eurax]|IHSS
636|1003|N|N|N||Preferred Generic|105583-Fluorouracil50MG/MLTopicalCream|IHSS
636|1003|N|N|N||Preferred Brand|208513-Estrogens,Conjugated(USP)0.3MGOralTablet[Premarin]|IHSS
636|1003|N|N|N||Preferred Generic|402505-12HRCarbamazepine200MGExtendedReleaseOralTablet|IHSS
636|1003|N|N|N||Preferred Brand|208535-thyroid(USP)30MGOralTablet[ArmourThyroid]|IHSS
636|1003|Y|N|N||Preferred Brand|1043582-24HRMetforminhydrochloride500MG/saxagliptin5MGExtendedReleaseOralTablet[Kombiglyze]|IHSS
636|1003|N|N|N||Preferred Brand|208540-thyroid(USP)60MGOralTablet[ArmourThyroid]|IHSS
636|1003|N|Y|N||Preferred Generic|810083-Carbidopa31.25MG/entacapone200MG/Levodopa125MGOralTablet|IHSS
636|1003|N|N|N||Preferred Brand|208543-thyroid(USP)90MGOralTablet[ArmourThyroid]|IHSS
636|1003|N|N|N||Preferred Generic|349405-Olmesartanmedoxomil40MGOralTablet|IHSS
636|1003|N|N|N||Preferred Brand|208547-thyroid(USP)180MGOralTablet[ArmourThyroid]|IHSS
636|1003|N|N|N||Preferred Generic|197863-Leucovorin5MGOralTablet|IHSS
636|1003|N|N|N||Preferred Brand|208549-thyroid(USP)240MGOralTablet[ArmourThyroid]|IHSS
636|1003|N|Y|N||Preferred Generic|311286-Levalbuterol0.21MG/MLInhalationSolution|IHSS
636|1003|N|N|N||Preferred Brand|208551-thyroid(USP)300MGOralTablet[ArmourThyroid]|IHSS
636|1003|N|N|N||Preferred Brand|213291-ParoxetineHydrochloride2MG/MLOralSuspension[Paxil]|IHSS
636|1003|N|N|N||Preferred Brand|208949-Estrogens,Conjugated(USP)0.9MGOralTablet[Premarin]|IHSS
636|1003|N|Y|N||Preferred Generic|1085816-spinosad9MG/MLMedicatedShampoo|IHSS
636|1003|N|N|N||Preferred Brand|209002-prednisolone1.2MG/MLOphthalmicSuspension[PredMild]|IHSS
636|1003|N|Y|N||Preferred Brand|212381-aminosalicylicacid4000MGOralGranules[PaserD/R]|IHSS
636|1003|N|N|N||Preferred Brand|212039-Estrogens,Esterified(USP)0.3MGOralTablet[Menest]|IHSS
636|1003|N|N|N||Preferred Generic|1014571-12HRcetirizinehydrochloride5MG/PseudoephedrineHydrochloride120MGExtendedReleaseOralTablet|IHSS
636|1003|N|N|N||Preferred Brand|212118-Nelfinavir250MGOralTablet[Viracept]|IHSS
636|1003|N|N|N||Preferred Generic|1012021-Prednisolonesodiumphosphate2.5MG/ML/SulfacetamideSodium100MG/MLOphthalmicSolution|IHSS
636|1003|N|N|N||Preferred Brand|212232-Estrogens,Esterified(USP)0.625MGOralTablet[Menest]|IHSS
636|1003|N|N|Y||Preferred Generic|892672-MorphineSulfate30MGOralTablet|IHSS
636|1003|N|N|N||Preferred Brand|2122526-dolutegravir50MG/Lamivudine300MGOralTablet[Dovato]|IHSS
636|1003|N|N|Y||Preferred Generic|857005-Acetaminophen325MG/HydrocodoneBitartrate7.5MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|313361-Thiothixene10MGOralCapsule|IHSS
636|1003|N|N|Y||Preferred Generic|897710-HydromorphoneHydrochloride8MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|853201-24HRquetiapine50MGExtendedReleaseOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|807832-24HRLevetiracetam500MGExtendedReleaseOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|993781-Acetaminophen300MG/CodeinePhosphate30MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|197797-hydroxyurea500MGOralCapsule|IHSS
636|1003|N|N|Y||Preferred Generic|636045-Hydrochlorothiazide25MG/valsartan320MGOralTablet|IHSS
636|1003|N|Y|N||Preferred Brand|833139-Milnacipranhydrochloride100MGOralTablet[Savella]|IHSS
636|1003|N|N|Y||Preferred Generic|541878-Amphetamineaspartate1.25MG/AmphetamineSulfate1.25MG/Dextroamphetaminesaccharate1.25MG/DextroamphetamineSulfate1.25MGOr|IHSS
636|1003|N|N|Y||Preferred Generic|483442-pregabalin25MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|314230-Sirolimus1MG/MLOralSolution|IHSS
636|1003|N|N|N||Preferred Generic|343033-Dexamethasone0.75MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|349591-atomoxetine10MGOralCapsule|IHSS
636|1003|N|N|Y||Preferred Generic|349197-Clonazepam2MGDisintegratingOralTablet|IHSS
636|1003|N|Y|N||Preferred Generic|403851-Carbidopa25MG/entacapone200MG/Levodopa100MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|313761-zaleplon10MGOralCapsule|IHSS
636|1003|N|Y|N||Preferred Generic|996594-24HRMemantinehydrochloride14MGExtendedReleaseOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|349490-aripiprazole15MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|312086-Ondansetron8MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|310191-estradiolvalerate40MG/MLInjectableSolution|IHSS
636|1003|N|N|N||Preferred Generic|197905-Lovastatin40MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1049595-Abuse-Deterrent12HROxycodoneHydrochloride60MGExtendedReleaseOralTablet[Oxycontin]|IHSS
636|1003|N|N|Y||Preferred Generic|2563971-3MLinsulinglargine-yfgn100UNT/MLPenInjector|IHSS
636|1003|N|N|N||Preferred Generic|1053753-Nystatin100000UNT/ML/TriamcinoloneAcetonide1MG/MLTopicalCream|IHSS
636|1003|N|N|Y||Preferred Generic|205323-celecoxib200MGOralCapsule|IHSS
636|1003|N|N|Y||Preferred Generic|200224-montelukast10MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1302845-24HRPhentermine3.75MG/topiramate23MGExtendedReleaseOralCapsule[Qsymia]|IHSS
636|1003|N|N|Y||Preferred Generic|197735-Gentamicin1MG/MLTopicalCream|IHSS
636|1003|Y|N|N||Preferred Brand|1375922-bromfenac0.7MG/MLOphthalmicSolution[Prolensa]|IHSS
636|1003|N|N|N||Preferred Generic|198008-Nadolol80MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|197519-Clindamycin10MG/MLTopicalLotion|IHSS
636|1003|Y|N|N||Preferred Brand|1544383-0.2MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|IHSS
636|1003|N|N|Y||Preferred Generic|1650142-DoxycyclineMonohydrate100MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|1115698-Oseltamivir6MG/MLOralSuspension|IHSS
636|1003|N|N|N||Preferred Generic|617296-Amoxicillin500MG/Clavulanate125MGOralTablet|IHSS
636|1003|N|N|N||Preferred Brand|2588080-3MLcabotegravir200MG/MLInjection[Apretude]|IHSS
636|1003|N|N|Y||Preferred Brand|830263-1MLHepatitisBSurfaceAntigenVaccine0.04MG/MLInjection[Recombivax]|IHSS
636|1003|N|N|Y||Preferred Brand|794610-darunavir600MGOralTablet[Prezista]|IHSS
636|1003|Y|N|N||Preferred Brand|1653225-1MLEtanercept50MG/MLAuto-Injector[Enbrel]|IHSS
636|1003|N|N|Y||Preferred Brand|2603514-0.5MLmeaslesvirusvaccinelive,attenuatedSchwarzstrain5024UNT/ML/mumpsvirusvaccinelive,RIT-4385strain31684UNT/ML/rubell|IHSS
636|1003|Y|N|N||Preferred Brand|1666334-Ticagrelor60MGOralTablet[Brilinta]|IHSS
636|1003|N|N|N||Preferred Generic|748806-{21(EthinylEstradiol0.05MG/EthynodiolDiacetate1MGOralTablet)/7(InertIngredients1MGOralTablet)}Pack|IHSS
636|1003|N|N|Y||Preferred Brand|1731317-3MLinsulin,regular,human500UNT/MLPenInjector[HumulinR]|IHSS
636|1003|N|N|N||Preferred Brand|261353-Trimethoprim10MG/MLOralSolution[Primsol]|IHSS
636|1003|Y|N|Y||Preferred Generic|197636-dronabinol5MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Brand|2625900-Sunlenca5-TabletPack|IHSS
636|1003|Y|N|N||Preferred Generic|904952-3MLibandronicacid1MG/MLPrefilledSyringe|IHSS
636|1003|N|N|N||Preferred Brand|2625912-Sunlenca927MG2-VialKit|IHSS
636|1003|N|N|N||Preferred Generic|284988-Didanosine400MGDelayedReleaseOralCapsule|IHSS
636|1003|N|N|N||Preferred Brand|284551-nilutamide150MGOralTablet[Nilandron]|IHSS
636|1003|Y|N|N||Preferred Generic|857216-Sevelamerhydrochloride400MGOralTablet|IHSS
636|1003|N|N|N||Preferred Brand|284592-Methotrexate5MGOralTablet[Trexall]|IHSS
636|1003|N|N|N||Preferred Generic|283433-Melatonin10MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Brand|284593-Methotrexate10MGOralTablet[Trexall]|IHSS
636|1003|N|N|N||Preferred Generic|992528-Terbinafinehydrochloride10MG/MLTopicalCream|IHSS
636|1003|N|N|N||Preferred Brand|284594-Methotrexate7.5MGOralTablet[Trexall]|IHSS
636|1003|Y|N|N||Preferred Generic|643720-lenalidomide25MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Brand|284595-Methotrexate15MGOralTablet[Trexall]|IHSS
636|1003|Y|N|N||Preferred Generic|577057-72HRFentanyl0.012MG/HRTransdermalSystem|IHSS
636|1003|N|N|N||Preferred Brand|285028-abacavir300MG/Lamivudine150MG/Zidovudine300MGOralTablet[Trizivir]|IHSS
636|1003|N|N|N||Preferred Generic|242680-abacavir20MG/MLOralSolution|IHSS
636|1003|N|N|N||Preferred Brand|351750-podofilox0.005MG/MGTopicalGel[Condylox]|IHSS
636|1003|N|N|N||Preferred Generic|904475-PravastatinSodium40MGOralTablet|IHSS
636|1003|N|N|N||Preferred Brand|352210-Mesna400MGOralTablet[Mesnex]|IHSS
636|1003|Y|N|N||Preferred Generic|310436-Galantamine4MGOralTablet|IHSS
636|1003|N|N|N||Preferred Brand|402110-fosamprenavir700MGOralTablet[Lexiva]|IHSS
636|1003|N|N|N||Preferred Generic|898372-Benazeprilhydrochloride20MG/Hydrochlorothiazide25MGOralTablet|IHSS
636|1003|N|N|N||Preferred Brand|404475-Azathioprine75MGOralTablet[Azasan]|IHSS
636|1003|Y|N|N||Preferred Generic|198070-Penicillamine250MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Brand|404476-Azathioprine100MGOralTablet[Azasan]|IHSS
636|1003|Y|N|N||Preferred Generic|1947301-2MLpalonosetron0.125MG/MLInjection|IHSS
636|1003|N|N|N||Preferred Brand|404492-5MLLaronidase0.58MG/MLInjection[Aldurazyme]|IHSS
636|1003|N|N|N||Preferred Generic|896762-Labetalolhydrochloride200MGOralTablet|IHSS
636|1003|N|N|N||Preferred Brand|404550-Estrogens,Conjugated(USP)0.45MGOralTablet[Premarin]|IHSS
636|1003|Y|N|N||Preferred Generic|1373483-dimethylfumarate120MGDelayedReleaseOralCapsule|IHSS
636|1003|N|N|N||Preferred Brand|542370-Nelfinavir625MGOralTablet[Viracept]|IHSS
636|1003|N|N|N||Preferred Generic|200132-Acarbose25MGOralTablet|IHSS
636|1003|N|N|N||Preferred Brand|603378-tipranavir250MGOralCapsule[Aptivus]|IHSS
636|1003|N|N|N||Preferred Generic|866412-24HRmetoprololsuccinate100MGExtendedReleaseOralTablet|IHSS
636|1003|N|N|N||Preferred Brand|608934-Metronidazole0.0075MG/MGVaginalGel[Vandazole]|IHSS
636|1003|Y|N|N||Preferred Generic|1000001-Amlodipine5MG/Hydrochlorothiazide25MG/Olmesartanmedoxomil40MGOralTablet|IHSS
636|1003|N|N|N||Preferred Brand|616148-emtricitabine10MG/MLOralSolution[Emtriva]|IHSS
636|1003|N|N|N||Preferred Generic|866021-Cyproheptadinehydrochloride0.4MG/MLOralSolution|IHSS
636|1003|Y|N|N||Preferred Brand|856666-rifaximin550MGOralTablet[XIFAXAN]|IHSS
636|1003|Y|N|N||Preferred Brand|853354-0.5MLustekinumab90MG/MLPrefilledSyringe[Stelara]|IHSS
636|1003|N|N|N||Preferred Generic|866427-24HRmetoprololsuccinate25MGExtendedReleaseOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|758032-0.5MLInterferonbeta-1a0.044MG/MLPrefilledSyringe[Rebif]|IHSS
636|1003|Y|N|N||Preferred Generic|1373497-{14(dimethylfumarate120MGDelayedReleaseOralCapsule)/46(dimethylfumarate240MGDelayedReleaseOralCapsule)}Pack|IHSS
636|1003|Y|N|N||Preferred Generic|153822-candesartancilexetil4MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|723846-orlistat60MGOralCapsule[Alli]|IHSS
636|1003|N|N|N||Preferred Generic|897612-24HRVerapamilhydrochloride120MGExtendedReleaseOralCapsule|IHSS
636|1003|Y|N|N||Preferred Brand|616283-sunitinib12.5MGOralCapsule[Sutent]|IHSS
636|1003|Y|N|N||Preferred Brand|404450-Thalidomide200MGOralCapsule[Thalomid]|IHSS
636|1003|Y|N|N||Preferred Generic|197366-Amoxapine50MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|2611460-ivacaftor94MG/lumacaftor75MGOralGranules[ORKAMBI]|IHSS
636|1003|N|N|N||Preferred Generic|898353-Amlodipine5MG/Benazeprilhydrochloride10MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Brand|202301-Estrogens,Conjugated(USP)1.25MGOralTablet[Premarin]|IHSS
636|1003|Y|N|N||Preferred Brand|2540695-1MLrisankizumab-rzaa150MG/MLAuto-Injector[Skyrizi]|IHSS
636|1003|Y|N|N||Preferred Brand|2467571-berotralstat150MGOralCapsule[Orladeyo]|IHSS
636|1003|N|N|N||Preferred Generic|903887-FluvoxamineMaleate25MGOralTablet|IHSS
636|1003|N|N|N||Preferred Brand|2043322-1.33MLibalizumab-uiyk150MG/MLInjection[Trogarzo]|IHSS
636|1003|Y|N|N||Preferred Brand|2359285-24HRempagliflozin10MG/linagliptin5MG/metforminhydrochloride1000MGExtendedReleaseOralTablet[Trijardy]|IHSS
636|1003|Y|N|N||Preferred Generic|403818-moxifloxacin5MG/MLOphthalmicSolution|IHSS
636|1003|Y|N|N||Preferred Brand|2261794-Diroximelfumarate231MGDelayedReleaseOralCapsule[Vumerity]|IHSS
636|1003|Y|N|N||Preferred Brand|2199685-tenapanor50MGOralTablet[Ibsrela]|IHSS
636|1003|Y|N|N||Preferred Generic|1596779-14ACTUATBudesonide2MG/ACTUATRectalFoam|IHSS
636|1003|Y|N|N||Preferred Brand|1989109-1MLbenralizumab30MG/MLPrefilledSyringe[Fasenra]|IHSS
636|1003|Y|N|N||Preferred Generic|656659-bosentan125MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|260376-Terazosin10MGOralCapsule|IHSS
636|1003|Y|N|N||Preferred Brand|206791-mesalamine250MGExtendedReleaseOralCapsule[Pentasa]|IHSS
636|1003|N|N|N||Preferred Generic|1648759-NITROFURANTOIN,MACROCRYSTALS100MGOralCapsule|IHSS
636|1003|Y|N|N||Preferred Brand|2057212-1MLfilgrastim-aafi0.3MG/MLInjection[Nivestym]|IHSS
636|1003|Y|N|N||Preferred Brand|2048025-0.6MLpegfilgrastim-jmdb10MG/MLPrefilledSyringe[Fulphila]|IHSS
636|1003|N|N|N||Preferred Generic|995607-EthambutolHydrochloride400MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|886634-ButorphanolTartrate1MG/ACTUATMeteredDoseNasalSpray|IHSS
636|1003|Y|N|N||Preferred Brand|1925257-0.7MLabatacept125MG/MLPrefilledSyringe[Orencia]|IHSS
636|1003|Y|N|N||Preferred Brand|1921010-0.1MLadalimumab100MG/MLPrefilledSyringe[Humira]|IHSS
636|1003|Y|N|N||Preferred Generic|905347-DemeclocyclineHydrochloride300MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1858267-tenofoviralafenamide25MGOralTablet[Vemlidy]|IHSS
636|1003|N|N|N||Preferred Brand|850457-darunavir150MGOralTablet[Prezista]|IHSS
636|1003|N|N|Y||Preferred Brand|1596445-7ACTUATumeclidinium0.0625MG/ACTUATDryPowderInhaler[Incruse]|IHSS
636|1003|N|N|N||Preferred Brand|855673-Phenytoinsodium100MGExtendedReleaseOralCapsule[Dilantin]|IHSS
636|1003|N|N|N||Preferred Generic|1095224-{21(EthinylEstradiol0.035MG/Norethindrone0.4MGChewableTablet)/7(Ferrousfumarate75MGChewableTablet)}Pack|IHSS
636|1003|N|N|N||Preferred Brand|855863-Phenytoinsodium200MGExtendedReleaseOralCapsule[Phenytek]|IHSS
636|1003|Y|N|N||Preferred Brand|1729013-selexipag1MGOralTablet[Uptravi]|IHSS
636|1003|N|N|N||Preferred Brand|855871-Phenytoinsodium30MGExtendedReleaseOralCapsule[Dilantin]|IHSS
636|1003|Y|N|N||Preferred Brand|1718932-olanzapine300MGInjection[Zyprexa]|IHSS
636|1003|N|N|N||Preferred Brand|855875-Phenytoinsodium300MGExtendedReleaseOralCapsule[Phenytek]|IHSS
636|1003|N|N|N||Preferred Generic|1094107-Phenazopyridinehydrochloride100MGOralTablet|IHSS
636|1003|N|N|N||Preferred Brand|858079-Levonorgestrel1.5MGOralTablet[PlanBOne-Step]|IHSS
636|1003|Y|N|N||Preferred Brand|1653243-1MLsecukinumab150MG/MLAuto-Injector[Cosentyx]|IHSS
636|1003|N|N|N||Preferred Brand|863829-amylase120000UNT/lipase24000UNT/protease76000UNTDelayedReleaseOralCapsule[Creon]|IHSS
636|1003|N|N|N||Preferred Generic|1090807-Psyllium3400MGPowderforOralSuspension[Konsyl]|IHSS
636|1003|N|N|N||Preferred Brand|863836-amylase30000UNT/lipase6000UNT/protease19000UNTDelayedReleaseOralCapsule[Creon]|IHSS
636|1003|N|N|N||Preferred Generic|643066-efavirenz600MG/emtricitabine200MG/Tenofovirdisoproxilfumarate300MGOralTablet|IHSS
636|1003|N|N|N||Preferred Brand|863841-amylase60000UNT/lipase12000UNT/protease38000UNTDelayedReleaseOralCapsule[Creon]|IHSS
636|1003|Y|N|N||Preferred Brand|1602120-empagliflozin25MG/Linagliptin5MGOralTablet[Glyxambi]|IHSS
636|1003|N|N|N||Preferred Brand|866049-60ACTUATsalmeterol0.05MG/ACTUATDryPowderInhaler[Serevent]|IHSS
636|1003|N|N|N||Preferred Generic|1085640-TriamcinoloneAcetonide0.005MG/MGTopicalOintment|IHSS
636|1003|N|N|N||Preferred Brand|896019-60ACTUATFluticasonepropionate0.05MG/ACTUATDryPowderInhaler[Flovent]|IHSS
636|1003|Y|N|N||Preferred Brand|1551886-lanthanumcarbonate750MGOralPowder[Fosrenol]|IHSS
636|1003|N|N|N||Preferred Brand|896023-60ACTUATFluticasonepropionate0.1MG/ACTUATDryPowderInhaler[Flovent]|IHSS
636|1003|Y|N|N||Preferred Brand|1544402-0.6MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|IHSS
636|1003|N|N|N||Preferred Brand|896027-60ACTUATFluticasonepropionate0.25MG/ACTUATDryPowderInhaler[Flovent]|IHSS
636|1003|N|N|N||Preferred Generic|1085636-TriamcinoloneAcetonide0.001MG/MGTopicalOintment|IHSS
636|1003|N|N|N||Preferred Brand|901518-0.5MLNeisseriameningitidisserogroupAoligosaccharidediphtheriaCRM197proteinconjugatevaccine0.02MG/ML/Neisseriameningiti|IHSS
636|1003|Y|N|N||Preferred Brand|1482513-eslicarbazepineacetate200MGOralTablet[Aptiom]|IHSS
636|1003|N|N|N||Preferred Brand|966158-LevothyroxineSodium0.025MGOralTablet[Synthroid]|IHSS
636|1003|N|N|N||Preferred Generic|106387-Permethrin50MG/MLTopicalCream|IHSS
636|1003|N|N|N||Preferred Brand|966171-LevothyroxineSodium0.075MGOralTablet[Synthroid]|IHSS
636|1003|N|N|N||Preferred Generic|485020-MycophenolicAcid180MGDelayedReleaseOralTablet|IHSS
636|1003|N|N|N||Preferred Brand|966191-LevothyroxineSodium0.125MGOralTablet[Synthroid]|IHSS
636|1003|Y|N|N||Preferred Brand|1365866-nepafenac3MG/MLOphthalmicSuspension[Ilevro]|IHSS
636|1003|N|N|N||Preferred Brand|966201-LevothyroxineSodium0.15MGOralTablet[Synthroid]|IHSS
636|1003|Y|N|N||Preferred Brand|1251922-24HRRotigotine0.333MG/HRTransdermalSystem[Neupro]|IHSS
636|1003|N|N|N||Preferred Brand|966205-LevothyroxineSodium0.175MGOralTablet[Synthroid]|IHSS
636|1003|N|N|N||Preferred Generic|105585-Methotrexate2.5MGOralTablet|IHSS
636|1003|N|N|N||Preferred Brand|966218-LevothyroxineSodium0.3MGOralTablet[Synthroid]|IHSS
636|1003|N|N|N||Preferred Generic|403855-Hydrochlorothiazide25MG/Olmesartanmedoxomil40MGOralTablet|IHSS
636|1003|N|N|N||Preferred Brand|966247-LevothyroxineSodium0.05MGOralTablet[Synthroid]|IHSS
636|1003|Y|N|N||Preferred Brand|1190179-2MLSodiumHyaluronate10MG/MLPrefilledSyringe[Euflexxa]|IHSS
636|1003|N|N|N||Preferred Brand|966250-LevothyroxineSodium0.1MGOralTablet[Synthroid]|IHSS
636|1003|N|N|N||Preferred Generic|402247-Atazanavir200MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Brand|966251-LevothyroxineSodium0.2MGOralTablet[Synthroid]|IHSS
636|1003|Y|N|N||Preferred Brand|1091654-azilsartanmedoxomil80MGOralTablet[Edarbi]|IHSS
636|1003|N|N|N||Preferred Brand|966271-LevothyroxineSodium0.137MGOralTablet[Synthroid]|IHSS
636|1003|Y|N|N||Preferred Brand|1043574-24HRMetforminhydrochloride1000MG/saxagliptin5MGExtendedReleaseOralTablet[Kombiglyze]|IHSS
636|1003|N|N|N||Preferred Brand|966282-LevothyroxineSodium0.088MGOralTablet[Synthroid]|IHSS
636|1003|N|N|N||Preferred Generic|351250-Escitalopram20MGOralTablet|IHSS
636|1003|N|N|N||Preferred Brand|977431-everolimus0.25MGOralTablet[Zortress]|IHSS
636|1003|N|Y|N||Preferred Generic|197419-Bumetanide2MGOralTablet|IHSS
636|1003|N|N|N||Preferred Brand|977436-everolimus0.5MGOralTablet[Zortress]|IHSS
636|1003|N|N|N||Preferred Generic|349491-Lamivudine300MGOralTablet|IHSS
636|1003|N|N|N||Preferred Brand|977440-everolimus0.75MGOralTablet[Zortress]|IHSS
636|1003|N|N|N||Preferred Generic|197889-LithiumCarbonate300MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Brand|978950-Natazia28DayPack|IHSS
636|1003|N|Y|N||Preferred Generic|857564-24HRtrospiumchloride60MGExtendedReleaseOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|1000048-doxepin10MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Brand|2173508-Nonoxynol-91000MGVaginalSponge[TodaySponge]|IHSS
636|1003|N|N|N||Preferred Generic|1000054-doxepin10MG/MLOralSolution|IHSS
636|1003|N|Y|N||Preferred Generic|403850-Carbidopa12.5MG/entacapone200MG/Levodopa50MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|1000058-doxepin100MGOralCapsule|IHSS
636|1003|N|Y|N||Preferred Generic|310600-Griseofulvin500MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|1000064-doxepin150MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|103457-Fluocinonide0.0005MG/MGTopicalOintment|IHSS
636|1003|N|N|N||Preferred Generic|1000070-doxepin25MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|103403-Hydrocortisone10MG/MLTopicalLotion|IHSS
636|1003|N|N|N||Preferred Generic|1000076-doxepin50MGOralCapsule|IHSS
636|1003|N|Y|N||Preferred Generic|1368424-alogliptin25MG/pioglitazone15MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|1000097-doxepin75MGOralCapsule|IHSS
636|1003|N|Y|N||Preferred Brand|861821-Metforminhydrochloride500MG/sitagliptin50MGOralTablet[Janumet]|IHSS
636|1003|N|N|N||Preferred Generic|1000114-medroxyprogesteroneacetate10MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|1020477-DiphenhydramineHydrochloride50MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|1000126-1MLmedroxyprogesteroneacetate150MG/MLInjection|IHSS
636|1003|N|Y|N||Preferred Brand|1992832-ertugliflozin15MG/sitagliptin100MGOralTablet[Steglujan]|IHSS
636|1003|N|N|N||Preferred Generic|1000135-medroxyprogesteroneacetate2.5MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|1014673-cetirizinehydrochloride1MG/MLOralSolution|IHSS
636|1003|N|N|N||Preferred Generic|1000141-medroxyprogesteroneacetate5MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|313979-fludrocortisoneacetate0.1MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|1000153-1MLmedroxyprogesteroneacetate150MG/MLPrefilledSyringe|IHSS
636|1003|N|N|Y||Preferred Generic|993770-Acetaminophen300MG/CodeinePhosphate15MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|1000647-PilocarpineHydrochloride10MG/MLOphthalmicSolution|IHSS
636|1003|N|N|N||Preferred Generic|1010878-LidocaineHydrochloride40MG/MLMucousMembraneTopicalSolution|IHSS
636|1003|N|N|N||Preferred Generic|1000673-SulfacetamideSodium0.1MG/MGOphthalmicOintment|IHSS
636|1003|N|N|Y||Preferred Generic|899518-dexmethylphenidatehydrochloride5MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|1000862-PilocarpineHydrochloride20MG/MLOphthalmicSolution|IHSS
636|1003|N|N|Y||Preferred Generic|892625-MorphineSulfate20MG/MLOralSolution|IHSS
636|1003|N|N|N||Preferred Generic|1000897-PilocarpineHydrochloride40MG/MLOphthalmicSolution|IHSS
636|1003|N|N|N||Preferred Generic|1006688-SulfacetamideSodium100MG/MLTopicalLotion|IHSS
636|1003|N|N|N||Preferred Generic|1005856-SulfacetamideSodium100MG/ML/Sulfur50MG/MLTopicalLotion|IHSS
636|1003|N|N|Y||Preferred Generic|856569-24HRPropranololHydrochloride80MGExtendedReleaseOralCapsule|IHSS
636|1003|N|N|N||Preferred Brand|1306298-cobicistat150MG/elvitegravir150MG/emtricitabine200MG/Tenofovirdisoproxilfumarate300MGOralTablet[Stribild]|IHSS
636|1003|N|N|Y||Preferred Generic|892589-MorphineSulfate2MG/MLOralSolution|IHSS
636|1003|N|N|Y||Preferred Generic|855633-DiclofenacSodium0.01MG/MGTopicalGel|IHSS
636|1003|N|N|N||Preferred Generic|313565-valacyclovir500MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|854241-0.8MLEnoxaparinsodium100MG/MLPrefilledSyringe|IHSS
636|1003|N|N|Y||Preferred Generic|847252-3MLInsulinLispro25UNT/ML/insulinlisproprotamine,human75UNT/MLPenInjector|IHSS
636|1003|N|N|Y||Preferred Generic|905495-ChlordiazepoxideHydrochloride25MGOralCapsule|IHSS
636|1003|N|N|Y||Preferred Generic|728109-Oseltamivir30MGOralCapsule|IHSS
636|1003|N|N|Y||Preferred Generic|991486-CodeinePhosphate2MG/ML/PromethazineHydrochloride1.25MG/MLOralSolution|IHSS
636|1003|N|N|N||Preferred Generic|197785-Hydrocortisone25MG/MLTopicalLotion|IHSS
636|1003|N|N|Y||Preferred Generic|798133-Erythromycin20MG/MLMedicatedPad[Ery]|IHSS
636|1003|N|Y|N||Preferred Brand|1992695-ertugliflozin2.5MG/Metforminhydrochloride500MGOralTablet[Segluromet]|IHSS
636|1003|N|N|Y||Preferred Generic|687043-Amphetamineaspartate3.125MG/AmphetamineSulfate3.125MG/Dextroamphetaminesaccharate3.125MG/DextroamphetamineSulfate3.125|IHSS
636|1003|N|N|Y||Preferred Generic|636042-Hydrochlorothiazide12.5MG/valsartan320MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|314072-latanoprost0.05MG/MLOphthalmicSolution|IHSS
636|1003|N|Y|N||Preferred Brand|833151-Savella4-WeekTitrationPack|IHSS
636|1003|N|N|Y||Preferred Generic|577957-Amphetamineaspartate3.75MG/AmphetamineSulfate3.75MG/Dextroamphetaminesaccharate3.75MG/DextroamphetamineSulfate3.75MGOr|IHSS
636|1003|N|N|Y||Preferred Generic|541363-Amphetamineaspartate7.5MG/AmphetamineSulfate7.5MG/Dextroamphetaminesaccharate7.5MG/DextroamphetamineSulfate7.5MGOralTa|IHSS
636|1003|N|N|N||Preferred Generic|314165-prednisolone10MG/MLOphthalmicSolution|IHSS
636|1003|N|N|Y||Preferred Generic|483438-pregabalin100MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|314214-rivastigmine1.5MGOralCapsule|IHSS
636|1003|N|Y|N||Preferred Generic|1368431-alogliptin25MG/pioglitazone30MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|401953-Risperidone1MGDisintegratingOralTablet|IHSS
636|1003|N|Y|Y||Preferred Generic|314227-Sumatriptan20MG/ACTUATNasalSpray|IHSS
636|1003|N|N|Y||Preferred Generic|349595-atomoxetine60MGOralCapsule|IHSS
636|1003|N|N|Y||Preferred Generic|349514-celecoxib400MGOralCapsule|IHSS
636|1003|N|Y|N||Preferred Generic|197505-Cimetidine200MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|349195-Clonazepam0.25MGDisintegratingOralTablet|IHSS
636|1003|N|Y|N||Preferred Generic|311345-linezolid20MG/MLOralSuspension|IHSS
636|1003|N|N|N||Preferred Generic|328160-Cyclosporine100MGOralCapsule|IHSS
636|1003|N|N|Y||Preferred Generic|314209-rizatriptan10MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|313415-Tobramycin3MG/MLOphthalmicSolution|IHSS
636|1003|N|Y|N||Preferred Generic|810090-Carbidopa18.75MG/entacapone200MG/Levodopa75MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|349401-Olmesartanmedoxomil20MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|313161-Sumatriptan50MGOralTablet|IHSS
636|1003|N|Y|Y||Preferred Brand|2601770-0.5MLtirzepatide20MG/MLAuto-Injector[Mounjaro]|IHSS
636|1003|N|N|Y||Preferred Generic|312745-quetiapine300MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|312079-olanzapine7.5MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|197893-LithiumCarbonate600MGOralCapsule|IHSS
636|1003|N|N|Y||Preferred Generic|309307-Ciprofloxacin3MG/MLOphthalmicSolution|IHSS
636|1003|N|N|N||Preferred Generic|197903-Lovastatin10MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1043567-24HRMetforminhydrochloride1000MG/saxagliptin2.5MGExtendedReleaseOralTablet[Kombiglyze]|IHSS
636|1003|N|N|Y||Preferred Generic|309333-Clindamycin10MG/MLTopicalSolution|IHSS
636|1003|N|N|N||Preferred Generic|105292-isoniazid10MG/MLOralSolution|IHSS
636|1003|N|N|Y||Preferred Generic|2621571-Sensor3MLinsulinlispro100UNT/MLPenInjector|IHSS
636|1003|N|N|Y||Preferred Generic|251872-pantoprazole20MGDelayedReleaseOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1115459-1MLLeuprolideAcetate3.75MG/MLPrefilledSyringe[Lupron]|IHSS
636|1003|N|N|N||Preferred Brand|2385353-citricacid0.01MG/MG/lacticacid0.018MG/MG/potassiumbitartrate0.004MG/MGVaginalGel[Phexxi]|IHSS
636|1003|N|N|Y||Preferred Generic|241527-168HREstradiol0.00312MG/HRTransdermalSystem|IHSS
636|1003|N|N|Y||Preferred Generic|205322-celecoxib100MGOralCapsule|IHSS
636|1003|Y|N|N||Preferred Brand|1243052-ivacaftor150MGOralTablet[Kalydeco]|IHSS
636|1003|N|N|Y||Preferred Generic|2001566-BXRating24HRMethylphenidateHydrochloride36MGExtendedReleaseOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1251918-24HRRotigotine0.125MG/HRTransdermalSystem[Neupro]|IHSS
636|1003|N|N|N||Preferred Generic|429212-Clozapine50MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|199376-potassiumcitrate5MEQExtendedReleaseOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|1812015-Osmotic24HRNifedipine90MGExtendedReleaseOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1310147-everolimus5MGTabletforOralSuspension[Afinitor]|IHSS
636|1003|N|N|N||Preferred Generic|198006-Nadolol20MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|197901-Lorazepam1MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1441413-0.4MLMethotrexate37.5MG/MLAuto-Injector[Otrexup]|IHSS
636|1003|N|N|Y||Preferred Generic|197541-Colchicine0.6MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|197512-Ciprofloxacin750MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|544455-Lactulose667MG/MLOralSolution[Generlac]|IHSS
636|1003|Y|N|N||Preferred Brand|1544394-0.4MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|IHSS
636|1003|N|N|Y||Preferred Generic|1806195-50/50Release24HRMethylphenidateHydrochloride10MGExtendedReleaseOralCapsule|IHSS
636|1003|N|N|Y||Preferred Generic|1649990-DoxycyclineMonohydrate100MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|596843-lansoprazole15MGDelayedReleaseOralCapsule|IHSS
636|1003|N|N|Y||Preferred Generic|1111339-olopatadine1MG/MLOphthalmicSolution|IHSS
636|1003|N|N|N||Preferred Generic|602393-abacavir600MG/Lamivudine300MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1551923-naloxegol12.5MGOralTablet[Movantik]|IHSS
636|1003|N|N|Y||Preferred Generic|1049221-Acetaminophen325MG/OxycodoneHydrochloride5MGOralTablet|IHSS
636|1003|N|N|N||Preferred Brand|1796083-dolutegravir25MGOralTablet[Tivicay]|IHSS
636|1003|N|N|Y||Preferred Brand|847199-3MLinsulinisophane,human100UNT/MLPenInjector[HumulinN]|IHSS
636|1003|N|N|Y||Preferred Brand|830253-0.5MLHepatitisBSurfaceAntigenVaccine0.01MG/MLPrefilledSyringe[Recombivax]|IHSS
636|1003|Y|N|N||Preferred Brand|1606866-ivacaftor50MGOralGranules[Kalydeco]|IHSS
636|1003|N|N|Y||Preferred Brand|731281-InsulinLispro50UNT/ML/insulinlisproprotamine,human50UNT/MLInjectableSuspension[HumalogMix]|IHSS
636|1003|Y|N|N||Preferred Brand|1650282-RebifRebidoseTitrationPack|IHSS
636|1003|N|N|N||Preferred Generic|702519-Phenobarbital4MG/MLOralSolution|IHSS
636|1003|N|N|Y||Preferred Brand|2605557-0.5MLinfluenzaAvirusA/Darwin/6/2021(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.03MG/ML/i|IHSS
636|1003|N|N|Y||Preferred Brand|2360588-0.5MLNeisseriameningitidisserogroupAcapsularpolysaccharidetetanustoxoidproteinconjugatevaccine0.02MG/ML/Neisseriameni|IHSS
636|1003|Y|N|N||Preferred Brand|1659818-aripiprazole300MGInjection[Abilify]|IHSS
636|1003|N|N|N||Preferred Generic|746645-lopinavir100MG/Ritonavir25MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Brand|208821-Dexamethasone0.001MG/MG/Tobramycin0.003MG/MGOphthalmicOintment[Tobradex]|IHSS
636|1003|N|N|N||Preferred Generic|748868-{21(EthinylEstradiol0.02MG/Levonorgestrel0.1MGOralTablet)/7(InertIngredients1MGOralTablet)}Pack|IHSS
636|1003|N|N|Y||Preferred Brand|1992171-3MLInsulinLispro100UNT/MLPenInjector[Admelog]|IHSS
636|1003|N|N|Y||Preferred Brand|1723478-dabigatranetexilate110MGOralCapsule[Pradaxa]|IHSS
636|1003|Y|N|N||Preferred Brand|1729057-selexipag0.4MGOralTablet[Uptravi]|IHSS
636|1003|N|N|N||Preferred Generic|1098134-24HRNiacin1000MGExtendedReleaseOralTablet|IHSS
636|1003|Y|N|Y||Preferred Generic|835809-testosteroneenanthate200MG/MLInjectableSolution|IHSS
636|1003|N|N|N||Preferred Generic|1099288-DesipramineHydrochloride10MGOralTablet|IHSS
636|1003|Y|N|Y||Preferred Generic|197635-dronabinol2.5MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|1099292-DesipramineHydrochloride100MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|308189-Amoxicillin80MG/MLOralSuspension|IHSS
636|1003|N|N|N||Preferred Generic|1099296-DesipramineHydrochloride150MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|903847-PyridostigmineBromide180MGExtendedReleaseOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|1099300-DesipramineHydrochloride25MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|308135-Amlodipine10MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|1099304-DesipramineHydrochloride50MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|996572-{21(Memantinehydrochloride10MGOralTablet)/28(Memantinehydrochloride5MGOralTablet)}Pack|IHSS
636|1003|N|N|N||Preferred Generic|1099316-DesipramineHydrochloride75MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|864681-Atovaquone62.5MG/proguanilhydrochloride25MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|1099563-24HRDivalproexSodium250MGExtendedReleaseOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|850087-24HRlamotrigine100MGExtendedReleaseOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|1099569-24HRDivalproexSodium500MGExtendedReleaseOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|283523-gabapentin50MG/MLOralSolution|IHSS
636|1003|N|N|N||Preferred Generic|1099625-DivalproexSodium125MGDelayedReleaseOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|993856-lacosamide10MG/MLOralSolution|IHSS
636|1003|N|N|N||Preferred Generic|1099648-5MLValproicAcid100MG/MLInjection|IHSS
636|1003|Y|N|N||Preferred Generic|810071-24HRFesoterodineFumarate4MGExtendedReleaseOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|1099678-DivalproexSodium250MGDelayedReleaseOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|992475-PromethazineHydrochloride50MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|1099681-ValproicAcid250MGOralCapsule|IHSS
636|1003|Y|N|N||Preferred Generic|722122-ambrisentan5MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|1099687-ValproicAcid50MG/MLOralSolution|IHSS
636|1003|Y|N|N||Preferred Generic|643712-lenalidomide15MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|1099870-DivalproexSodium500MGDelayedReleaseOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|991061-DicyclomineHydrochloride10MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|1116150-bacitracinzinc0.4UNT/MG/hydrocortisoneacetate0.01MG/MG/NeomycinSulfate0.0035MG/MG/PolymyxinBSulfate10UNT/MGOphthalmic|IHSS
636|1003|Y|N|N||Preferred Generic|477347-lanthanumcarbonate500MGChewableTablet|IHSS
636|1003|N|N|N||Preferred Generic|1116758-chloroquinephosphate500MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|245314-Albuterol5MG/MLInhalationSolution|IHSS
636|1003|N|N|N||Preferred Generic|1117531-chloroquinephosphate250MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|905273-TrihexyphenidylHydrochloride0.4MG/MLOralSolution|IHSS
636|1003|N|N|N||Preferred Generic|1150836-LevobunololHydrochloride5MG/MLOphthalmicSolution|IHSS
636|1003|Y|N|N||Preferred Generic|403811-aprepitant125MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|1190568-AtropineSulfate0.005MG/ML/DiphenoxylateHydrochloride0.5MG/MLOralSolution|IHSS
636|1003|N|N|N||Preferred Generic|904467-PravastatinSodium20MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|1190570-AtropineSulfate0.01MG/MGOphthalmicOintment|IHSS
636|1003|Y|N|N||Preferred Generic|313447-Tranylcypromine10MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|1190572-AtropineSulfate0.025MG/DiphenoxylateHydrochloride2.5MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|308429-Atovaquone150MG/MLOralSuspension|IHSS
636|1003|N|N|N||Preferred Generic|1190655-AtropineSulfate10MG/MLOphthalmicSolution|IHSS
636|1003|N|N|N||Preferred Generic|900575-Ritonavir100MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|1191013-Proparacainehydrochloride5MG/MLOphthalmicSolution|IHSS
636|1003|N|N|N||Preferred Generic|898362-Benazeprilhydrochloride10MG/Hydrochlorothiazide12.5MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|1191256-FluocinoloneAcetonide0.00025MG/MGTopicalOintment|IHSS
636|1003|Y|N|N||Preferred Generic|199521-Vigabatrin500MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|1191315-FluocinoloneAcetonide0.25MG/MLTopicalCream|IHSS
636|1003|Y|N|N||Preferred Generic|198056-Oxandrolone2.5MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|1193358-100MLLevetiracetam10MG/MLInjection|IHSS
636|1003|N|N|N||Preferred Generic|897683-Verapamilhydrochloride80MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|1193360-100MLLevetiracetam15MG/MLInjection|IHSS
636|1003|Y|N|N||Preferred Generic|1923826-deferasirox360MGOralGranules|IHSS
636|1003|N|N|N||Preferred Generic|1193362-100MLLevetiracetam5MG/MLInjection|IHSS
636|1003|N|N|N||Preferred Generic|897596-24HRVerapamilhydrochloride300MGExtendedReleaseOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|1234571-PhenylephrineHydrochloride100MG/MLOphthalmicSolution|IHSS
636|1003|N|N|N||Preferred Generic|204135-Desonide0.0005MG/MGTopicalOintment|IHSS
636|1003|N|N|N||Preferred Generic|1242786-Alyacen1/3528-DayKit|IHSS
636|1003|Y|N|N||Preferred Generic|1657173-0.5MLSumatriptan8MG/MLCartridge|IHSS
636|1003|N|N|N||Preferred Generic|1242787-Alyacen7/7/7Kit|IHSS
636|1003|Y|N|N||Preferred Generic|1146690-24HRlamotrigine250MGExtendedReleaseOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|1243585-Flurbiprofensodium0.3MG/MLOphthalmicSolution|IHSS
636|1003|N|N|N||Preferred Generic|2001424-efavirenz400MG/Lamivudine300MG/Tenofovirdisoproxilfumarate300MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|1245919-Marlissa28DayPack|IHSS
636|1003|N|N|N||Preferred Generic|884185-ClonidineHydrochloride0.2MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|1250490-hydrocortisoneacetate5MG/MLTopicalCream|IHSS
636|1003|Y|N|N||Preferred Generic|1304979-icosapentethyl1000MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|1252016-Viorele28DayPack|IHSS
636|1003|N|N|N||Preferred Generic|866144-Cyproheptadinehydrochloride4MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|1291082-hydrocortisoneacetate25MGRectalSuppository|IHSS
636|1003|Y|N|N||Preferred Generic|1085728-TriamcinoloneAcetonide0.001MG/MGOralPaste|IHSS
636|1003|N|N|N||Preferred Generic|1298066-Cyclopentolatehydrochloride10MG/MLOphthalmicSolution|IHSS
636|1003|Y|N|N||Preferred Brand|996633-NamendaXR28DayTitrationPack|IHSS
636|1003|N|N|N||Preferred Generic|1358763-{21(EthinylEstradiol0.02MG/norethindroneacetate1MGOralTablet)/7(Ferrousfumarate75MGOralTablet)}Pack|IHSS
636|1003|N|N|N||Preferred Generic|863669-Tamsulosinhydrochloride0.4MGOralCapsule|IHSS
636|1003|Y|N|N||Preferred Brand|861966-Iloprost0.02MG/MLInhalationSolution[Ventavis]|IHSS
636|1003|Y|N|N||Preferred Generic|1092357-rufinamide40MG/MLOralSuspension|IHSS
636|1003|Y|N|N||Preferred Brand|858051-0.5MLpaliperidonepalmitate156MG/MLPrefilledSyringe[Invega]|IHSS
636|1003|Y|N|N||Preferred Brand|854852-lisdexamfetaminedimesylate50MGOralCapsule[Vyvanse]|IHSS
636|1003|Y|N|N||Preferred Generic|1011739-aliskiren300MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|848164-0.5MLgolimumab100MG/MLPrefilledSyringe[Simponi]|IHSS
636|1003|N|N|N||Preferred Generic|1359132-{5(EthinylEstradiol0.02MG/norethindroneacetate1MGOralTablet)/7(EthinylEstradiol0.03MG/norethindroneacetate1MGOralTabl|IHSS
636|1003|Y|N|N||Preferred Generic|1251903-EthacrynicAcid25MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|825425-eltrombopag25MGOralTablet[Promacta]|IHSS
636|1003|Y|N|N||Preferred Brand|748738-Topotecan0.25MGOralCapsule[Hycamtin]|IHSS
636|1003|N|N|N||Preferred Generic|1359858-Fluticasonepropionate0.5MG/ACTUAT/salmeterol0.05MG/ACTUATDryPowderInhaler|IHSS
636|1003|N|N|N||Preferred Brand|644304-Tamoxifen2MG/MLOralSolution[Soltamox]|IHSS
636|1003|Y|N|N||Preferred Brand|731245-0.42MLdarbepoetinalfa0.06MG/MLPrefilledSyringe[Aranesp]|IHSS
636|1003|N|N|N||Preferred Generic|885213-benztropinemesylate1MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|727714-0.67MLanakinra149MG/MLPrefilledSyringe[Kineret]|IHSS
636|1003|Y|N|N||Preferred Brand|722256-24HRRotigotine0.0833MG/HRTransdermalSystem[Neupro]|IHSS
636|1003|N|N|N||Preferred Generic|886671-FlecainideAcetate150MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|897722-Verapamilhydrochloride40MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|643175-dasatinib50MGOralTablet[Sprycel]|IHSS
636|1003|Y|N|N||Preferred Brand|616116-lenalidomide5MGOralCapsule[Revlimid]|IHSS
636|1003|N|N|N||Preferred Generic|897590-24HRVerapamilhydrochloride200MGExtendedReleaseOralCapsule|IHSS
636|1003|Y|N|N||Preferred Brand|402092-Cyclosporine0.5MG/MLOphthalmicSuspension[Restasis]|IHSS
636|1003|Y|N|N||Preferred Generic|1923828-deferasirox180MGOralGranules|IHSS
636|1003|N|N|N||Preferred Generic|897649-Verapamilhydrochloride240MGExtendedReleaseOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|2630667-OrenitramMonth1TitrationKit|IHSS
636|1003|Y|N|N||Preferred Brand|2602787-0.6MLpegfilgrastim-pbbk10MG/MLPrefilledSyringe[Fylnetra]|IHSS
636|1003|Y|N|N||Preferred Generic|197975-Methyltestosterone10MGOralCapsule|IHSS
636|1003|Y|N|N||Preferred Generic|198200-Rifabutin150MGOralCapsule|IHSS
636|1003|Y|N|N||Preferred Brand|2594608-siponimod1MGOralTablet[Mayzent]|IHSS
636|1003|Y|N|N||Preferred Generic|199672-Albendazole200MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|2557216-trikafta50MG/37.5MG/25MGand75MGPack|IHSS
636|1003|Y|N|N||Preferred Brand|2536758-24HRviloxazine200MGExtendedReleaseOralCapsule[Qelbree]|IHSS
636|1003|Y|N|N||Preferred Generic|2105413-3MLNeostigmineMethylsulfate1MG/MLPrefilledSyringe|IHSS
636|1003|Y|N|N||Preferred Brand|2375329-2MLdupilumab150MG/MLAuto-Injector[Dupixent]|IHSS
636|1003|Y|N|N||Preferred Generic|308345-apraclonidine5MG/MLOphthalmicSolution|IHSS
636|1003|Y|N|N||Preferred Generic|310599-Granisetron1MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|2393593-monomethylfumarate95MGDelayedReleaseOralCapsule[Bafiertam]|IHSS
636|1003|Y|N|N||Preferred Generic|313472-Trientinehydrochloride250MGOralCapsule|IHSS
636|1003|Y|N|N||Preferred Brand|2362178-opicapone25MGOralCapsule[Ongentys]|IHSS
636|1003|Y|N|N||Preferred Brand|2288433-Zeposia7-DayStarterPack|IHSS
636|1003|N|N|N||Preferred Brand|759473-20ACTUATZanamivir5MG/ACTUATDryPowderInhaler[Relenza]|IHSS
636|1003|N|N|N||Preferred Generic|904481-PravastatinSodium80MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|2262731-MicronizedIsotretinoin8MGOralCapsule[Absorica]|IHSS
636|1003|Y|N|N||Preferred Brand|2260709-0.6MLpegfilgrastim-bmez10MG/MLPrefilledSyringe[Ziextenzo]|IHSS
636|1003|Y|N|N||Preferred Generic|485421-24HRdarifenacin15MGExtendedReleaseOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|2196592-120ACTUATformoterolfumarate0.005MG/ACTUAT/mometasonefuroate0.05MG/ACTUATMeteredDoseInhaler[Dulera]|IHSS
636|1003|N|N|N||Preferred Generic|966248-LevothyroxineSodium0.112MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|602635-lanthanumcarbonate1000MGChewableTablet|IHSS
636|1003|Y|N|N||Preferred Brand|2166401-ivacaftor25MGOralGranules[Kalydeco]|IHSS
636|1003|Y|N|N||Preferred Brand|1729076-UptraviTitrationPack|IHSS
636|1003|N|N|N||Preferred Generic|152695-meloxicam15MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|700883-temozolomide140MGOralCapsule|IHSS
636|1003|Y|N|N||Preferred Brand|2119481-Cetirizine2.4MG/MLOphthalmicSolution[Zerviate]|IHSS
636|1003|N|N|N||Preferred Generic|1607990-{24(EthinylEstradiol0.025MG/Norethindrone0.8MGChewableTablet)/4(Ferrousfumarate75MGChewableTablet)}Pack|IHSS
636|1003|Y|N|N||Preferred Brand|2100100-Xofluza80MGDosePack(2x40MGTablets)|IHSS
636|1003|Y|N|N||Preferred Brand|205924-1MLEpoetinAlfa4000UNT/MLInjection[Procrit]|IHSS
636|1003|Y|N|N||Preferred Generic|802749-candesartancilexetil32MG/Hydrochlorothiazide25MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|848131-Amlodipine10MG/Hydrochlorothiazide12.5MG/valsartan160MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|2058906-cannabidiol100MG/MLOralSolution[Epidiolex]|IHSS
636|1003|Y|N|N||Preferred Brand|2057205-0.5MLfilgrastim-aafi0.6MG/MLPrefilledSyringe[Nivestym]|IHSS
636|1003|N|N|N||Preferred Generic|1655968-8MLMethotrexate25MG/MLInjection|IHSS
636|1003|Y|N|N||Preferred Brand|2047614-1MLepoetinalfa-epbx4000UNT/MLInjection[Retacrit]|IHSS
636|1003|Y|N|N||Preferred Generic|857224-Sevelamerhydrochloride800MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|861375-sevelamercarbonate800MGPowderforOralSuspension|IHSS
636|1003|Y|N|N||Preferred Brand|2001321-Roflumilast0.25MGOralTablet[Daliresp]|IHSS
636|1003|N|N|N||Preferred Brand|2055766-DORAVIRINE100MGOralTablet[Pifeltro]|IHSS
636|1003|Y|N|N||Preferred Brand|1945048-30ACTUATfluticasonefuroate0.1MG/ACTUAT/umeclidinium0.0625MG/ACTUAT/vilanterol0.025MG/ACTUATDryPowderInhaler[Trelegy]|IHSS
636|1003|Y|N|N||Preferred Brand|1925255-0.4MLabatacept125MG/MLPrefilledSyringe[Orencia]|IHSS
636|1003|N|N|N||Preferred Generic|1725059-NaloxoneHydrochloride40MG/MLNasalSpray|IHSS
636|1003|Y|N|N||Preferred Brand|1873765-plecanatide3MGOralTablet[Trulance]|IHSS
636|1003|Y|N|N||Preferred Generic|903857-PyridostigmineBromide60MGOralTablet|IHSS
636|1003|N|N|N||Preferred Brand|847749-lopinavir80MG/ML/Ritonavir20MG/MLOralSolution[Kaletra]|IHSS
636|1003|Y|N|N||Preferred Brand|1871459-lisdexamfetaminedimesylate40MGChewableTablet[Vyvanse]|IHSS
636|1003|Y|N|N||Preferred Brand|1801840-lifitegrast50MG/MLOphthalmicSolution[Xiidra]|IHSS
636|1003|Y|N|Y||Preferred Generic|197634-dronabinol10MGOralCapsule|IHSS
636|1003|Y|N|Y||Preferred Generic|245723-Tretinoin0.0005MG/MGTopicalGel|IHSS
636|1003|Y|N|N||Preferred Brand|1797880-Nafarelin0.2MG/ACTUATMeteredDoseNasalSpray[Synarel]|IHSS
636|1003|Y|N|Y||Preferred Generic|860654-epinastinehydrochloride0.5MG/MLOphthalmicSolution|IHSS
636|1003|Y|N|N||Preferred Brand|1746898-10MLreslizumab10MG/MLInjection[Cinqair]|IHSS
636|1003|Y|N|N||Preferred Brand|1741049-24HRtofacitinib11MGExtendedReleaseOralTablet[Xeljanz]|IHSS
636|1003|N|N|N||Preferred Generic|1738511-ParoxetineHydrochloride40MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|1094543-Briellyn28DayPack|IHSS
636|1003|N|N|N||Preferred Generic|1744001-emtricitabine100MG/Tenofovirdisoproxilfumarate150MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1729053-selexipag0.2MGOralTablet[Uptravi]|IHSS
636|1003|N|N|N||Preferred Generic|1744005-emtricitabine133MG/Tenofovirdisoproxilfumarate200MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1728099-romiplostim0.5MGInjection[Nplate]|IHSS
636|1003|N|N|N||Preferred Generic|1744009-emtricitabine167MG/Tenofovirdisoproxilfumarate250MGOralTablet|IHSS
636|1003|N|N|N||Preferred Brand|1809905-Taytulla1MG/20MCG28DayPack|IHSS
636|1003|N|N|N||Preferred Generic|1797867-Azelastinehydrochloride0.137MG/ACTUATMeteredDoseNasalSpray|IHSS
636|1003|Y|N|N||Preferred Brand|1666385-Buprenorphine2.9MG/Naloxone0.71MGSublingualTablet[Zubsolv]|IHSS
636|1003|N|N|N||Preferred Generic|1797907-Fluticasonepropionate0.05MG/ACTUATMeteredDoseNasalSpray|IHSS
636|1003|N|N|N||Preferred Brand|2590643-emtricitabine120MG/tenofoviralafenamide15MGOralTablet[Descovy]|IHSS
636|1003|N|N|N||Preferred Generic|1797913-TriamcinoloneAcetonide0.055MG/ACTUATMeteredDoseNasalSpray|IHSS
636|1003|N|N|N||Preferred Generic|728225-maraviroc300MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|1797929-Budesonide0.032MG/ACTUATMeteredDoseNasalSpray|IHSS
636|1003|Y|N|N||Preferred Brand|1659161-1MLalirocumab150MG/MLAuto-Injector[Praluent]|IHSS
636|1003|N|N|N||Preferred Generic|1801289-SmokingCessation12HRBupropionHydrochloride150MGExtendedReleaseOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1650901-0.5MLInterferonbeta-1a0.06MG/MLAuto-Injector[Avonex]|IHSS
636|1003|N|N|N||Preferred Generic|1801294-MicroencapsulatedPotassiumChloride20MEQExtendedReleaseOralTablet|IHSS
636|1003|N|N|N||Preferred Brand|2589618-0.5MLnaloxonehydrochloride10MG/MLPrefilledSyringe[Zimhi]|IHSS
636|1003|N|N|N||Preferred Generic|1801298-MicroencapsulatedPotassiumChloride10MEQExtendedReleaseOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|686924-carvedilol3.125MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|1806181-30/70Release24HRMethylphenidateHydrochloride10MGExtendedReleaseOralCapsule|IHSS
636|1003|Y|N|N||Preferred Brand|1649605-PlegridyPenStarterPack|IHSS
636|1003|N|N|N||Preferred Generic|1806187-30/70Release24HRMethylphenidateHydrochloride20MGExtendedReleaseOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|628953-PotassiumChloride10MEQExtendedReleaseOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|1806189-30/70Release24HRMethylphenidateHydrochloride30MGExtendedReleaseOralCapsule|IHSS
636|1003|Y|N|N||Preferred Brand|1605075-0.8MLFILGRASTIM-SNDZ0.6MG/MLPrefilledSyringe[Zarxio]|IHSS
636|1003|N|N|N||Preferred Generic|1870230-NDA0208000.3MLEpinephrine1MG/MLAuto-Injector|IHSS
636|1003|Y|N|N||Preferred Brand|1601373-naloxegol25MGOralTablet[Movantik]|IHSS
636|1003|N|N|N||Preferred Generic|1918194-60ACTUATfluticasonepropionate0.113MG/ACTUAT/salmeterol0.014MG/ACTUATDryPowderInhaler|IHSS
636|1003|N|N|N||Preferred Generic|617316-Amoxicillin400MG/Clavulanate57MGChewableTablet|IHSS
636|1003|N|N|N||Preferred Generic|1918203-60ACTUATfluticasonepropionate0.232MG/ACTUAT/salmeterol0.014MG/ACTUATDryPowderInhaler|IHSS
636|1003|N|N|N||Preferred Generic|1085633-TriamcinoloneAcetonide0.00025MG/MGTopicalOintment|IHSS
636|1003|N|N|N||Preferred Generic|1918209-60ACTUATfluticasonepropionate0.055MG/ACTUAT/salmeterol0.014MG/ACTUATDryPowderInhaler|IHSS
636|1003|Y|N|N||Preferred Brand|1593775-24HRdapagliflozin10MG/Metforminhydrochloride1000MGExtendedReleaseOralTablet[Xigduo]|IHSS
636|1003|N|N|N||Preferred Generic|1923428-Timolol2.5MG/MLOphthalmicSolution|IHSS
636|1003|Y|N|N||Preferred Brand|1551884-lanthanumcarbonate1000MGOralPowder[Fosrenol]|IHSS
636|1003|N|N|N||Preferred Generic|1923432-dorzolamide20MG/ML/Timolol5MG/MLOphthalmicSolution|IHSS
636|1003|N|N|N||Preferred Brand|1796079-dolutegravir10MGOralTablet[Tivicay]|IHSS
636|1003|N|N|N||Preferred Generic|1946772-Methotrexate25MG/MLInjectableSolution|IHSS
636|1003|Y|N|N||Preferred Brand|1544396-0.45MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|IHSS
636|1003|N|N|N||Preferred Generic|197303-Acetazolamide125MGOralTablet|IHSS
636|1003|N|N|N||Preferred Brand|2540709-naloxonehydrochloride80MG/MLNasalSpray[Kloxxado]|IHSS
636|1003|N|N|N||Preferred Generic|197304-Acetazolamide250MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|562524-12HRAcetazolamide500MGExtendedReleaseOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|197305-AceticAcid20MG/MLOticSolution|IHSS
636|1003|Y|N|N||Preferred Brand|1488679-12HRTreprostinil2.5MGExtendedReleaseOralTablet[Orenitram]|IHSS
636|1003|N|N|N||Preferred Generic|197310-Acyclovir200MGOralCapsule|IHSS
636|1003|Y|N|N||Preferred Brand|1441418-0.4MLMethotrexate50MG/MLAuto-Injector[Otrexup]|IHSS
636|1003|N|N|N||Preferred Generic|197311-Acyclovir400MGOralTablet|IHSS
636|1003|N|N|N||Preferred Brand|2539032-Nextstellis28Day|IHSS
636|1003|N|N|N||Preferred Generic|197316-Albuterol2MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|486148-24HRNitroglycerin0.2MG/HRTransdermalSystem|IHSS
636|1003|N|N|N||Preferred Generic|197318-Albuterol4MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1439901-riociguat2MGOralTablet[Adempas]|IHSS
636|1003|N|N|N||Preferred Generic|197319-Allopurinol100MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|483325-Levonorgestrel1.5MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|197320-Allopurinol300MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1429367-lenalidomide20MGOralCapsule[Revlimid]|IHSS
636|1003|N|N|N||Preferred Generic|197361-Amlodipine5MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1364515-Bedaquiline100MGOralTablet[Sirturo]|IHSS
636|1003|N|N|N||Preferred Generic|197362-ammoniumlactate120MG/MLTopicalLotion|IHSS
636|1003|N|N|N||Preferred Generic|476576-cefdinir50MG/MLOralSuspension|IHSS
636|1003|N|N|N||Preferred Generic|197379-Atenolol100MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1243229-Tenofovirdisoproxilfumarate250MGOralTablet[Viread]|IHSS
636|1003|N|N|N||Preferred Generic|197380-Atenolol25MGOralTablet|IHSS
636|1003|N|N|N||Preferred Brand|2396259-Twirla3CountWeeklyTransdermalSystem|IHSS
636|1003|N|N|N||Preferred Generic|197381-Atenolol50MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|403967-zonisamide50MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|197382-Atenolol100MG/Chlorthalidone25MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1244064-0.4MLMethylnaltrexonebromide20MG/MLPrefilledSyringe[Relistor]|IHSS
636|1003|N|N|N||Preferred Generic|197383-Atenolol50MG/Chlorthalidone25MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|403854-Hydrochlorothiazide12.5MG/Olmesartanmedoxomil40MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|197388-Azathioprine50MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1243026-Linagliptin2.5MG/Metforminhydrochloride1000MGOralTablet[Jentadueto]|IHSS
636|1003|N|N|N||Preferred Generic|197391-Baclofen10MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1149617-COLLAGENASE0.25UNT/MGTopicalOintment[Santyl]|IHSS
636|1003|N|N|N||Preferred Generic|197392-Baclofen20MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|402696-24HRFelodipine5MGExtendedReleaseOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|197405-Betamethasone0.0005MG/MGTopicalOintment|IHSS
636|1003|N|N|N||Preferred Generic|402131-aripiprazole5MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|197407-Betamethasone1MG/MLTopicalCream|IHSS
636|1003|Y|N|N||Preferred Brand|1115259-1.5MLLeuprolideAcetate30MG/MLPrefilledSyringe[Lupron]|IHSS
636|1003|N|N|N||Preferred Generic|197408-Betamethasone1MG/MLTopicalLotion|IHSS
636|1003|Y|N|N||Preferred Brand|1091650-azilsartanmedoxomil40MGOralTablet[Edarbi]|IHSS
636|1003|N|N|N||Preferred Generic|197409-Betamethasone0.001MG/MGTopicalOintment|IHSS
636|1003|N|N|N||Preferred Generic|387003-Levetiracetam1000MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|197411-Bromocriptine2.5MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1040058-DextromethorphanHydrobromide20MG/QuinidineSulfate10MGOralCapsule[Nuedexta]|IHSS
636|1003|N|N|N||Preferred Generic|197433-calciumacetate667MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|359296-calciumacetate667MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|197443-Carbidopa10MG/Levodopa100MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|1050493-{21(drospirenone3MG/EthinylEstradiol0.03MG/levomefolatecalcium0.451MGOralTablet)/7(levomefolatecalcium0.451MGOralTabl|IHSS
636|1003|N|N|N||Preferred Generic|197444-Carbidopa25MG/Levodopa100MGOralTablet|IHSS
636|1003|N|Y|Y||Preferred Generic|606726-Esomeprazole20MGDelayedReleaseOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|197445-Carbidopa25MG/Levodopa250MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|905516-ChlordiazepoxideHydrochloride5MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|197449-Cefaclor500MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|349547-aripiprazole30MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|197454-Cephalexin500MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|197891-LithiumCarbonate300MGExtendedReleaseOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|197499-Chlorthalidone25MGOralTablet|IHSS
636|1003|N|Y|Y||Preferred Brand|2601746-0.5MLtirzepatide10MG/MLAuto-Injector[Mounjaro]|IHSS
636|1003|N|N|N||Preferred Generic|197500-Chlorthalidone50MGOralTablet|IHSS
636|1003|N|N|N||Preferred Brand|2178792-0.3MLEpinephrine0.5MG/MLPrefilledSyringe[Symjepi]|IHSS
636|1003|N|N|N||Preferred Generic|197516-Clarithromycin250MGOralTablet|IHSS
636|1003|N|Y|N||Preferred Generic|996615-24HRMemantinehydrochloride7MGExtendedReleaseOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|197517-Clarithromycin500MGOralTablet|IHSS
636|1003|N|Y|N||Preferred Generic|857560-trospiumchloride20MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|197518-Clindamycin150MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Brand|1313887-Phenytoin50MGChewableTablet[Dilantin]|IHSS
636|1003|N|N|N||Preferred Generic|197535-Clozapine100MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|1046985-HyoscyamineSulfate0.125MGDisintegratingOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|197536-Clozapine25MGOralTablet|IHSS
636|1003|N|Y|N||Preferred Generic|606730-Esomeprazole40MGDelayedReleaseOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|197553-Cyclosporine25MGOralCapsule|IHSS
636|1003|N|Y|N||Preferred Generic|349590-Levalbuterol0.103MG/MLInhalationSolution|IHSS
636|1003|N|N|N||Preferred Generic|197557-Dapsone100MGOralTablet|IHSS
636|1003|N|N|N||Preferred Brand|1605257-Levonorgestrel0.000813MG/HRIntrauterineSystem[Liletta]|IHSS
636|1003|N|N|N||Preferred Generic|197558-Dapsone25MGOralTablet|IHSS
636|1003|N|Y|N||Preferred Generic|284008-travoprost0.04MG/MLOphthalmicSolution|IHSS
636|1003|N|N|N||Preferred Generic|197575-Desoximetasone0.0025MG/MGTopicalOintment|IHSS
636|1003|N|N|N||Preferred Brand|2171002-Slynd28DayPack|IHSS
636|1003|N|N|N||Preferred Generic|197577-Dexamethasone0.5MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|315090-Erythromycin333MGDelayedReleaseOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|197579-Dexamethasone1MGOralTablet|IHSS
636|1003|N|Y|N||Preferred Generic|197551-Cycloserine250MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|197580-Dexamethasone1.5MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|103401-Hydrocortisone0.025MG/MGTopicalOintment|IHSS
636|1003|N|N|N||Preferred Generic|197581-Dexamethasone2MGOralTablet|IHSS
636|1003|N|Y|N||Preferred Generic|1797863-flunisolide0.025MG/ACTUATMeteredDoseNasalSpray|IHSS
636|1003|N|N|N||Preferred Generic|197582-Dexamethasone4MGOralTablet|IHSS
636|1003|N|Y|N||Preferred Generic|1368410-alogliptin12.5MG/pioglitazone30MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|197583-Dexamethasone6MGOralTablet|IHSS
636|1003|N|N|N||Preferred Brand|1601660-Atazanavir300MG/cobicistat150MGOralTablet[Evotaz]|IHSS
636|1003|N|N|N||Preferred Generic|197595-Dicloxacillin250MGOralCapsule|IHSS
636|1003|N|Y|N||Preferred Brand|835721-Ethionamide250MGOralTablet[Trecator]|IHSS
636|1003|N|N|N||Preferred Generic|197596-Dicloxacillin500MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Brand|213284-hydroxyurea400MGOralCapsule[Droxia]|IHSS
636|1003|N|N|N||Preferred Generic|197604-Digoxin0.125MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|314078-Loxapine10MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|197606-Digoxin0.25MGOralTablet|IHSS
636|1003|N|Y|N||Preferred Brand|665036-sitagliptin100MGOralTablet[Januvia]|IHSS
636|1003|N|N|N||Preferred Generic|197622-Dipyridamole50MGOralTablet|IHSS
636|1003|N|Y|N||Preferred Brand|1992700-ertugliflozin7.5MG/Metforminhydrochloride1000MGOralTablet[Segluromet]|IHSS
636|1003|N|N|N||Preferred Generic|197623-Disulfiram250MGOralTablet|IHSS
636|1003|N|N|N||Preferred Brand|213283-hydroxyurea300MGOralCapsule[Droxia]|IHSS
636|1003|N|N|N||Preferred Generic|197624-Disulfiram500MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|314006-24HRGlipizide5MGExtendedReleaseOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|197625-Doxazosin1MGOralTablet|IHSS
636|1003|N|Y|N||Preferred Brand|1551300-0.5MLdulaglutide1.5MG/MLAuto-Injector[Trulicity]|IHSS
636|1003|N|N|N||Preferred Generic|197626-Doxazosin2MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|313919-salmoncalcitonin200UNT/ACTUATNasalSpray|IHSS
636|1003|N|N|N||Preferred Generic|197627-Doxazosin4MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|998671-168HRClonidine0.00417MG/HRTransdermalSystem|IHSS
636|1003|N|N|N||Preferred Generic|197628-Doxazosin8MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|993755-Acetaminophen24MG/ML/CodeinePhosphate2.4MG/MLOralSolution|IHSS
636|1003|N|N|N||Preferred Generic|197650-Erythromycin500MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|313586-venlafaxine75MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|197657-Estradiol0.5MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|197770-Hydrochlorothiazide50MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|197658-Estradiol1MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|904447-Alendronicacid0.933MG/MLOralSolution|IHSS
636|1003|N|N|N||Preferred Generic|197659-Estradiol2MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|897749-HydromorphoneHydrochloride3MGRectalSuppository|IHSS
636|1003|N|N|N||Preferred Generic|197682-Ethosuximide250MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Brand|1598989-Atazanavir50MGOralPowder[Reyataz]|IHSS
636|1003|N|N|N||Preferred Generic|197684-Etodolac200MGOralCapsule|IHSS
636|1003|N|N|Y||Preferred Generic|892582-MorphineSulfate15MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|197685-Etodolac300MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Brand|212373-Estrogens,Esterified(USP)1.25MGOralTablet[Menest]|IHSS
636|1003|N|N|N||Preferred Generic|197686-Etodolac400MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|313354-Thioridazine10MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|197687-Etoposide50MGOralCapsule|IHSS
636|1003|N|N|Y||Preferred Generic|862006-24HRGuanfacine1MGExtendedReleaseOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|197699-Fluconazole150MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|854873-Zolpidemtartrate10MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|862013-24HRGuanfacine2MGExtendedReleaseOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|197732-Furosemide80MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|856999-Acetaminophen325MG/HydrocodoneBitartrate10MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|313366-Thiothixene5MGOralCapsule|IHSS
636|1003|N|N|Y||Preferred Generic|856481-24HRPropranololHydrochloride160MGExtendedReleaseOralCapsule|IHSS
636|1003|N|N|Y||Preferred Generic|854894-Zolpidemtartrate6.25MGExtendedReleaseOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|197741-Guaifenesin200MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|313581-24HRvenlafaxine150MGExtendedReleaseOralCapsule|IHSS
636|1003|N|N|Y||Preferred Generic|854248-1MLEnoxaparinsodium100MG/MLPrefilledSyringe|IHSS
636|1003|N|N|Y||Preferred Generic|854238-0.6MLEnoxaparinsodium100MG/MLPrefilledSyringe|IHSS
636|1003|N|N|Y||Preferred Generic|899557-dexmethylphenidatehydrochloride2.5MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|846378-24HRLevetiracetam750MGExtendedReleaseOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|313582-venlafaxine25MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|861227-24HRAmphetamineaspartate6.25MG/AmphetamineSulfate6.25MG/Dextroamphetaminesaccharate6.25MG/DextroamphetamineSulfate6.25|IHSS
636|1003|N|N|Y||Preferred Generic|835829-testosteronecypionate100MG/MLInjectableSolution|IHSS
636|1003|N|N|Y||Preferred Generic|596934-duloxetine60MGDelayedReleaseOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|197782-Hydrocortisone10MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|993890-Acetaminophen300MG/CodeinePhosphate60MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|809992-lacosamide150MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|999961-Glycopyrrolate0.2MG/MLOralSolution|IHSS
636|1003|N|N|Y||Preferred Generic|801961-2MLDiazepam5MG/MLRectalGel|IHSS
636|1003|N|N|Y||Preferred Generic|797274-Clindamycin10MG/MLMedicatedPad|IHSS
636|1003|N|Y|N||Preferred Brand|1243848-24HRMetforminhydrochloride500MG/sitagliptin50MGExtendedReleaseOralTablet[Janumet]|IHSS
636|1003|N|Y|N||Preferred Brand|1992821-ertugliflozin15MGOralTablet[Steglatro]|IHSS
636|1003|N|N|Y||Preferred Generic|721794-24HRquetiapine300MGExtendedReleaseOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|686379-celecoxib50MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|197803-Ibuprofen20MG/MLOralSuspension|IHSS
636|1003|N|N|Y||Preferred Generic|616698-Risperidone3MGDisintegratingOralTablet|IHSS
636|1003|N|Y|N||Preferred Brand|1992837-ertugliflozin5MG/sitagliptin100MGOralTablet[Steglujan]|IHSS
636|1003|N|N|Y||Preferred Generic|966920-POLYETHYLENEGLYCOL3350236000MG/PotassiumChloride2970MG/SodiumBicarbonate6740MG/SodiumChloride5860MG/sodiumsulfate22740|IHSS
636|1003|N|N|Y||Preferred Generic|616483-quetiapine400MGOralTablet|IHSS
636|1003|N|Y|N||Preferred Generic|1368034-alogliptin12.5MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|596926-duloxetine20MGDelayedReleaseOralCapsule|IHSS
636|1003|N|N|Y||Preferred Generic|577208-Omega-3AcidEthylEsters(USP)1000MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|197815-Indapamide1.25MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|485442-Eszopiclone2MGOralTablet|IHSS
636|1003|N|Y|N||Preferred Brand|861771-Metforminhydrochloride1000MG/sitagliptin50MGOralTablet[Janumet]|IHSS
636|1003|N|Y|N||Preferred Brand|2395779-0.5MLdulaglutide6MG/MLAuto-Injector[Trulicity]|IHSS
636|1003|N|N|Y||Preferred Generic|483450-pregabalin75MGOralCapsule|IHSS
636|1003|N|N|Y||Preferred Generic|403922-168HREstradiol0.00156MG/HRTransdermalSystem|IHSS
636|1003|N|Y|N||Preferred Generic|1368392-alogliptin12.5MG/Metforminhydrochloride500MGOralTablet|IHSS
636|1003|N|Y|N||Preferred Generic|1246673-Ivermectin5MG/MLTopicalLotion|IHSS
636|1003|N|N|Y||Preferred Generic|477560-Fenofibrate145MGOralTablet|IHSS
636|1003|N|Y|N||Preferred Generic|1855389-Levalbuterol2.5MG/MLInhalationSolution|IHSS
636|1003|N|N|Y||Preferred Generic|403825-Risperidone0.5MGDisintegratingOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|359818-Nicotine4MGOralLozenge|IHSS
636|1003|N|N|N||Preferred Generic|1013629-{24(drospirenone3MG/EthinylEstradiol0.02MG/levomefolatecalcium0.451MGOralTablet)/4(levomefolatecalcium0.451MGOralTabl|IHSS
636|1003|N|N|N||Preferred Generic|197973-Methylprednisolone8MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|351246-montelukast4MGOralGranules|IHSS
636|1003|N|N|Y||Preferred Generic|349594-atomoxetine40MGOralCapsule|IHSS
636|1003|N|Y|N||Preferred Generic|242754-Levalbuterol0.417MG/MLInhalationSolution|IHSS
636|1003|N|N|Y||Preferred Generic|349353-Hydrochlorothiazide25MG/valsartan160MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|315183-PotassiumChloride8MEQExtendedReleaseOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|197860-Leucovorin10MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|349201-valsartan160MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|315223-Sumatriptan25MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|317128-Misoprostol0.2MGOralTablet|IHSS
636|1003|N|Y|N||Preferred Generic|403852-Carbidopa37.5MG/entacapone200MG/Levodopa150MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|318202-Erythromycin20MG/MLTopicalSolution|IHSS
636|1003|N|Y|N||Preferred Generic|745791-200ACTUATLevalbuterol0.045MG/ACTUATMeteredDoseInhaler|IHSS
636|1003|N|N|Y||Preferred Generic|314285-zonisamide100MGOralCapsule|IHSS
636|1003|N|N|Y||Preferred Generic|314200-pantoprazole40MGDelayedReleaseOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|197885-Hydrochlorothiazide12.5MG/Lisinopril10MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|312831-Risperidone2MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|349208-Sirolimus1MGOralTablet|IHSS
636|1003|N|Y|N||Preferred Generic|996603-24HRMemantinehydrochloride21MGExtendedReleaseOralCapsule|IHSS
636|1003|N|N|Y||Preferred Generic|313570-Vancomycin125MGOralCapsule|IHSS
636|1003|N|Y|Y||Preferred Brand|1716219-patiromer16800MGPowderforOralSuspension[Veltassa]|IHSS
636|1003|N|N|Y||Preferred Generic|313412-tizanidine2MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|313160-Sumatriptan100MGOralTablet|IHSS
636|1003|N|Y|Y||Preferred Brand|2200654-semaglutide3MGOralTablet[Rybelsus]|IHSS
636|1003|N|Y|Y||Preferred Generic|197978-Metolazone10MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|312829-Risperidone0.5MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|312744-quetiapine25MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|349545-aripiprazole10MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|312077-olanzapine15MGOralTablet|IHSS
636|1003|N|Y|Y||Preferred Generic|200193-zolmitriptan2.5MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|351265-Buprenorphine8MGSublingualTablet|IHSS
636|1003|N|N|Y||Preferred Generic|311975-Nicotine4MGChewingGum|IHSS
636|1003|N|N|Y||Preferred Generic|242438-montelukast5MGChewableTablet|IHSS
636|1003|N|Y|Y||Preferred Generic|854868-Rabeprazolesodium20MGDelayedReleaseOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|353538-24HRIsosorbideMononitrate60MGExtendedReleaseOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|310289-Fenofibrate200MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|1052658-etravirine200MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|310152-Erythromycin0.02MG/MGTopicalGel|IHSS
636|1003|N|N|Y||Preferred Generic|309332-Clindamycin0.01MG/MGTopicalGel|IHSS
636|1003|N|N|N||Preferred Generic|381056-IsosorbideDinitrate10MGOralTablet|IHSS
636|1003|N|N|N||Preferred Brand|2380551-12HRfostemsavir600MGExtendedReleaseOralTablet[Rukobia]|IHSS
636|1003|N|N|Y||Preferred Generic|283417-benzonatate200MGOralCapsule|IHSS
636|1003|N|N|Y||Preferred Generic|261962-Ramipril10MGOralCapsule|IHSS
636|1003|Y|N|N||Preferred Brand|1114074-Vandetanib100MGOralTablet[Caprelsa]|IHSS
636|1003|N|N|Y||Preferred Generic|244374-BenzoylPeroxide0.05MG/MG/Erythromycin0.03MG/MGTopicalGel|IHSS
636|1003|N|N|N||Preferred Generic|197941-Methimazole10MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|351136-Albuterol0.417MG/MLInhalationSolution|IHSS
636|1003|N|N|Y||Preferred Generic|242891-84HREstradiol0.00208MG/HRTransdermalSystem|IHSS
636|1003|N|N|N||Preferred Brand|1741739-emtricitabine200MG/Rilpivirine25MG/tenofoviralafenamide25MGOralTablet[Odefsey]|IHSS
636|1003|N|N|Y||Preferred Generic|242120-InsulinLispro100UNT/MLInjectableSolution|IHSS
636|1003|N|N|Y||Preferred Generic|238004-168HREstradiol0.00417MG/HRTransdermalSystem|IHSS
636|1003|Y|N|N||Preferred Brand|1235157-azilsartanmedoxomil40MG/Chlorthalidone25MGOralTablet[Edarbyclor]|IHSS
636|1003|N|N|Y||Preferred Generic|203088-Ketoconazole20MG/MLTopicalCream|IHSS
636|1003|N|N|N||Preferred Generic|197956-Methyldopa250MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|402506-12HRCarbamazepine400MGExtendedReleaseOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|200329-Omeprazole40MGDelayedReleaseOralCapsule|IHSS
636|1003|N|N|Y||Preferred Generic|200095-irbesartan150MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|197960-Hydrochlorothiazide25MG/Methyldopa250MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|403875-emtricitabine200MGOralCapsule|IHSS
636|1003|N|N|Y||Preferred Generic|2001564-BXRating24HRMethylphenidateHydrochloride18MGExtendedReleaseOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|432400-cinacalcet90MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|200034-olanzapine2.5MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|199370-Ciprofloxacin100MGOralTablet|IHSS
636|1003|N|Y|Y||Preferred Generic|313159-Sumatriptan5MG/ACTUATNasalSpray|IHSS
636|1003|N|N|Y||Preferred Generic|1009145-Amphetamineaspartate1.875MG/AmphetamineSulfate1.875MG/Dextroamphetaminesaccharate1.875MG/DextroamphetamineSulfate1.87|IHSS
636|1003|N|N|N||Preferred Generic|197986-Minoxidil10MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1429282-NeostigmineMethylsulfate0.5MG/MLInjectableSolution[Bloxiverz]|IHSS
636|1003|N|N|Y||Preferred Generic|198052-Ondansetron4MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1431647-4MLgolimumab12.5MG/MLInjection[Simponi]|IHSS
636|1003|N|N|Y||Preferred Generic|198034-24HRNifedipine30MGExtendedReleaseOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|197900-Lorazepam0.5MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1439896-riociguat1MGOralTablet[Adempas]|IHSS
636|1003|Y|N|N||Preferred Brand|1442143-Macitentan10MGOralTablet[Opsumit]|IHSS
636|1003|N|N|Y||Preferred Generic|197590-Diazepam2MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|197529-Clonazepam2MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|198012-Naproxen375MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|197397-benzonatate100MGOralCapsule|IHSS
636|1003|Y|N|N||Preferred Brand|1482814-1MLgolimumab100MG/MLPrefilledSyringe[Simponi]|IHSS
636|1003|Y|N|N||Preferred Brand|1310144-everolimus3MGTabletforOralSuspension[Afinitor]|IHSS
636|1003|N|N|Y||Preferred Generic|1923426-SotalolHydrochloride80MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1546189-0.5MLpeginterferonbeta-1a0.25MG/MLPrefilledSyringe[Plegridy]|IHSS
636|1003|N|N|Y||Preferred Generic|1812011-Osmotic24HRNifedipine30MGExtendedReleaseOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|1806193-30/70Release24HRMethylphenidateHydrochloride50MGExtendedReleaseOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|198032-Nifedipine10MGOralCapsule|IHSS
636|1003|N|N|Y||Preferred Generic|1597076-60ACTUATTestosterone20.25MG/ACTUATTopicalGel|IHSS
636|1003|Y|N|N||Preferred Brand|1544398-0.5MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|IHSS
636|1003|Y|N|N||Preferred Brand|1486981-dapagliflozin5MGOralTablet[Farxiga]|IHSS
636|1003|N|N|Y||Preferred Generic|1543069-Lidocaine0.05MG/MGTopicalOintment|IHSS
636|1003|N|N|Y||Preferred Generic|1091150-MethylphenidateHydrochloride10MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1551474-12HRBupropionHydrochloride90MG/Naltrexonehydrochloride8MGExtendedReleaseOralTablet[Contrave]|IHSS
636|1003|Y|N|N||Preferred Brand|1545174-hydrocortisoneacetate100MG/MLRectalFoam[Cortifoam]|IHSS
636|1003|N|N|Y||Preferred Generic|1091392-MethylphenidateHydrochloride20MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1593831-24HRdapagliflozin5MG/Metforminhydrochloride500MGExtendedReleaseOralTablet[Xigduo]|IHSS
636|1003|N|N|Y||Preferred Generic|106346-Mupirocin0.02MG/MGTopicalOintment|IHSS
636|1003|N|N|Y||Preferred Generic|1049214-Acetaminophen325MG/OxycodoneHydrochloride10MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|1049909-DiphenhydramineHydrochloride25MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Brand|1359026-LoestrinFe1.5/3028DayPack|IHSS
636|1003|N|N|Y||Preferred Brand|901518-0.5MLNeisseriameningitidisserogroupAoligosaccharidediphtheriaCRM197proteinconjugatevaccine0.02MG/ML/Neisseriameningiti|IHSS
636|1003|N|N|Y||Preferred Brand|847189-3MLinsulinisophane,human70UNT/ML/insulin,regular,human30UNT/MLPenInjector[Humulin]|IHSS
636|1003|Y|N|N||Preferred Brand|1602607-2MLaripiprazole200MG/MLPrefilledSyringe[Abilify]|IHSS
636|1003|N|N|Y||Preferred Brand|804186-0.5MLMeaslesVirusVaccineLive,Enders'attenuatedEdmonstonstrain2000UNT/ML/MumpsVirusVaccineLive,JerylLynnStrain25000UNT/|IHSS
636|1003|N|N|N||Preferred Generic|198075-Perphenazine16MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|617311-atorvastatin40MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Brand|798482-0.5MLHepatitisAVaccine(Inactivated)StrainHM1751440UNT/MLPrefilledSyringe[Havrix]|IHSS
636|1003|N|N|Y||Preferred Brand|351427-24HRNicotine0.583MG/HRTransdermalSystem[NicodermC-Q]|IHSS
636|1003|N|N|N||Preferred Generic|198077-Perphenazine4MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|646456-Nystatin100UNT/MGTopicalPowder|IHSS
636|1003|N|N|Y||Preferred Brand|351859-insulin,regular,human500UNT/MLInjectableSolution[HumulinR]|IHSS
636|1003|N|N|N||Preferred Generic|722131-Amlodipine10MG/valsartan320MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Brand|311026-insulinisophane,human100UNT/MLInjectableSuspension[HumulinN]|IHSS
636|1003|N|N|Y||Preferred Brand|2605552-influenzaAvirusA/Darwin/9/2021(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.03MG/ML/influe|IHSS
636|1003|Y|N|N||Preferred Brand|1596023-ferriccitrate1000MGOralTablet[Auryxia]|IHSS
636|1003|N|N|Y||Preferred Brand|2047639-sodiumzirconiumcyclosilicate5000MGPowderforOralSuspension[Lokelma]|IHSS
636|1003|N|N|N||Preferred Generic|198089-Phenobarbital60MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|722137-Amlodipine5MG/valsartan320MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Brand|2588066-rivaroxaban1MG/MLOralSuspension[Xarelto]|IHSS
636|1003|N|N|N||Preferred Generic|748800-{21(drospirenone3MG/EthinylEstradiol0.03MGOralTablet)/7(InertIngredients1MGOralTablet)}Pack|IHSS
636|1003|N|N|Y||Preferred Brand|2166204-10ACTUATtiotropium0.0025MG/ACTUATInhalationSpray[Spiriva]|IHSS
636|1003|N|N|Y||Preferred Brand|2059017-rivaroxaban2.5MGOralTablet[Xarelto]|IHSS
636|1003|Y|N|N||Preferred Brand|1657212-omalizumab150MGInjection[Xolair]|IHSS
636|1003|N|N|N||Preferred Generic|748961-{28(Norethindrone0.35MGOralTablet)}Pack|IHSS
636|1003|N|N|Y||Preferred Brand|2000133-Vancomycin25MG/MLOralSolution[Firvanq]|IHSS
636|1003|N|N|Y||Preferred Brand|1992169-InsulinLispro100UNT/MLInjectableSolution[Admelog]|IHSS
636|1003|Y|N|N||Preferred Brand|1720606-mepolizumab100MGInjection[Nucala]|IHSS
636|1003|N|N|Y||Preferred Brand|1658472-0.5MLStreptococcuspneumoniaetype1capsularpolysaccharideantigen0.05MG/ML/Streptococcuspneumoniaetype10Acapsularpolysac|IHSS
636|1003|Y|N|N||Preferred Brand|1729029-selexipag1.2MGOralTablet[Uptravi]|IHSS
636|1003|Y|N|N||Preferred Brand|1729065-selexipag0.8MGOralTablet[Uptravi]|IHSS
636|1003|N|N|Y||Preferred Brand|1658155-0.5MLHepatitisBSurfaceAntigenVaccine0.01MG/MLInjection[Recombivax]|IHSS
636|1003|N|N|N||Preferred Generic|198144-Prednisone1MGOralTablet|IHSS
636|1003|Y|N|Y||Preferred Generic|891881-MorphineSulfate15MGExtendedReleaseOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|198145-Prednisone10MGOralTablet|IHSS
636|1003|Y|N|Y||Preferred Generic|804544-difluprednate0.5MG/MLOphthalmicSuspension|IHSS
636|1003|N|N|N||Preferred Generic|198146-Prednisone2.5MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|308212-Ampicillin500MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|198148-Prednisone50MGOralTablet|IHSS
636|1003|Y|N|Y||Preferred Generic|106303-Tretinoin0.5MG/MLTopicalCream|IHSS
636|1003|N|N|N||Preferred Generic|198150-Primidone50MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|308191-Amoxicillin500MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|198152-Probenecid500MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Brand|1300206-0.5MLBordetellapertussisfilamentoushemagglutininvaccine,inactivated0.01MG/ML/Bordetellapertussisfimbriae2/3vaccine,in|IHSS
636|1003|N|N|N||Preferred Generic|198153-Colchicine0.5MG/Probenecid500MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|992395-gatifloxacin5MG/MLOphthalmicSolution|IHSS
636|1003|N|N|N||Preferred Generic|198175-Propylthiouracil50MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|900038-PhentermineHydrochloride30MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|198181-Pyrazinamide500MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|308136-Amlodipine2.5MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|198201-Rifampin150MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|997420-Fexofenadinehydrochloride180MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|198202-Rifampin300MGOralCapsule|IHSS
636|1003|Y|N|N||Preferred Generic|896244-120ACTUATFluticasonepropionate0.115MG/ACTUAT/salmeterol0.021MG/ACTUATMeteredDoseInhaler|IHSS
636|1003|N|N|N||Preferred Generic|198211-Simvastatin40MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|996571-Memantinehydrochloride5MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|198215-SodiumFluoride0.55MGChewableTablet|IHSS
636|1003|Y|N|N||Preferred Generic|864769-MethadoneHydrochloride2MG/MLOralSolution|IHSS
636|1003|N|N|N||Preferred Generic|198222-Spironolactone100MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|864675-Atovaquone250MG/proguanilhydrochloride100MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|198223-Spironolactone50MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|995624-MeclizineHydrochloride12.5MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|198224-Hydrochlorothiazide25MG/Spironolactone25MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|834241-febuxostat80MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|198232-Sulfasalazine500MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|283672-Citalopram10MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|198238-Sulindac150MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|995241-HydroxyzineHydrochloride2MG/MLOralSolution|IHSS
636|1003|N|N|N||Preferred Generic|198239-Sulindac200MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|848140-Amlodipine5MG/Hydrochlorothiazide12.5MG/valsartan160MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|198240-Tamoxifen10MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|993691-BupropionHydrochloride75MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|198270-Thioridazine100MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|833204-dexlansoprazole30MGDelayedReleaseOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|198274-Thioridazine25MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|803353-PhentermineHydrochloride37.5MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|198275-Thioridazine50MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|993536-12HRBupropionHydrochloride200MGExtendedReleaseOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|198316-Hydrochlorothiazide25MG/Triamterene37.5MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|992438-PromethazineHydrochloride12.5MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|198322-Trifluoperazine1MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|725021-24HRrivastigmine0.192MG/HRTransdermalSystem|IHSS
636|1003|N|N|N||Preferred Generic|198323-Trifluoperazine10MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|722116-ambrisentan10MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|198324-Trifluoperazine2MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|992184-methenaminemandelate500MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|198325-Trifluoperazine5MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|639537-candesartancilexetil32MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|198332-Trimethoprim100MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|991188-Chlorpromazinehydrochloride200MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|198334-Sulfamethoxazole400MG/Trimethoprim80MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|253039-Melatonin1MG/MLOralSolution|IHSS
636|1003|N|N|N||Preferred Generic|198335-Sulfamethoxazole800MG/Trimethoprim160MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|602912-lenalidomide5MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|198352-Zidovudine100MGOralCapsule|IHSS
636|1003|Y|N|N||Preferred Generic|349407-Treprostinil1MG/MLInjectableSolution|IHSS
636|1003|N|N|N||Preferred Generic|198365-Prochlorperazine10MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|248109-Ribavirin200MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|198369-torsemide10MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|96304-Primidone250MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|198370-torsemide100MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|485436-entecavir1MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|198371-torsemide20MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|905269-TrihexyphenidylHydrochloride2MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|198372-torsemide5MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|403930-Isotretinoin30MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|198377-Tacrolimus1MGOralCapsule|IHSS
636|1003|Y|N|N||Preferred Generic|351276-Oxandrolone10MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|198378-Tacrolimus5MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|905158-Sirolimus0.5MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|198382-famciclovir500MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|904431-Alendronicacid70MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|198427-lamotrigine100MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|318179-ergoloidmesylates,USP1MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|198428-lamotrigine150MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|313211-temozolomide5MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|198429-lamotrigine200MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|903891-FluvoxamineMaleate50MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|198630-ferrousgluconate324MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|283317-Hydrochlorothiazide12.5MG/telmisartan80MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|198707-Hydrocortisone5MG/MLTopicalCream|IHSS
636|1003|N|N|N||Preferred Generic|903697-liothyroninesodium0.025MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|198741-MagnesiumOxide400MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|238154-Acetaminophen325MG/butalbital50MG/Caffeine40MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|198759-Niacin100MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|245134-72HRFentanyl0.025MG/HRTransdermalSystem|IHSS
636|1003|N|N|N||Preferred Generic|198760-Niacin50MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|898350-Amlodipine2.5MG/Benazeprilhydrochloride10MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|199047-Famotidine10MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|200328-capecitabine500MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|199058-mycophenolatemofetil250MGOralCapsule|IHSS
636|1003|Y|N|N||Preferred Generic|1988980-24HRpregabalin82.5MGExtendedReleaseOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|199143-Niacin250MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|898356-Amlodipine5MG/Benazeprilhydrochloride20MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|199147-Lamivudine150MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|197929-Meprobamate400MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|199148-Lamivudine10MG/MLOralSolution|IHSS
636|1003|N|N|N||Preferred Generic|898342-Amlodipine10MG/Benazeprilhydrochloride20MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|199149-Acarbose50MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|205292-efavirenz50MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|199150-Acarbose100MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|197555-Danazol200MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|199159-Tretinoin10MGOralCapsule|IHSS
636|1003|Y|N|N||Preferred Generic|1874553-24HRdesvenlafaxinesuccinate100MGExtendedReleaseOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|199163-Melatonin3MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|897618-24HRVerapamilhydrochloride180MGExtendedReleaseOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|199164-Phenobarbital97.2MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|204844-Azithromycin600MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|199167-Phenobarbital32.4MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|1860148-Abuse-Deterrent12HROxycodoneHydrochloride80MGExtendedReleaseOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|199168-Phenobarbital64.8MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|1362706-MexiletineHydrochloride150MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|199192-famciclovir125MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|1737459-PamidronateDisodium30MGInjection|IHSS
636|1003|N|N|N||Preferred Generic|199193-famciclovir250MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|1657160-0.5MLSumatriptan12MG/MLCartridge|IHSS
636|1003|N|N|N||Preferred Generic|199224-anastrozole1MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|1360304-Budesonide0.08MG/ACTUAT/formoterolfumarate0.0045MG/ACTUATMeteredDoseInhaler|IHSS
636|1003|N|N|N||Preferred Generic|199245-glimepiride1MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|645884-Somatropin5MG/MLInjectableSolution[Omnitrope]|IHSS
636|1003|N|N|N||Preferred Generic|199246-glimepiride2MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|200256-repaglinide1MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|199247-glimepiride4MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|885209-benztropinemesylate2MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|199351-trandolapril2MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|1428947-lenalidomide20MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|199352-trandolapril4MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|884173-ClonidineHydrochloride0.1MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|199353-trandolapril1MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|1308569-24HRrivastigmine0.554MG/HRTransdermalSystem|IHSS
636|1003|N|N|N||Preferred Generic|199378-12HRCarbamazepine100MGExtendedReleaseOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|1299917-Tiagabinehydrochloride4MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|199387-Risperidone1MG/MLOralSolution|IHSS
636|1003|N|N|N||Preferred Generic|866436-24HRmetoprololsuccinate50MGExtendedReleaseOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|199390-Etodolac500MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|866094-buspironehydrochloride5MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|199422-Nevirapine200MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|1098608-24HRlamotrigine300MGExtendedReleaseOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|199425-Melatonin1MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|1012895-fingolimod0.5MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|199663-Zidovudine300MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|866083-buspironehydrochloride10MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|199703-cabergoline0.5MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|979115-0.6MLMethylnaltrexonebromide20MG/MLInjection[Relistor]|IHSS
636|1003|N|N|N||Preferred Generic|199884-Levofloxacin250MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|865117-FluphenazineHydrochloride1MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|199885-Levofloxacin500MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|199889-topiramate100MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|199888-topiramate25MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|861045-1.5MLpramlintideacetate1MG/MLPenInjector[Symlin]|IHSS
636|1003|Y|N|N||Preferred Brand|864110-1.5MLSomatropin3.3MG/MLCartridge[Omnitrope]|IHSS
636|1003|Y|N|N||Preferred Generic|1307061-Buprenorphine12MG/Naloxone3MGSublingualFilm|IHSS
636|1003|Y|N|N||Preferred Brand|858055-1MLpaliperidonepalmitate156MG/MLPrefilledSyringe[Invega]|IHSS
636|1003|Y|N|N||Preferred Brand|858044-saxagliptin2.5MGOralTablet[Onglyza]|IHSS
636|1003|N|N|N||Preferred Generic|199903-Hydrochlorothiazide12.5MGOralCapsule|IHSS
636|1003|Y|N|N||Preferred Brand|854844-lisdexamfetaminedimesylate70MGOralCapsule[Vyvanse]|IHSS
636|1003|Y|N|N||Preferred Generic|1010604-Buprenorphine8MG/Naloxone2MGSublingualFilm|IHSS
636|1003|N|N|N||Preferred Generic|1359028-{21(EthinylEstradiol0.03MG/norethindroneacetate1.5MGOralTablet)}Pack|IHSS
636|1003|Y|N|N||Preferred Brand|854836-lisdexamfetaminedimesylate30MGOralCapsule[Vyvanse]|IHSS
636|1003|Y|N|N||Preferred Brand|828703-1.2MLPlerixafor20MG/MLInjection[Mozobil]|IHSS
636|1003|N|N|N||Preferred Generic|200033-carvedilol25MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|1100075-abirateroneacetate250MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|847913-60ACTUATexenatide0.01MG/ACTUATPenInjector[Byetta]|IHSS
636|1003|N|N|N||Preferred Brand|617333-Amoxicillin25MG/ML/Clavulanate6.25MG/MLOralSuspension[Augmentin]|IHSS
636|1003|Y|N|N||Preferred Brand|828364-hydrocortisoneacetate10MG/ML/Pramoxinehydrochloride10MG/MLRectalFoam[Proctofoam-HC]|IHSS
636|1003|Y|N|N||Preferred Brand|825170-HumiraPen40MG/0.8ML-Crohn'sDiseaseStarterPack|IHSS
636|1003|N|N|N||Preferred Generic|1359779-Fluticasonepropionate0.1MG/ACTUAT/salmeterol0.05MG/ACTUATDryPowderInhaler|IHSS
636|1003|Y|N|N||Preferred Brand|731229-0.6MLdarbepoetinalfa0.5MG/MLPrefilledSyringe[Aranesp]|IHSS
636|1003|N|N|N||Preferred Generic|200131-12HRCarbamazepine300MGExtendedReleaseOralCapsule|IHSS
636|1003|Y|N|N||Preferred Generic|1310525-teriflunomide14MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|751970-0.5MLInterferongamma-1b0.2MG/MLInjection[Actimmune]|IHSS
636|1003|Y|N|N||Preferred Generic|1373491-dimethylfumarate240MGDelayedReleaseOralCapsule|IHSS
636|1003|Y|N|N||Preferred Brand|731328-0.5MLpeginterferonalfa-2a0.36MG/MLPrefilledSyringe[Pegasys]|IHSS
636|1003|Y|N|N||Preferred Brand|731241-1MLdarbepoetinalfa0.5MG/MLPrefilledSyringe[Aranesp]|IHSS
636|1003|Y|N|N||Preferred Generic|1437968-Cyclophosphamide25MGOralCapsule|IHSS
636|1003|Y|N|N||Preferred Brand|858074-0.25MLpaliperidonepalmitate156MG/MLPrefilledSyringe[Invega]|IHSS
636|1003|Y|N|N||Preferred Brand|730046-0.5MLdarbepoetinalfa0.2MG/MLPrefilledSyringe[Aranesp]|IHSS
636|1003|Y|N|N||Preferred Brand|727705-0.8MLadalimumab50MG/MLPrefilledSyringe[Humira]|IHSS
636|1003|N|N|N||Preferred Generic|885857-Balsalazidedisodium750MGOralCapsule|IHSS
636|1003|Y|N|N||Preferred Brand|706831-Risperidone25MGInjection[Risperdal]|IHSS
636|1003|Y|N|N||Preferred Generic|1607617-24HRdesvenlafaxinesuccinate25MGExtendedReleaseOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|1648788-30ACTUATfluticasonefuroate0.2MG/ACTUAT/vilanterol0.025MG/ACTUATDryPowderInhaler|IHSS
636|1003|Y|N|N||Preferred Brand|706827-Risperidone37.5MGInjection[Risperdal]|IHSS
636|1003|N|N|N||Preferred Generic|903456-liothyroninesodium0.005MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|643714-lenalidomide15MGOralCapsule[Revlimid]|IHSS
636|1003|Y|N|N||Preferred Brand|643173-dasatinib20MGOralTablet[Sprycel]|IHSS
636|1003|Y|N|N||Preferred Generic|1793916-0.5MLSumatriptan8MG/MLAuto-Injector|IHSS
636|1003|Y|N|N||Preferred Brand|616018-abatacept250MGInjection[Orencia]|IHSS
636|1003|N|N|N||Preferred Generic|897584-24HRVerapamilhydrochloride100MGExtendedReleaseOralCapsule|IHSS
636|1003|Y|N|N||Preferred Generic|1860157-Abuse-Deterrent12HROxycodoneHydrochloride10MGExtendedReleaseOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|603978-nepafenac1MG/MLOphthalmicSuspension[Nevanac]|IHSS
636|1003|Y|N|N||Preferred Brand|352045-1MLdarbepoetinalfa0.04MG/MLInjection[Aranesp]|IHSS
636|1003|Y|N|N||Preferred Generic|1923822-deferasirox90MGOralGranules|IHSS
636|1003|N|N|N||Preferred Generic|1362720-MexiletineHydrochloride250MGOralCapsule|IHSS
636|1003|Y|N|N||Preferred Brand|352047-1MLdarbepoetinalfa0.1MG/MLInjection[Aranesp]|IHSS
636|1003|Y|N|N||Preferred Generic|197365-Amoxapine25MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|2630671-OrenitramMonth3TitrationKit|IHSS
636|1003|Y|N|N||Preferred Brand|2627722-0.8MLadalimumab-atto50MG/MLAuto-Injector[Amjevita]|IHSS
636|1003|Y|N|N||Preferred Generic|197556-Danazol50MGOralCapsule|IHSS
636|1003|Y|N|N||Preferred Brand|2583635-0.67MLdupilumab150MG/MLPrefilledSyringe[Dupixent]|IHSS
636|1003|Y|N|N||Preferred Generic|197928-Meprobamate200MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|1367436-21DAYEthinylEstradiol0.000625MG/HR/Etonogestrel0.005MG/HRVaginalSystem|IHSS
636|1003|Y|N|N||Preferred Brand|2604628-2.4MLrisankizumab-rzaa150MG/MLCartridge[Skyrizi]|IHSS
636|1003|N|N|N||Preferred Brand|744846-raltegravir400MGOralTablet[ISENTRESS]|IHSS
636|1003|Y|N|N||Preferred Brand|2596445-0.4MLmepolizumab100MG/MLPrefilledSyringe[Nucala]|IHSS
636|1003|Y|N|N||Preferred Brand|2590054-24HRupadacitinib30MGExtendedReleaseOralTablet[Rinvoq]|IHSS
636|1003|N|N|N||Preferred Generic|1373503-{7(EthinylEstradiol0.01MGOralTablet)/42(EthinylEstradiol0.02MG/Levonorgestrel0.15MGOralTablet)/21(EthinylEstradiol0.0|IHSS
636|1003|N|N|N||Preferred Generic|886666-FlecainideAcetate100MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|2559707-1.14MLdupilumab175MG/MLAuto-Injector[Dupixent]|IHSS
636|1003|Y|N|N||Preferred Brand|2550713-0.5MLsecukinumab150MG/MLPrefilledSyringe[Cosentyx]|IHSS
636|1003|Y|N|N||Preferred Generic|205315-topiramate25MGOralCapsule|IHSS
636|1003|Y|N|N||Preferred Brand|2536742-baloxavirmarboxil80MGOralTablet[Xofluza]|IHSS
636|1003|N|N|N||Preferred Generic|898690-Benazeprilhydrochloride20MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|898723-Benazeprilhydrochloride5MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|2532351-Ponvory14DayPack|IHSS
636|1003|Y|N|N||Preferred Brand|2273115-24HRtofacitinib22MGExtendedReleaseOralTablet[Xeljanz]|IHSS
636|1003|Y|N|N||Preferred Generic|283316-Hydrochlorothiazide12.5MG/telmisartan40MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|141935-Haloperidol2MG/MLOralSolution|IHSS
636|1003|Y|N|N||Preferred Brand|2473042-ponatinib10MGOralTablet[Iclusig]|IHSS
636|1003|N|N|N||Preferred Brand|748857-Yasmin28DayPack|IHSS
636|1003|Y|N|N||Preferred Brand|2463733-epoetinalfa-epbx10000UNT/MLInjectableSolution[Retacrit]|IHSS
636|1003|Y|N|N||Preferred Brand|2392142-0.5MLetanercept50MG/MLInjection[Enbrel]|IHSS
636|1003|N|N|N||Preferred Generic|141963-Azithromycin40MG/MLOralSuspension|IHSS
636|1003|N|N|N||Preferred Generic|898687-Benazeprilhydrochloride10MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|2371768-Oriahnn28DayKit|IHSS
636|1003|Y|N|N||Preferred Brand|2359358-24HRempagliflozin5MG/linagliptin2.5MG/metforminhydrochloride1000MGExtendedReleaseOralTablet[Trijardy]|IHSS
636|1003|Y|N|N||Preferred Generic|348719-Tobramycin60MG/MLInhalationSolution|IHSS
636|1003|Y|N|N||Preferred Brand|2288412-ozanimod0.92MGOralCapsule[Zeposia]|IHSS
636|1003|Y|N|N||Preferred Generic|349409-Treprostinil2.5MG/MLInjectableSolution|IHSS
636|1003|Y|N|N||Preferred Generic|351109-Budesonide0.25MG/MLInhalationSuspension|IHSS
636|1003|Y|N|N||Preferred Brand|2283236-bempedoicacid180MG/ezetimibe10MGOralTablet[Nexlizet]|IHSS
636|1003|N|N|N||Preferred Generic|905283-TrihexyphenidylHydrochloride5MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|2268227-ubrogepant100MGOralTablet[Ubrelvy]|IHSS
636|1003|Y|N|N||Preferred Brand|2262727-MicronizedIsotretinoin32MGOralCapsule[Absorica]|IHSS
636|1003|Y|N|N||Preferred Generic|465355-voriconazole40MG/MLOralSuspension|IHSS
636|1003|Y|N|N||Preferred Brand|2256947-lasmiditan50MGOralTablet[Reyvow]|IHSS
636|1003|N|N|N||Preferred Brand|762002-Mircette28DayPack|IHSS
636|1003|N|N|N||Preferred Generic|1440184-hydrocortisoneacetate0.01MG/MGTopicalOintment|IHSS
636|1003|Y|N|N||Preferred Brand|2205634-1MLbenralizumab30MG/MLAuto-Injector[Fasenra]|IHSS
636|1003|Y|N|N||Preferred Brand|2170993-1MLmepolizumab100MG/MLAuto-Injector[Nucala]|IHSS
636|1003|Y|N|N||Preferred Generic|577348-ramelteon8MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|578330-candesartancilexetil32MG/Hydrochlorothiazide12.5MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|2174390-symdeko50MG/75MGand75MGPack|IHSS
636|1003|N|N|N||Preferred Generic|991039-Chlorpromazinehydrochloride10MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|2169276-dapagliflozin5MG/saxagliptin5MGOralTablet[Qtern]|IHSS
636|1003|Y|N|N||Preferred Brand|213475-1MLEpoetinAlfa40000UNT/MLInjection[Procrit]|IHSS
636|1003|N|N|N||Preferred Generic|991044-Chlorpromazinehydrochloride100MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1593858-lisdexamfetaminedimesylate10MGOralCapsule[Vyvanse]|IHSS
636|1003|N|N|N||Preferred Brand|1000491-Prempro0.3/1.528DayPack|IHSS
636|1003|N|N|N||Preferred Generic|259255-atorvastatin80MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|212219-EpoetinAlfa20000UNT/MLInjectableSolution[Procrit]|IHSS
636|1003|Y|N|N||Preferred Generic|705824-100MLzoledronicacid0.05MG/MLInjection|IHSS
636|1003|Y|N|N||Preferred Brand|2121061-ceritinib150MGOralTablet[Zykadia]|IHSS
636|1003|Y|N|N||Preferred Brand|2119391-Spravato56MGDoseKit|IHSS
636|1003|N|N|N||Preferred Generic|260243-Progesterone100MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|993518-12HRBupropionHydrochloride150MGExtendedReleaseOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|2106075-0.9MLtocilizumab180MG/MLAuto-Injector[Actemra]|IHSS
636|1003|Y|N|N||Preferred Brand|208083-sargramostim0.25MG/MLInjectableSolution[Leukine]|IHSS
636|1003|Y|N|N||Preferred Generic|728231-12HRranolazine1000MGExtendedReleaseOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|205922-1MLEpoetinAlfa3000UNT/MLInjection[Procrit]|IHSS
636|1003|Y|N|N||Preferred Generic|754508-{1(aprepitant125MGOralCapsule)/2(aprepitant80MGOralCapsule)}Pack|IHSS
636|1003|N|N|N||Preferred Generic|1648755-NITROFURANTOIN,MACROCRYSTALS25MG/Nitrofurantoin,Monohydrate75MGOralCapsule|IHSS
636|1003|Y|N|N||Preferred Brand|2059189-amikacinliposomal70.3MG/MLInhalationSuspension[Arikayce]|IHSS
636|1003|N|N|N||Preferred Brand|205562-Estramustine140MGOralCapsule[Emcyt]|IHSS
636|1003|Y|N|N||Preferred Brand|2058950-0.5MLomalizumab150MG/MLPrefilledSyringe[Xolair]|IHSS
636|1003|Y|N|N||Preferred Brand|2058887-1MLgalcanezumab-gnlm120MG/MLPrefilledSyringe[Emgality]|IHSS
636|1003|Y|N|N||Preferred Generic|834235-febuxostat40MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|205532-DornaseAlfa1MG/MLInhalationSolution[Pulmozyme]|IHSS
636|1003|N|N|N||Preferred Generic|283485-Mirtazapine45MGDisintegratingOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|848145-Amlodipine5MG/Hydrochlorothiazide25MG/valsartan160MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|2054995-lusutrombopag3MGOralTablet[Mulpleta]|IHSS
636|1003|Y|N|N||Preferred Brand|2045959-Doptelet40MGDailyDoseCartonPack|IHSS
636|1003|Y|N|N||Preferred Generic|855642-DiclofenacSodium0.03MG/MGTopicalGel|IHSS
636|1003|N|N|N||Preferred Generic|995278-HydroxyzinePamoate50MGOralCapsule|IHSS
636|1003|Y|N|N||Preferred Brand|2047602-1MLepoetinalfa-epbx2000UNT/MLInjection[Retacrit]|IHSS
636|1003|N|N|N||Preferred Brand|831870-darunavir75MGOralTablet[Prezista]|IHSS
636|1003|Y|N|N||Preferred Brand|2003767-1.14MLsarilumab175MG/MLAuto-Injector[Kevzara]|IHSS
636|1003|Y|N|N||Preferred Brand|1999389-symdeko100MG/150MGand150MGPack|IHSS
636|1003|N|N|N||Preferred Generic|1665050-Cefazolin1000MGInjection|IHSS
636|1003|N|N|N||Preferred Brand|152854-Itraconazole10MG/MLOralSolution[Sporanox]|IHSS
636|1003|Y|N|N||Preferred Brand|1946522-4-Month1.5MLLeuprolideAcetate20MG/MLPrefilledSyringe[Lupron]|IHSS
636|1003|Y|N|N||Preferred Brand|1940498-24HRdapagliflozin2.5MG/Metforminhydrochloride1000MGExtendedReleaseOralTablet[Xigduo]|IHSS
636|1003|Y|N|N||Preferred Generic|876524-Amlodipine5MG/telmisartan40MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1923338-1.14MLsarilumab132MG/MLPrefilledSyringe[Kevzara]|IHSS
636|1003|N|N|N||Preferred Generic|307730-Acyclovir40MG/MLOralSuspension|IHSS
636|1003|Y|N|N||Preferred Generic|896272-120ACTUATFluticasonepropionate0.23MG/ACTUAT/salmeterol0.021MG/ACTUATMeteredDoseInhaler|IHSS
636|1003|Y|N|N||Preferred Brand|1921245-HumiraPen80MG/0.8ML-StarterPackageforCrohn'sDisease,UlcerativeColitisorHidradenitisSuppurativa(3count)|IHSS
636|1003|Y|N|N||Preferred Brand|1871467-lisdexamfetaminedimesylate60MGChewableTablet[Vyvanse]|IHSS
636|1003|Y|N|N||Preferred Generic|903843-PyridostigmineBromide12MG/MLOralSolution|IHSS
636|1003|N|N|Y||Preferred Brand|1046920-Nicotine4MGInhalationSolution[Nicotrol]|IHSS
636|1003|Y|N|N||Preferred Brand|1872980-0.4MLadalimumab100MG/MLAuto-Injector[Humira]|IHSS
636|1003|Y|N|N||Preferred Generic|905341-DemeclocyclineHydrochloride150MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1871463-lisdexamfetaminedimesylate20MGChewableTablet[Vyvanse]|IHSS
636|1003|Y|N|N||Preferred Brand|1870968-deflazacort22.75MG/MLOralSuspension[Emflaza]|IHSS
636|1003|Y|N|N||Preferred Generic|997010-QuinineSulfate324MGOralCapsule|IHSS
636|1003|Y|N|N||Preferred Brand|1790146-bromfenac0.75MG/MLOphthalmicSolution[Bromsite]|IHSS
636|1003|Y|N|Y||Preferred Generic|106302-Tretinoin0.25MG/MLTopicalCream|IHSS
636|1003|N|N|Y||Preferred Brand|1300468-0.5MLHaemophilusinfluenzaetypebstrain1482,capsularpolysaccharideinactivatedtetanustoxoidconjugatevaccine0.068MG/MLInj|IHSS
636|1003|Y|N|N||Preferred Brand|1812470-ivacaftor125MG/lumacaftor100MGOralTablet[ORKAMBI]|IHSS
636|1003|N|N|Y||Preferred Brand|1364447-apixaban5MGOralTablet[Eliquis]|IHSS
636|1003|Y|N|N||Preferred Brand|1801278-HumiraPsoriasisStarterPack40MG/0.8MLPen(4count)|IHSS
636|1003|Y|N|N||Preferred Brand|1796096-24HRLinagliptin5MG/Metforminhydrochloride1000MGExtendedReleaseOralTablet[Jentadueto]|IHSS
636|1003|N|N|Y||Preferred Brand|1549683-Xarelto30-DayStarterPackKit|IHSS
636|1003|Y|N|Y||Preferred Generic|892646-MorphineSulfate200MGExtendedReleaseOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1747187-0.4MLMethotrexate43.8MG/MLAuto-Injector[Otrexup]|IHSS
636|1003|Y|N|N||Preferred Brand|1745114-1MLixekizumab80MG/MLPrefilledSyringe[Taltz]|IHSS
636|1003|N|N|N||Preferred Generic|308508-Bacitracin0.5UNT/MGOphthalmicOintment|IHSS
636|1003|Y|N|N||Preferred Brand|1734642-elbasvir50MG/grazoprevir100MGOralTablet[Zepatier]|IHSS
636|1003|N|N|N||Preferred Generic|308689-BenzoylPeroxide0.025MG/MGTopicalGel|IHSS
636|1003|N|N|N||Preferred Generic|749783-{6(Azithromycin250MGOralTablet)}Pack|IHSS
636|1003|N|N|N||Preferred Generic|308694-BenzoylPeroxide0.05MG/MGTopicalGel|IHSS
636|1003|N|N|N||Preferred Generic|1094104-Phenazopyridinehydrochloride200MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|308714-Betamethasone0.5MG/ML/Clotrimazole10MG/MLTopicalCream|IHSS
636|1003|Y|N|N||Preferred Brand|1729061-selexipag0.6MGOralTablet[Uptravi]|IHSS
636|1003|N|N|N||Preferred Generic|308724-bexarotene0.01MG/MGTopicalGel|IHSS
636|1003|Y|N|N||Preferred Brand|1729047-selexipag1.6MGOralTablet[Uptravi]|IHSS
636|1003|N|N|N||Preferred Generic|308725-bexarotene75MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|198108-Piroxicam20MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|308867-Calcitriol0.00025MGOralCapsule|IHSS
636|1003|Y|N|N||Preferred Brand|1726846-0.4MLadalimumab100MG/MLPrefilledSyringe[Humira]|IHSS
636|1003|N|N|N||Preferred Generic|308868-Calcitriol0.0005MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|198107-Piroxicam10MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|308962-Captopril100MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|748832-{6(EthinylEstradiol0.03MG/Levonorgestrel0.05MGOralTablet)/10(EthinylEstradiol0.03MG/Levonorgestrel0.125MGOralTablet)/5|IHSS
636|1003|N|N|N||Preferred Generic|308963-Captopril12.5MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1721690-1MLEpoetinAlfa10000UNT/MLInjection[Procrit]|IHSS
636|1003|N|N|N||Preferred Generic|308964-Captopril50MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1660934-60ACTUATformoterolfumarate0.005MG/ACTUAT/mometasonefuroate0.1MG/ACTUATMeteredDoseInhaler[Dulera]|IHSS
636|1003|N|N|N||Preferred Generic|308973-Carbamazepine100MGChewableTablet|IHSS
636|1003|N|N|N||Preferred Generic|198104-Pindolol10MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|308976-Carbamazepine20MG/MLOralSuspension|IHSS
636|1003|N|N|N||Preferred Generic|748798-{24(drospirenone3MG/EthinylEstradiol0.02MGOralTablet)/4(InertIngredients1MGOralTablet)}Pack|IHSS
636|1003|N|N|N||Preferred Generic|308979-Carbamazepine200MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1665906-1MLevolocumab140MG/MLPrefilledSyringe[Repatha]|IHSS
636|1003|N|N|N||Preferred Generic|308988-Carbidopa25MG/Levodopa100MGExtendedReleaseOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|728223-maraviroc150MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|308989-Carbidopa50MG/Levodopa200MGExtendedReleaseOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1659814-aripiprazole400MGInjection[Abilify]|IHSS
636|1003|N|N|N||Preferred Generic|309044-Cefaclor25MG/MLOralSuspension|IHSS
636|1003|Y|N|N||Preferred Brand|1657982-20MLtocilizumab20MG/MLInjection[Actemra]|IHSS
636|1003|N|N|N||Preferred Generic|309045-Cefaclor250MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|727316-NDA0194300.3MLEpinephrine0.5MG/MLAuto-Injector|IHSS
636|1003|N|N|N||Preferred Generic|309049-Cefadroxil500MGOralCapsule|IHSS
636|1003|Y|N|N||Preferred Brand|1606870-ivacaftor75MGOralGranules[Kalydeco]|IHSS
636|1003|N|N|N||Preferred Generic|309054-cefdinir25MG/MLOralSuspension|IHSS
636|1003|N|N|N||Preferred Generic|198083-Phenobarbital100MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|309098-Cefuroxime500MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|722126-Amlodipine10MG/valsartan160MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|309110-Cephalexin25MG/MLOralSuspension|IHSS
636|1003|Y|N|N||Preferred Brand|1653166-1MLgolimumab100MG/MLAuto-Injector[Simponi]|IHSS
636|1003|N|N|N||Preferred Generic|309112-Cephalexin250MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|686418-ErythromycinEthylsuccinate80MG/MLOralSuspension|IHSS
636|1003|N|N|N||Preferred Generic|309113-Cephalexin50MG/MLOralSuspension|IHSS
636|1003|Y|N|N||Preferred Brand|1650004-0.5MLInterferonbeta-1a0.088MG/MLAuto-Injector[Rebif]|IHSS
636|1003|N|N|N||Preferred Generic|309114-Cephalexin500MGOralCapsule|IHSS
636|1003|Y|N|N||Preferred Brand|1649593-0.5MLpeginterferonbeta-1a0.25MG/MLAuto-Injector[Plegridy]|IHSS
636|1003|N|N|N||Preferred Generic|309115-Cephalexin250MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|686400-ErythromycinEthylsuccinate40MG/MLOralSuspension|IHSS
636|1003|N|N|N||Preferred Generic|309290-ciclopirox7.7MG/MLTopicalLotion|IHSS
636|1003|N|N|N||Preferred Generic|617430-Amoxicillin80MG/ML/Clavulanate11.4MG/MLOralSuspension|IHSS
636|1003|N|N|N||Preferred Generic|309291-ciclopirox80MG/MLTopicalSolution|IHSS
636|1003|Y|N|N||Preferred Brand|1605455-Otezla28-DayStarterPack|IHSS
636|1003|N|N|N||Preferred Generic|309313-Citalopram2MG/MLOralSolution|IHSS
636|1003|Y|N|N||Preferred Brand|1605071-0.5MLFILGRASTIM-SNDZ0.6MG/MLPrefilledSyringe[Zarxio]|IHSS
636|1003|N|N|N||Preferred Generic|309337-Clindamycin20MG/MLVaginalCream|IHSS
636|1003|N|N|N||Preferred Generic|617993-Amoxicillin120MG/ML/Clavulanate8.58MG/MLOralSuspension|IHSS
636|1003|N|N|N||Preferred Generic|309367-Clotrimazole10MG/MLTopicalCream|IHSS
636|1003|Y|N|N||Preferred Brand|1598268-3MLliraglutide6MG/MLPenInjector[Saxenda]|IHSS
636|1003|N|N|N||Preferred Generic|309370-Clotrimazole10MG/MLTopicalSolution|IHSS
636|1003|N|N|N||Preferred Generic|617423-Amoxicillin40MG/ML/Clavulanate5.7MG/MLOralSuspension|IHSS
636|1003|N|N|N||Preferred Generic|309371-Clotrimazole10MGOralLozenge|IHSS
636|1003|N|N|N||Preferred Brand|1102277-Rilpivirine25MGOralTablet[Edurant]|IHSS
636|1003|N|N|N||Preferred Generic|309374-Clozapine200MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1597570-Buprenorphine11.4MG/Naloxone2.9MGSublingualTablet[Zubsolv]|IHSS
636|1003|N|N|N||Preferred Generic|309594-vitaminB121MG/MLInjectableSolution|IHSS
636|1003|N|N|N||Preferred Generic|106258-Hydrocortisone10MG/MLTopicalCream|IHSS
636|1003|N|N|N||Preferred Generic|309679-Dexamethasone0.001MG/MG/Neomycin0.0035MG/MG/PolymyxinB10UNT/MGOphthalmicOintment|IHSS
636|1003|Y|N|N||Preferred Brand|1593833-24HRdapagliflozin5MG/Metforminhydrochloride1000MGExtendedReleaseOralTablet[Xigduo]|IHSS
636|1003|N|N|N||Preferred Generic|309680-Dexamethasone1MG/ML/Neomycin3.5MG/ML/PolymyxinB10000UNT/MLOphthalmicSuspension|IHSS
636|1003|Y|N|N||Preferred Brand|1592752-nintedanib150MGOralCapsule[Ofev]|IHSS
636|1003|N|N|N||Preferred Generic|309686-Dexamethasone0.1MG/MLOralSolution|IHSS
636|1003|N|N|N||Preferred Generic|198040-Nitroglycerin0.6MGSublingualTablet|IHSS
636|1003|N|N|N||Preferred Generic|309952-Dipyridamole25MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1546198-PlegridyStarterPack|IHSS
636|1003|N|N|N||Preferred Generic|309955-Dipyridamole75MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|198039-Nitroglycerin0.4MGSublingualTablet|IHSS
636|1003|N|N|N||Preferred Generic|310003-dofetilide0.125MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|598006-Erythromycin250MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|310004-dofetilide0.25MGOralCapsule|IHSS
636|1003|Y|N|N||Preferred Brand|1545668-empagliflozin25MGOralTablet[Jardiance]|IHSS
636|1003|N|N|N||Preferred Generic|310005-dofetilide0.5MGOralCapsule|IHSS
636|1003|Y|N|N||Preferred Brand|1544386-0.25MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|IHSS
636|1003|N|N|N||Preferred Generic|310015-dorzolamide20MG/MLOphthalmicSolution|IHSS
636|1003|N|N|N||Preferred Generic|198033-Nifedipine20MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|310154-Erythromycin250MGDelayedReleaseOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|582926-podofilox5MG/MLTopicalSolution|IHSS
636|1003|N|N|N||Preferred Generic|310155-Erythromycin250MGDelayedReleaseOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1544390-0.35MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|IHSS
636|1003|N|N|N||Preferred Generic|310157-Erythromycin500MGDelayedReleaseOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|562510-SodiumFluoride2MG/MLMouthwash|IHSS
636|1003|N|N|N||Preferred Generic|310169-Estradiol0.1MG/MLVaginalCream|IHSS
636|1003|Y|N|N||Preferred Brand|1541928-sunitinib37.5MGOralCapsule[Sutent]|IHSS
636|1003|N|N|N||Preferred Generic|310261-exemestane25MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1488675-12HRTreprostinil1MGExtendedReleaseOralTablet[Orenitram]|IHSS
636|1003|N|N|N||Preferred Generic|310273-Famotidine20MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|562508-Amoxicillin875MG/Clavulanate125MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|310346-Finasteride5MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1435117-28ACTUATTeriparatide0.02MG/ACTUATPenInjector[Forteo]|IHSS
636|1003|N|N|N||Preferred Generic|310352-Fluconazole10MG/MLOralSuspension|IHSS
636|1003|N|N|N||Preferred Generic|198013-Naproxen250MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|310353-Fluconazole40MG/MLOralSuspension|IHSS
636|1003|N|N|N||Preferred Generic|486515-SodiumChloride0.154MEQ/MLIrrigationSolution|IHSS
636|1003|N|N|N||Preferred Generic|310362-Fluocinonide0.0005MG/MGTopicalGel|IHSS
636|1003|Y|N|N||Preferred Brand|1441530-0.9MLtocilizumab180MG/MLPrefilledSyringe[Actemra]|IHSS
636|1003|N|N|N||Preferred Generic|310364-Fluocinonide0.5MG/MLTopicalSolution|IHSS
636|1003|N|N|N||Preferred Generic|486146-24HRNitroglycerin0.6MG/HRTransdermalSystem|IHSS
636|1003|N|N|N||Preferred Generic|310377-Fluorometholone1MG/MLOphthalmicSuspension|IHSS
636|1003|Y|N|N||Preferred Brand|1441407-0.4MLMethotrexate25MG/MLAuto-Injector[Otrexup]|IHSS
636|1003|N|N|N||Preferred Generic|310379-Fluorouracil20MG/MLTopicalSolution|IHSS
636|1003|Y|N|N||Preferred Brand|1439899-riociguat1.5MGOralTablet[Adempas]|IHSS
636|1003|N|N|N||Preferred Generic|310380-Fluorouracil50MG/MLTopicalSolution|IHSS
636|1003|N|N|N||Preferred Generic|486131-BenzoylPeroxide0.1MG/MGTopicalGel|IHSS
636|1003|N|N|N||Preferred Generic|310384-Fluoxetine10MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|477367-solifenacinsuccinate5MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|310385-Fluoxetine20MGOralCapsule|IHSS
636|1003|Y|N|N||Preferred Brand|1431104-Buprenorphine5.7MG/Naloxone1.4MGSublingualTablet[Zubsolv]|IHSS
636|1003|N|N|N||Preferred Generic|310386-Fluoxetine4MG/MLOralSolution|IHSS
636|1003|Y|N|N||Preferred Brand|1429284-NeostigmineMethylsulfate1MG/MLInjectableSolution[Bloxiverz]|IHSS
636|1003|N|N|N||Preferred Generic|310410-FolicAcid1MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|477372-solifenacinsuccinate10MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|310429-Furosemide20MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1364362-ponatinib45MGOralTablet[Iclusig]|IHSS
636|1003|N|N|N||Preferred Generic|310433-gabapentin600MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|476809-Mirtazapine7.5MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|310434-gabapentin800MGOralTablet|IHSS
636|1003|N|N|N||Preferred Brand|1037185-LoLoestrinFe28DayPack|IHSS
636|1003|N|N|N||Preferred Generic|310442-Ganciclovir500MGInjection|IHSS
636|1003|Y|N|N||Preferred Brand|1357547-tofacitinib5MGOralTablet[Xeljanz]|IHSS
636|1003|N|N|N||Preferred Generic|310459-Gemfibrozil600MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1115464-1MLLeuprolideAcetate7.5MG/MLPrefilledSyringe[Lupron]|IHSS
636|1003|N|N|N||Preferred Generic|310488-Glipizide10MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|197971-Methylprednisolone32MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|310489-24HRGlipizide2.5MGExtendedReleaseOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|429503-Hydrochlorothiazide12.5MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|310490-Glipizide5MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1302833-24HRPhentermine7.5MG/topiramate46MGExtendedReleaseOralCapsule[Qsymia]|IHSS
636|1003|N|N|N||Preferred Generic|310534-Glyburide2.5MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|403966-zonisamide25MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|310536-Glyburide3MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1251914-24HRRotigotine0.0417MG/HRTransdermalSystem[Neupro]|IHSS
636|1003|N|N|N||Preferred Generic|310537-Glyburide5MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1244062-0.6MLMethylnaltrexonebromide20MG/MLPrefilledSyringe[Relistor]|IHSS
636|1003|N|N|N||Preferred Generic|310539-Glyburide6MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|403888-MicroencapsulatedPotassiumChloride15MEQExtendedReleaseOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|310594-Gramicidin0.025MG/ML/Neomycin1.75MG/ML/PolymyxinB10000UNT/MLOphthalmicSolution|IHSS
636|1003|N|N|N||Preferred Generic|403818-moxifloxacin5MG/MLOphthalmicSolution|IHSS
636|1003|N|N|N||Preferred Generic|310604-Guaifenesin20MG/MLOralSolution|IHSS
636|1003|Y|N|N||Preferred Brand|1243040-Linagliptin2.5MG/Metforminhydrochloride850MGOralTablet[Jentadueto]|IHSS
636|1003|N|N|N||Preferred Generic|310670-Haloperidol0.5MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1242233-lenalidomide2.5MGOralCapsule[Revlimid]|IHSS
636|1003|N|N|N||Preferred Generic|310671-Haloperidol1MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|403853-Hydrochlorothiazide12.5MG/Olmesartanmedoxomil20MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|310672-Haloperidol5MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1148502-crizotinib200MGOralCapsule[Xalkori]|IHSS
636|1003|N|N|N||Preferred Generic|310687-Hydrocortisone10MG/ML/Neomycin3.5MG/ML/PolymyxinB10000UNT/MLOticSuspension|IHSS
636|1003|N|N|N||Preferred Generic|402698-24HRFelodipine2.5MGExtendedReleaseOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|310796-Hydrochlorothiazide12.5MG/quinapril10MGOralTablet|IHSS
636|1003|N|N|N||Preferred Brand|1358770-LoestrinFe1/2028DayPack|IHSS
636|1003|N|N|N||Preferred Generic|310797-Hydrochlorothiazide12.5MG/quinapril20MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1116639-Ticagrelor90MGOralTablet[Brilinta]|IHSS
636|1003|N|N|N||Preferred Generic|310798-Hydrochlorothiazide25MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|360110-Sirolimus2MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|310809-Hydrochlorothiazide25MG/quinapril20MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1115456-1MLLeuprolideAcetate15MG/MLPrefilledSyringe[Lupron]|IHSS
636|1003|N|N|N||Preferred Generic|310812-Hydrochlorothiazide25MG/Triamterene37.5MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1114096-Vandetanib300MGOralTablet[Caprelsa]|IHSS
636|1003|N|N|N||Preferred Generic|310818-Hydrochlorothiazide50MG/Triamterene75MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|402246-Atazanavir150MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|310891-Hydrocortisone25MG/MLTopicalCream|IHSS
636|1003|Y|N|N||Preferred Brand|1049576-Abuse-Deterrent12HROxycodoneHydrochloride30MGExtendedReleaseOralTablet[Oxycontin]|IHSS
636|1003|N|N|N||Preferred Generic|311166-isoniazid100MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|391937-Lactulose667MG/MLOralSolution|IHSS
636|1003|N|N|N||Preferred Generic|311192-IsosorbideMononitrate10MGOralTablet|IHSS
636|1003|N|N|N||Preferred Brand|1721619-cobicistat150MG/elvitegravir150MG/emtricitabine200MG/tenofoviralafenamide10MGOralTablet[Genvoya]|IHSS
636|1003|N|N|N||Preferred Generic|311196-24HRIsosorbideMononitrate120MGExtendedReleaseOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1046402-1.7MLdenosumab70MG/MLInjection[Xgeva]|IHSS
636|1003|N|N|N||Preferred Generic|311197-IsosorbideMononitrate20MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1011715-aliskiren150MG/Hydrochlorothiazide25MGOralTablet[TekturnaHCT]|IHSS
636|1003|N|N|N||Preferred Generic|311264-lamotrigine25MGChewableTablet|IHSS
636|1003|N|N|N||Preferred Generic|359601-Guaifenesin400MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|311277-lansoprazole30MGDelayedReleaseOralCapsule|IHSS
636|1003|N|N|N||Preferred Brand|2374566-dolutegravir5MGTabletforOralSuspension[Tivicay]|IHSS
636|1003|N|N|N||Preferred Generic|311288-Levetiracetam250MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1011755-aliskiren300MG/Hydrochlorothiazide25MGOralTablet[TekturnaHCT]|IHSS
636|1003|N|N|N||Preferred Generic|311289-Levetiracetam500MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|197904-Lovastatin20MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|311290-Levetiracetam750MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1002300-nilotinib150MGOralCapsule[Tasigna]|IHSS
636|1003|N|N|N||Preferred Generic|311296-Levofloxacin750MGOralTablet|IHSS
636|1003|N|Y|Y||Preferred Generic|351134-zolmitriptan5MGDisintegratingOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|311353-Lisinopril2.5MGOralTablet|IHSS
636|1003|N|N|N||Preferred Brand|1099897-GeneressFe28DayPack|IHSS
636|1003|N|N|N||Preferred Generic|311354-Lisinopril5MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Brand|1656346-sacubitril24MG/valsartan26MGOralTablet[Entresto]|IHSS
636|1003|N|N|N||Preferred Generic|311355-LithiumCarbonate150MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|349553-aripiprazole20MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|311372-Loratadine10MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|197892-LithiumCarbonate450MGExtendedReleaseOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|311385-Loxapine25MGOralCapsule|IHSS
636|1003|N|Y|Y||Preferred Generic|1797865-mometasonefuroate0.05MG/ACTUATMeteredDoseNasalSpray|IHSS
636|1003|N|N|N||Preferred Generic|311386-Loxapine5MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Brand|1650201-LayolisFe28DayPack|IHSS
636|1003|N|N|N||Preferred Generic|311486-meloxicam7.5MGOralTablet|IHSS
636|1003|N|Y|Y||Preferred Brand|2601764-0.5MLtirzepatide5MG/MLAuto-Injector[Mounjaro]|IHSS
636|1003|N|N|N||Preferred Generic|311487-Melphalan50MGInjection|IHSS
636|1003|N|Y|Y||Preferred Brand|2200658-semaglutide7MGOralTablet[Rybelsus]|IHSS
636|1003|N|N|N||Preferred Generic|311666-Metoclopramide10MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|197890-LithiumCarbonate300MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|311668-Metoclopramide5MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|1047895-HyoscyamineSulfate0.125MG/MLOralSolution|IHSS
636|1003|N|N|N||Preferred Generic|311678-Metronidazole7.5MG/MLTopicalCream|IHSS
636|1003|N|Y|Y||Preferred Brand|1716215-patiromer8400MGPowderforOralSuspension[Veltassa]|IHSS
636|1003|N|N|N||Preferred Generic|311679-Metronidazole0.0075MG/MGTopicalGel|IHSS
636|1003|N|Y|N||Preferred Generic|996609-24HRMemantinehydrochloride28MGExtendedReleaseOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|311681-Metronidazole500MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|197887-Hydrochlorothiazide25MG/Lisinopril20MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|311704-Mifepristone200MGOralTablet|IHSS
636|1003|N|Y|N||Preferred Generic|855189-24HRtolterodinetartrate4MGExtendedReleaseOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|311725-Mirtazapine15MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|197886-Hydrochlorothiazide12.5MG/Lisinopril20MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|311726-Mirtazapine45MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|348472-Theophylline600MGExtendedReleaseOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|311727-Misoprostol0.1MGOralTablet|IHSS
636|1003|N|Y|N||Preferred Generic|855178-tolterodinetartrate1MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|311753-mometasonefuroate1MG/MLTopicalCream|IHSS
636|1003|N|N|N||Preferred Generic|1043690-hydrocortisoneacetate10MG/MLTopicalCream|IHSS
636|1003|N|N|N||Preferred Generic|311892-nabumetone500MGOralTablet|IHSS
636|1003|N|Y|N||Preferred Generic|730988-Carbidopa50MG/entacapone200MG/Levodopa200MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|311893-nabumetone750MGOralTablet|IHSS
636|1003|N|Y|N||Preferred Generic|562806-Pimecrolimus10MG/MLTopicalCream|IHSS
636|1003|N|N|N||Preferred Generic|311943-Nevirapine10MG/MLOralSuspension|IHSS
636|1003|N|N|N||Preferred Generic|197862-Leucovorin25MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|311955-Niacin250MGExtendedReleaseOralTablet|IHSS
636|1003|N|Y|N||Preferred Generic|317094-entacapone200MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|311959-Niacin500MGExtendedReleaseOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|197861-Leucovorin15MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|311960-Niacin500MGExtendedReleaseOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|317110-24HRIsosorbideMononitrate30MGExtendedReleaseOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|311989-Nitrofurantoin5MG/MLOralSuspension|IHSS
636|1003|N|Y|N||Preferred Generic|311787-moxifloxacin400MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|311994-NITROFURANTOIN,MACROCRYSTALS25MGOralCapsule|IHSS
636|1003|N|Y|N||Preferred Generic|239239-Griseofulvin250MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|311995-NITROFURANTOIN,MACROCRYSTALS50MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|197855-Ketoprofen50MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|312036-Nortriptyline2MG/MLOralSolution|IHSS
636|1003|N|N|N||Preferred Generic|315134-Levocarnitine100MG/MLOralSolution|IHSS
636|1003|N|N|N||Preferred Generic|312055-Nystatin100000UNT/MLOralSuspension|IHSS
636|1003|N|Y|N||Preferred Generic|242831-Griseofulvin125MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|312059-Nystatin500000UNTOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|314277-venlafaxine50MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|312136-oxcarbazepine150MGOralTablet|IHSS
636|1003|N|Y|N||Preferred Generic|198373-calcipotriene0.00005MG/MGTopicalOintment|IHSS
636|1003|N|N|N||Preferred Generic|312137-oxcarbazepine300MGOralTablet|IHSS
636|1003|N|Y|N||Preferred Generic|197508-Cimetidine800MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|312138-oxcarbazepine600MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|314241-Theophylline450MGExtendedReleaseOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|312301-Pentoxifylline400MGExtendedReleaseOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|1014676-cetirizinehydrochloride5MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|312347-Phenelzine15MGOralTablet|IHSS
636|1003|N|Y|N||Preferred Generic|197417-Bumetanide0.5MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|312357-Phenobarbital15MGOralTablet|IHSS
636|1003|N|Y|N||Preferred Generic|1368954-mesalamine400MGDelayedReleaseOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|312362-Phenobarbital30MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|197832-isoniazid300MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|312440-pioglitazone30MGOralTablet|IHSS
636|1003|N|Y|N||Preferred Generic|1368385-alogliptin12.5MG/Metforminhydrochloride1000MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|312441-pioglitazone45MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|197818-Indomethacin50MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|312504-PotassiumChloride10MEQExtendedReleaseOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|314203-quinapril40MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|312515-PotassiumChloride1.33MEQ/MLOralSolution|IHSS
636|1003|N|Y|N||Preferred Generic|1368018-alogliptin6.25MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|312529-PotassiumChloride8MEQExtendedReleaseOralTablet|IHSS
636|1003|N|Y|N||Preferred Brand|833143-Milnacipranhydrochloride12.5MGOralTablet[Savella]|IHSS
636|1003|N|N|N||Preferred Generic|312593-Prazosin1MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|197816-Indapamide2.5MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|312594-Prazosin2MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|314111-Mirtazapine30MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|312614-prednisolone1MG/MLOralSolution|IHSS
636|1003|N|Y|N||Preferred Brand|833149-Milnacipranhydrochloride25MGOralTablet[Savella]|IHSS
636|1003|N|N|N||Preferred Generic|312615-Prednisone20MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|314077-Lisinopril20MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|312617-Prednisone5MGOralTablet|IHSS
636|1003|N|Y|N||Preferred Brand|665044-sitagliptin50MGOralTablet[Januvia]|IHSS
636|1003|N|N|N||Preferred Generic|312635-Prochlorperazine5MGOralTablet|IHSS
636|1003|N|Y|N||Preferred Brand|2599365-3MLsemaglutide2.68MG/MLPenInjector[Ozempic]|IHSS
636|1003|N|N|N||Preferred Generic|312641-Progesterone200MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|314076-Lisinopril10MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|312748-quinapril10MGOralTablet|IHSS
636|1003|N|Y|N||Preferred Brand|1243833-24HRMetforminhydrochloride1000MG/sitagliptin100MGExtendedReleaseOralTablet[Janumet]|IHSS
636|1003|N|N|N||Preferred Generic|312749-quinapril20MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|197805-Ibuprofen400MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|312750-quinapril5MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|314035-Haloperidol10MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|312835-rivastigmine3MGOralCapsule|IHSS
636|1003|N|Y|N||Preferred Brand|1992816-ertugliflozin5MGOralTablet[Steglatro]|IHSS
636|1003|N|N|N||Preferred Generic|312836-rivastigmine6MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|314000-Glyburide1.5MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|312845-ropinirole0.25MGOralTablet|IHSS
636|1003|N|Y|N||Preferred Brand|1992691-ertugliflozin2.5MG/Metforminhydrochloride1000MGOralTablet[Segluromet]|IHSS
636|1003|N|N|N||Preferred Generic|312846-ropinirole0.5MGOralTablet|IHSS
636|1003|N|Y|N||Preferred Brand|1356673-BenzylAlcohol0.05ML/MLTopicalLotion[Ulesfia]|IHSS
636|1003|N|N|N||Preferred Generic|312847-ropinirole2MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|313989-Fluoxetine40MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|312849-ropinirole5MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|313797-Amoxicillin25MG/MLOralSuspension|IHSS
636|1003|N|N|N||Preferred Generic|312899-Salsalate500MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|998679-168HRClonidine0.0125MG/HRTransdermalSystem|IHSS
636|1003|N|N|N||Preferred Generic|312938-Sertraline100MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|995868-CodeinePhosphate2MG/ML/Guaifenesin20MG/MLOralSolution|IHSS
636|1003|N|N|N||Preferred Generic|312940-Sertraline25MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|313850-Amoxicillin40MG/MLOralSuspension|IHSS
636|1003|N|N|N||Preferred Generic|312941-Sertraline50MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|993466-midodrinehydrochloride2.5MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|312961-Simvastatin20MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|313786-AceticAcid20MG/ML/Hydrocortisone10MG/MLOticSolution|IHSS
636|1003|N|N|N||Preferred Generic|312962-Simvastatin5MGOralTablet|IHSS
636|1003|N|N|N||Preferred Brand|1090807-Psyllium3400MGPowderforOralSuspension[Konsyl]|IHSS
636|1003|N|N|N||Preferred Generic|312997-SodiumChloride9MG/MLInhalationSolution|IHSS
636|1003|N|N|Y||Preferred Generic|992668-homatropinemethylbromide0.3MG/ML/HydrocodoneBitartrate1MG/MLOralSolution|IHSS
636|1003|N|N|N||Preferred Generic|313036-SodiumFluoride1.1MGChewableTablet|IHSS
636|1003|N|Y|N||Preferred Generic|197506-Cimetidine300MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|313096-Spironolactone25MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|905369-ChlordiazepoxideHydrochloride10MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|313107-Stavudine15MGOralCapsule|IHSS
636|1003|N|N|Y||Preferred Generic|904419-Alendronicacid10MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|313108-Stavudine20MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|197746-Guanfacine2MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|313109-Stavudine30MGOralCapsule|IHSS
636|1003|N|N|Y||Preferred Generic|897702-HydromorphoneHydrochloride4MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|313110-Stavudine40MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|197745-Guanfacine1MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|313123-Sucralfate100MG/MLOralSuspension|IHSS
636|1003|N|N|N||Preferred Generic|313521-Tropicamide5MG/MLOphthalmicSolution|IHSS
636|1003|N|N|N||Preferred Generic|313134-Sulfamethoxazole40MG/ML/Trimethoprim8MG/MLOralSuspension|IHSS
636|1003|N|N|Y||Preferred Generic|897630-24HRVerapamilhydrochloride360MGExtendedReleaseOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|313142-Sulfasalazine500MGDelayedReleaseOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|863559-valganciclovir50MG/MLOralSolution|IHSS
636|1003|N|N|N||Preferred Generic|313190-Tacrolimus0.5MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|197737-Glyburide1.25MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|313195-Tamoxifen20MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|313362-Thiothixene1MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|313215-Terazosin1MGOralCapsule|IHSS
636|1003|N|N|Y||Preferred Generic|884385-DextroamphetamineSulfate10MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|313217-Terazosin2MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|313306-Theophylline5.33MG/MLOralSolution|IHSS
636|1003|N|N|N||Preferred Generic|313219-Terazosin5MGOralCapsule|IHSS
636|1003|N|N|Y||Preferred Generic|862019-24HRGuanfacine3MGExtendedReleaseOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|313226-terconazole4MG/MLVaginalCream|IHSS
636|1003|N|N|Y||Preferred Generic|861237-24HRAmphetamineaspartate1.25MG/AmphetamineSulfate1.25MG/Dextroamphetaminesaccharate1.25MG/DextroamphetamineSulfate1.25|IHSS
636|1003|N|N|N||Preferred Generic|313227-terconazole8MG/MLVaginalCream|IHSS
636|1003|N|N|N||Preferred Generic|313291-Theophylline400MGExtendedReleaseOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|861232-24HRAmphetamineaspartate7.5MG/AmphetamineSulfate7.5MG/Dextroamphetaminesaccharate7.5MG/DextroamphetamineSulfate7.5MGEx|IHSS
636|1003|N|N|Y||Preferred Generic|830861-24HRDiltiazemHydrochloride120MGExtendedReleaseOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|197701-Fluconazole50MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|862025-24HRGuanfacine4MGExtendedReleaseOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|857366-EconazoleNitrate10MG/MLTopicalCream|IHSS
636|1003|N|N|Y||Preferred Generic|884386-DextroamphetamineSulfate5MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|857002-Acetaminophen325MG/HydrocodoneBitartrate5MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|856940-Acetaminophen21.7MG/ML/HydrocodoneBitartrate0.5MG/MLOralSolution|IHSS
636|1003|N|N|Y||Preferred Generic|866042-NeomycinSulfate500MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|897696-HydromorphoneHydrochloride2MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|856535-24HRPropranololHydrochloride60MGExtendedReleaseOralCapsule|IHSS
636|1003|N|N|Y||Preferred Generic|856460-24HRPropranololHydrochloride120MGExtendedReleaseOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|313364-Thiothixene2MGOralCapsule|IHSS
636|1003|N|N|Y||Preferred Generic|854876-Zolpidemtartrate5MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|861225-24HRAmphetamineaspartate5MG/AmphetamineSulfate5MG/Dextroamphetaminesaccharate5MG/DextroamphetamineSulfate5MGExtendedRe|IHSS
636|1003|N|N|Y||Preferred Generic|895670-24HRquetiapine150MGExtendedReleaseOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|854880-Zolpidemtartrate12.5MGExtendedReleaseOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|993462-midodrinehydrochloride10MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|854252-1MLEnoxaparinsodium150MG/MLPrefilledSyringe|IHSS
636|1003|N|N|Y||Preferred Generic|854245-0.8MLEnoxaparinsodium150MG/MLPrefilledSyringe|IHSS
636|1003|N|N|N||Preferred Generic|313564-valacyclovir1000MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|854228-0.3MLEnoxaparinsodium100MG/MLPrefilledSyringe|IHSS
636|1003|N|N|Y||Preferred Generic|894780-MorphineSulfate4MG/MLOralSolution|IHSS
636|1003|N|N|N||Preferred Generic|313580-venlafaxine100MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|854235-0.4MLEnoxaparinsodium100MG/MLPrefilledSyringe|IHSS
636|1003|N|N|Y||Preferred Generic|834022-KetorolacTromethamine10MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|899548-dexmethylphenidatehydrochloride10MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|904589-SotalolHydrochloride240MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|847191-3MLinsulinaspartprotamine,human70UNT/ML/insulinaspart,human30UNT/MLPenInjector|IHSS
636|1003|N|N|Y||Preferred Generic|991528-DextromethorphanHydrobromide3MG/ML/PromethazineHydrochloride1.25MG/MLOralSolution|IHSS
636|1003|N|N|Y||Preferred Generic|845488-Ramipril1.25MGOralCapsule|IHSS
636|1003|N|N|Y||Preferred Generic|835603-tramadolhydrochloride50MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|313585-24HRvenlafaxine75MGExtendedReleaseOralCapsule|IHSS
636|1003|N|N|Y||Preferred Generic|351266-Buprenorphine2MG/Naloxone0.5MGSublingualTablet|IHSS
636|1003|N|N|Y||Preferred Generic|993470-midodrinehydrochloride5MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|1014314-TriamcinoloneAcetonide1MG/MLTopicalCream|IHSS
636|1003|N|N|Y||Preferred Generic|830801-24HRDiltiazemHydrochloride300MGExtendedReleaseOralCapsule|IHSS
636|1003|N|N|N||Preferred Brand|213282-hydroxyurea200MGOralCapsule[Droxia]|IHSS
636|1003|N|N|Y||Preferred Generic|809996-lacosamide200MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|809987-lacosamide100MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|197783-Hydrocortisone20MGOralTablet|IHSS
636|1003|N|N|N||Preferred Brand|1600710-cobicistat150MG/darunavir800MGOralTablet[Prezcobix]|IHSS
636|1003|N|N|Y||Preferred Generic|801966-4MLDiazepam5MG/MLRectalGel|IHSS
636|1003|N|N|Y||Preferred Generic|801957-0.5MLDiazepam5MG/MLRectalGel|IHSS
636|1003|N|N|Y||Preferred Generic|998675-168HRClonidine0.00833MG/HRTransdermalSystem|IHSS
636|1003|N|N|Y||Preferred Generic|728113-Oseltamivir45MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|313584-venlafaxine37.5MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|197787-Hydrocortisone5MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|749788-{56(varenicline1MGOralTablet)}Pack|IHSS
636|1003|N|N|N||Preferred Brand|1313884-Phenytoin25MG/MLOralSuspension[Dilantin]|IHSS
636|1003|N|N|Y||Preferred Generic|721796-24HRquetiapine400MGExtendedReleaseOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|721791-24HRquetiapine200MGExtendedReleaseOralTablet|IHSS
636|1003|N|Y|N||Preferred Brand|1551306-0.5MLdulaglutide3MG/MLAuto-Injector[Trulicity]|IHSS
636|1003|N|N|Y||Preferred Generic|636671-varenicline0.5MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|313988-Furosemide40MGOralTablet|IHSS
636|1003|N|Y|N||Preferred Brand|1992703-ertugliflozin7.5MG/Metforminhydrochloride500MGOralTablet[Segluromet]|IHSS
636|1003|N|N|Y||Preferred Generic|645037-Risperidone0.25MGDisintegratingOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|608139-atomoxetine100MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|314034-Haloperidol2MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|314055-IsosorbideDinitrate5MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|616705-Risperidone4MGDisintegratingOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|197806-Ibuprofen600MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|616487-quetiapine50MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|608143-atomoxetine80MGOralCapsule|IHSS
636|1003|N|Y|N||Preferred Brand|2398842-3MLsemaglutide1.34MG/MLPenInjector[Ozempic]|IHSS
636|1003|N|N|N||Preferred Brand|1000497-Prempro0.45/1.528DayPack|IHSS
636|1003|N|N|Y||Preferred Generic|596930-duloxetine30MGDelayedReleaseOralCapsule|IHSS
636|1003|N|N|Y||Preferred Generic|577961-Amphetamineaspartate5MG/AmphetamineSulfate5MG/Dextroamphetaminesaccharate5MG/DextroamphetamineSulfate5MGOralTablet|IHSS
636|1003|N|Y|N||Preferred Brand|665040-sitagliptin25MGOralTablet[Januvia]|IHSS
636|1003|N|N|Y||Preferred Generic|541892-Amphetamineaspartate2.5MG/AmphetamineSulfate2.5MG/Dextroamphetaminesaccharate2.5MG/DextroamphetamineSulfate2.5MGOralTa|IHSS
636|1003|N|N|N||Preferred Generic|314075-Loxapine50MGOralCapsule|IHSS
636|1003|N|Y|N||Preferred Brand|833146-Milnacipranhydrochloride50MGOralTablet[Savella]|IHSS
636|1003|N|N|Y||Preferred Generic|577127-pregabalin225MGOralCapsule|IHSS
636|1003|N|N|Y||Preferred Generic|483446-pregabalin200MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|314106-Metronidazole250MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|314131-Niacin250MGExtendedReleaseOralCapsule|IHSS
636|1003|N|N|Y||Preferred Generic|485465-Eszopiclone3MGOralTablet|IHSS
636|1003|N|Y|N||Preferred Generic|1368006-alogliptin25MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|485440-Eszopiclone1MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|483448-pregabalin50MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|197817-Indomethacin25MGOralCapsule|IHSS
636|1003|N|N|Y||Preferred Generic|351267-Buprenorphine8MG/Naloxone2MGSublingualTablet|IHSS
636|1003|N|N|N||Preferred Generic|314182-PotassiumChloride2.67MEQ/MLOralSolution|IHSS
636|1003|N|N|N||Preferred Generic|314208-ropinirole1MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|483440-pregabalin150MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|314215-rivastigmine4.5MGOralCapsule|IHSS
636|1003|N|N|Y||Preferred Generic|477562-Fenofibrate48MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|403923-168HREstradiol0.0025MG/HRTransdermalSystem|IHSS
636|1003|N|Y|N||Preferred Generic|1368438-alogliptin25MG/pioglitazone45MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|197840-IsosorbideDinitrate40MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|403884-Levetiracetam100MG/MLOralSolution|IHSS
636|1003|N|N|Y||Preferred Generic|401954-Risperidone2MGDisintegratingOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|314231-Simvastatin10MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|351297-insulinaspartprotamine,human70UNT/ML/insulinaspart,human30UNT/MLInjectableSuspension|IHSS
636|1003|N|Y|N||Preferred Generic|197418-Bumetanide1MGOralTablet|IHSS
636|1003|N|Y|N||Preferred Generic|197507-Cimetidine400MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|359817-Nicotine2MGOralLozenge|IHSS
636|1003|Y|N|N||Preferred Brand|1732161-incobotulinumtoxinA100UNTInjection[Xeomin]|IHSS
636|1003|N|N|Y||Preferred Generic|351264-Buprenorphine2MGSublingualTablet|IHSS
636|1003|N|N|Y||Preferred Generic|351133-Fenofibrate54MGOralTablet|IHSS
636|1003|N|Y|N||Preferred Generic|204119-Malathion5MG/MLTopicalLotion|IHSS
636|1003|N|N|Y||Preferred Generic|349592-atomoxetine18MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|197854-Ketoprofen25MGOralCapsule|IHSS
636|1003|N|Y|N||Preferred Generic|2572292-0.4MLcyclosporine0.5MG/MLOphthalmicSuspension|IHSS
636|1003|N|N|Y||Preferred Generic|349593-atomoxetine25MGOralCapsule|IHSS
636|1003|N|N|Y||Preferred Generic|349199-valsartan80MGOralTablet|IHSS
636|1003|N|Y|N||Preferred Generic|308865-calcipotriene0.05MG/MLTopicalSolution|IHSS
636|1003|N|N|N||Preferred Generic|315187-Prednisone1MG/MLOralSolution|IHSS
636|1003|N|N|Y||Preferred Generic|349483-valsartan40MGOralTablet|IHSS
636|1003|N|Y|N||Preferred Generic|313921-calcipotriene0.05MG/MLTopicalCream|IHSS
636|1003|N|N|Y||Preferred Generic|349287-Fenofibrate160MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|349200-valsartan320MGOralTablet|IHSS
636|1003|N|Y|N||Preferred Generic|311347-linezolid600MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|313778-ziprasidone80MGOralCapsule|IHSS
636|1003|N|Y|N||Preferred Generic|349556-ezetimibe10MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|317136-Nortriptyline25MGOralCapsule|IHSS
636|1003|N|N|Y||Preferred Generic|349196-Clonazepam1MGDisintegratingOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|317573-pioglitazone15MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|349194-Clonazepam0.125MGDisintegratingOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|317174-quetiapine200MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|317173-Captopril25MGOralTablet|IHSS
636|1003|N|Y|N||Preferred Generic|855182-24HRtolterodinetartrate2MGExtendedReleaseOralCapsule|IHSS
636|1003|N|N|Y||Preferred Generic|314286-ziprasidone20MGOralCapsule|IHSS
636|1003|N|N|Y||Preferred Generic|314211-Risperidone4MGOralTablet|IHSS
636|1003|N|Y|N||Preferred Generic|686429-mesalamine1200MGDelayedReleaseOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|314135-naratriptan2.5MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|103456-Fluocinonide0.5MG/MLTopicalCream|IHSS
636|1003|N|Y|N||Preferred Generic|825130-24HRmesalamine375MGExtendedReleaseOralCapsule|IHSS
636|1003|N|N|Y||Preferred Generic|314154-olanzapine10MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|311265-lamotrigine5MGChewableTablet|IHSS
636|1003|N|Y|N||Preferred Generic|855194-tolterodinetartrate2MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|349251-Tenofovirdisoproxilfumarate300MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|313762-zaleplon5MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|349373-Olmesartanmedoxomil5MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|313571-Vancomycin250MGOralCapsule|IHSS
636|1003|N|N|Y||Preferred Generic|313566-valganciclovir450MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|349332-Escitalopram10MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|349477-efavirenz600MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|313413-tizanidine4MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|313222-terbinafine250MGOralTablet|IHSS
636|1003|N|Y|N||Preferred Generic|997406-12HRFexofenadinehydrochloride60MG/PseudoephedrineHydrochloride120MGExtendedReleaseOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|312832-Risperidone3MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|1047881-HyoscyamineSulfate0.025MG/MLOralSolution|IHSS
636|1003|N|N|N||Preferred Generic|349420-desloratadine5MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|312840-rizatriptan5MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|351172-Dutasteride0.5MGOralCapsule|IHSS
636|1003|N|N|Y||Preferred Generic|312830-Risperidone1MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|312828-Risperidone0.25MGOralTablet|IHSS
636|1003|N|Y|Y||Preferred Brand|2601758-0.5MLtirzepatide30MG/MLAuto-Injector[Mounjaro]|IHSS
636|1003|N|N|Y||Preferred Generic|312087-Ondansetron8MGDisintegratingOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|1047905-HyoscyamineSulfate0.125MGOralTablet|IHSS
636|1003|N|Y|Y||Preferred Brand|2601785-0.5MLtirzepatide15MG/MLAuto-Injector[Mounjaro]|IHSS
636|1003|N|N|Y||Preferred Generic|312743-quetiapine100MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|311759-montelukast4MGChewableTablet|IHSS
636|1003|N|N|N||Preferred Generic|104884-Metoclopramide1MG/MLOralSolution|IHSS
636|1003|N|N|N||Preferred Brand|2267310-Copper313MGDrugImplant[ParaGard]|IHSS
636|1003|N|N|Y||Preferred Generic|312078-olanzapine5MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|351137-Albuterol0.21MG/MLInhalationSolution|IHSS
636|1003|N|N|Y||Preferred Generic|312075-Ofloxacin3MG/MLOphthalmicSolution|IHSS
636|1003|N|N|Y||Preferred Generic|311918-naratriptan1MGOralTablet|IHSS
636|1003|N|Y|Y||Preferred Generic|314266-Tacrolimus0.001MG/MGTopicalOintment|IHSS
636|1003|N|N|Y||Preferred Generic|198252-tetracyclinehydrochloride500MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|351249-Escitalopram5MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1011712-aliskiren150MG/Hydrochlorothiazide12.5MGOralTablet[TekturnaHCT]|IHSS
636|1003|N|N|Y||Preferred Generic|310792-Hydrochlorothiazide12.5MG/irbesartan150MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1040025-Corticotropin80UNT/MLInjectableSolution[Acthar]|IHSS
636|1003|N|N|Y||Preferred Generic|310465-Gentamicin0.001MG/MGTopicalOintment|IHSS
636|1003|N|N|Y||Preferred Generic|310288-Fenofibrate134MGOralCapsule|IHSS
636|1003|Y|N|N||Preferred Brand|1011752-aliskiren300MG/Hydrochlorothiazide12.5MGOralTablet[TekturnaHCT]|IHSS
636|1003|Y|N|N||Preferred Brand|1049545-Abuse-Deterrent12HROxycodoneHydrochloride15MGExtendedReleaseOralTablet[Oxycontin]|IHSS
636|1003|N|N|Y||Preferred Generic|310190-estradiolvalerate20MG/MLInjectableSolution|IHSS
636|1003|N|N|Y||Preferred Generic|310149-Erythromycin0.005MG/MGOphthalmicOintment|IHSS
636|1003|N|N|N||Preferred Generic|197919-Melphalan2MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|309309-Ciprofloxacin500MGOralTablet|IHSS
636|1003|N|Y|Y||Preferred Generic|313189-Tacrolimus0.0003MG/MGTopicalOintment|IHSS
636|1003|Y|N|N||Preferred Brand|1045408-dasatinib80MGOralTablet[Sprycel]|IHSS
636|1003|N|N|Y||Preferred Generic|309314-Citalopram40MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1145932-1MLabatacept125MG/MLPrefilledSyringe[Orencia]|IHSS
636|1003|N|N|Y||Preferred Generic|283639-olanzapine20MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|283407-Mirtazapine30MGDisintegratingOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|197939-Methazolamide25MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|2563976-insulinglargine-yfgn100UNT/MLInjectableSolution|IHSS
636|1003|Y|N|N||Preferred Brand|1045404-dasatinib140MGOralTablet[Sprycel]|IHSS
636|1003|N|N|N||Preferred Generic|197940-Methazolamide50MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|259081-12HRAspirin25MG/Dipyridamole200MGExtendedReleaseOralCapsule|IHSS
636|1003|N|N|Y||Preferred Generic|242461-cilostazol100MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1100706-Linagliptin5MGOralTablet[Tradjenta]|IHSS
636|1003|Y|N|N||Preferred Brand|1115449-1MLLeuprolideAcetate11.25MG/MLPrefilledSyringe[Lupron]|IHSS
636|1003|N|N|Y||Preferred Generic|248478-84HREstradiol0.00104MG/HRTransdermalSystem|IHSS
636|1003|Y|N|N||Preferred Brand|1115473-1.5MLLeuprolideAcetate7.5MG/MLPrefilledSyringe[Lupron]|IHSS
636|1003|N|N|Y||Preferred Generic|242892-84HREstradiol0.00417MG/HRTransdermalSystem|IHSS
636|1003|N|N|Y||Preferred Generic|242462-cilostazol50MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|402695-24HRFelodipine10MGExtendedReleaseOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1364358-ponatinib15MGOralTablet[Iclusig]|IHSS
636|1003|N|N|Y||Preferred Generic|242333-168HREstradiol0.00104MG/HRTransdermalSystem|IHSS
636|1003|N|N|Y||Preferred Generic|241946-84HREstradiol0.00156MG/HRTransdermalSystem|IHSS
636|1003|N|N|N||Preferred Generic|197943-Methocarbamol500MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|2123111-NDA020503200ACTUATAlbuterol0.09MG/ACTUATMeteredDoseInhaler|IHSS
636|1003|Y|N|N||Preferred Brand|1115468-1.5MLLeuprolideAcetate15MG/MLPrefilledSyringe[Lupron]|IHSS
636|1003|N|N|N||Preferred Generic|197944-Methocarbamol750MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|238003-168HREstradiol0.00208MG/HRTransdermalSystem|IHSS
636|1003|N|N|Y||Preferred Generic|200285-Hydrochlorothiazide12.5MG/valsartan160MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1235150-azilsartanmedoxomil40MG/Chlorthalidone12.5MGOralTablet[Edarbyclor]|IHSS
636|1003|Y|N|N||Preferred Brand|1243033-Linagliptin2.5MG/Metforminhydrochloride500MGOralTablet[Jentadueto]|IHSS
636|1003|N|N|Y||Preferred Generic|2047882-1MLtestosteronecypionate200MG/MLInjection|IHSS
636|1003|N|N|N||Preferred Generic|197958-Methyldopa500MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|200345-Simvastatin80MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|200311-Fenofibrate67MGOralCapsule|IHSS
636|1003|Y|N|N||Preferred Brand|1243330-Tenofovirdisoproxilfumarate200MGOralTablet[Viread]|IHSS
636|1003|N|N|Y||Preferred Generic|198317-Triazolam0.125MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1243326-Tenofovirdisoproxilfumarate150MGOralTablet[Viread]|IHSS
636|1003|Y|N|N||Preferred Brand|1245003-eltrombopag12.5MGOralTablet[Promacta]|IHSS
636|1003|N|N|Y||Preferred Generic|2001568-BXRating24HRMethylphenidateHydrochloride54MGExtendedReleaseOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1300803-24HRmirabegron50MGExtendedReleaseOralTablet[Myrbetriq]|IHSS
636|1003|N|N|Y||Preferred Generic|2001565-BXRating24HRMethylphenidateHydrochloride27MGExtendedReleaseOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|200096-irbesartan300MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|197963-Hydrochlorothiazide15MG/Methyldopa250MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1313061-24HRPhentermine11.25MG/topiramate69MGExtendedReleaseOralCapsule[Qsymia]|IHSS
636|1003|N|N|Y||Preferred Generic|200094-irbesartan75MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|199381-potassiumcitrate10MEQExtendedReleaseOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1307630-bosutinib100MGOralTablet[Bosulif]|IHSS
636|1003|N|N|Y||Preferred Generic|198318-Triazolam0.25MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|432401-cinacalcet60MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|476556-emtricitabine200MG/Tenofovirdisoproxilfumarate300MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|198342-Urea400MG/MLTopicalCream|IHSS
636|1003|N|N|Y||Preferred Brand|1656351-sacubitril49MG/valsartan51MGOralTablet[Entresto]|IHSS
636|1003|Y|N|N||Preferred Brand|1364477-teduglutide5MGInjection[Gattex]|IHSS
636|1003|N|N|N||Preferred Generic|106336-Ketoconazole20MG/MLMedicatedShampoo|IHSS
636|1003|N|N|Y||Preferred Generic|198241-Temazepam15MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Brand|2465331-TyblumeChewable28DayPack|IHSS
636|1003|N|N|Y||Preferred Generic|198188-Ramipril2.5MGOralCapsule|IHSS
636|1003|N|N|Y||Preferred Generic|198051-Omeprazole20MGDelayedReleaseOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|197987-Minoxidil2.5MGOralTablet|IHSS
636|1003|N|N|N||Preferred Brand|1747697-emtricitabine200MG/tenofoviralafenamide25MGOralTablet[Descovy]|IHSS
636|1003|N|N|Y||Preferred Generic|198035-24HRNifedipine60MGExtendedReleaseOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|197902-Lorazepam2MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1431083-Buprenorphine1.4MG/Naloxone0.36MGSublingualTablet[Zubsolv]|IHSS
636|1003|N|N|Y||Preferred Generic|197738-Glycopyrrolate1MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|432402-cinacalcet30MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|198007-Nadolol40MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|197739-Glycopyrrolate2MGOralTablet|IHSS
636|1003|N|N|N||Preferred Brand|1358781-Loestrin1/2021DayPack|IHSS
636|1003|N|N|Y||Preferred Generic|197591-Diazepam5MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|197589-Diazepam10MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1439903-riociguat2.5MGOralTablet[Adempas]|IHSS
636|1003|N|N|Y||Preferred Generic|197527-Clonazepam0.5MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|485023-MycophenolicAcid360MGDelayedReleaseOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1441424-0.4MLMethotrexate62.5MG/MLAuto-Injector[Otrexup]|IHSS
636|1003|N|N|Y||Preferred Generic|197528-Clonazepam1MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|1923422-SotalolHydrochloride120MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|486152-24HRNitroglycerin0.4MG/HRTransdermalSystem|IHSS
636|1003|N|N|N||Preferred Generic|543546-Nystatin100000UNT/MLTopicalCream|IHSS
636|1003|N|N|Y||Preferred Generic|197511-Ciprofloxacin250MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|198014-Naproxen500MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|1926331-0.5UNTDoses3MLInsulinLispro100UNT/MLPenInjector|IHSS
636|1003|N|N|Y||Preferred Generic|1923424-SotalolHydrochloride160MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1488671-12HRTreprostinil0.25MGExtendedReleaseOralTablet[Orenitram]|IHSS
636|1003|Y|N|N||Preferred Brand|1597575-Buprenorphine8.6MG/Naloxone2.1MGSublingualTablet[Zubsolv]|IHSS
636|1003|N|N|Y||Preferred Generic|1812013-Osmotic24HRNifedipine60MGExtendedReleaseOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|1806197-30/70Release24HRMethylphenidateHydrochloride60MGExtendedReleaseOralCapsule|IHSS
636|1003|Y|N|N||Preferred Brand|1492746-apremilast30MGOralTablet[Otezla]|IHSS
636|1003|N|N|Y||Preferred Generic|1806185-50/50Release24HRMethylphenidateHydrochloride60MGExtendedReleaseOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|562251-Amoxicillin250MG/Clavulanate125MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1544388-0.3MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|IHSS
636|1003|N|N|Y||Preferred Generic|1806191-30/70Release24HRMethylphenidateHydrochloride40MGExtendedReleaseOralCapsule|IHSS
636|1003|N|N|Y||Preferred Generic|1244214-Budesonide3MGDelayedReleaseOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|562704-ropinirole4MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|583170-Salsalate750MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|1649401-DoxycyclineMonohydrate50MGOralCapsule|IHSS
636|1003|Y|N|N||Preferred Brand|1545664-empagliflozin10MGOralTablet[Jardiance]|IHSS
636|1003|N|N|Y||Preferred Generic|1596780-60ACTUATTestosterone12.5MG/ACTUATTopicalGel|IHSS
636|1003|N|N|Y||Preferred Generic|1490065-RaloxifeneHydrochloride60MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|198038-Nitroglycerin0.3MGSublingualTablet|IHSS
636|1003|N|N|Y||Preferred Generic|1037045-dabigatranetexilate150MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|597730-lopinavir200MG/Ritonavir50MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|598025-Amoxicillin250MGChewableTablet|IHSS
636|1003|N|N|Y||Preferred Generic|1111343-olopatadine2MG/MLOphthalmicSolution|IHSS
636|1003|N|N|N||Preferred Generic|602964-aripiprazole2MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|1091497-MethylphenidateHydrochloride5MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|1091225-8HRMethylphenidateHydrochloride20MGExtendedReleaseOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1592748-nintedanib100MGOralCapsule[Ofev]|IHSS
636|1003|Y|N|N||Preferred Brand|1597130-5000MGTestosterone0.01MG/MGTopicalGel[Androgel]|IHSS
636|1003|N|N|Y||Preferred Generic|1091145-8HRMethylphenidateHydrochloride10MGExtendedReleaseOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|1049225-Acetaminophen325MG/OxycodoneHydrochloride7.5MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|617309-Amoxicillin200MG/Clavulanate28.5MGChewableTablet|IHSS
636|1003|N|N|Y||Preferred Generic|1037179-dabigatranetexilate75MGOralCapsule|IHSS
636|1003|Y|N|N||Preferred Brand|1593835-24HRdapagliflozin10MG/Metforminhydrochloride500MGExtendedReleaseOralTablet[Xigduo]|IHSS
636|1003|N|N|N||Preferred Generic|617312-atorvastatin10MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Generic|104894-Ondansetron4MGDisintegratingOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|616578-lubiprostone0.024MGOralCapsule|IHSS
636|1003|N|N|Y||Preferred Brand|901644-0.5MLStreptococcuspneumoniaeserotype1capsularantigendiphtheriaCRM197proteinconjugatevaccine0.0044MG/ML/Streptococcuspn|IHSS
636|1003|N|N|Y||Preferred Brand|847213-3MLInsulinLispro50UNT/ML/insulinlisproprotamine,human50UNT/MLPenInjector[HumalogMix]|IHSS
636|1003|N|N|N||Preferred Generic|198047-Nortriptyline75MGOralCapsule|IHSS
636|1003|N|N|Y||Preferred Brand|836634-1MLhepatitisAvirusstrainCR326Fantigen,inactivated50UNT/MLPrefilledSyringe[Vaqta]|IHSS
636|1003|Y|N|N||Preferred Brand|1597124-2500MGTestosterone0.01MG/MGTopicalGel[Androgel]|IHSS
636|1003|N|N|N||Preferred Generic|198049-Ofloxacin300MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Brand|836636-0.5MLhepatitisAvirusstrainCR326Fantigen,inactivated50UNT/MLPrefilledSyringe[Vaqta]|IHSS
636|1003|N|N|Y||Preferred Brand|798428-1MLHepatitisBSurfaceAntigenVaccine0.02MG/MLPrefilledSyringe[Engerix-B]|IHSS
636|1003|Y|N|N||Preferred Brand|1602604-1.5MLaripiprazole200MG/MLPrefilledSyringe[Abilify]|IHSS
636|1003|Y|N|N||Preferred Brand|1605172-0.4MLdarbepoetinalfa0.025MG/MLPrefilledSyringe[Aranesp]|IHSS
636|1003|N|N|Y||Preferred Brand|830245-1MLHepatitisBSurfaceAntigenVaccine0.01MG/MLPrefilledSyringe[Recombivax]|IHSS
636|1003|N|N|N||Preferred Generic|198076-Perphenazine2MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Brand|803371-1MLHepatitisAVaccine(Inactivated)StrainHM175720UNT/ML/HepatitisBSurfaceAntigenVaccine0.02MG/MLPrefilledSyringe[Twinrix|IHSS
636|1003|N|N|Y||Preferred Brand|798479-1MLHepatitisAVaccine(Inactivated)StrainHM1751440UNT/MLPrefilledSyringe[Havrix]|IHSS
636|1003|Y|N|N||Preferred Brand|1649495-ivabradine7.5MGOralTablet[Corlanor]|IHSS
636|1003|N|N|Y||Preferred Brand|2605540-0.5MLinfluenzaAvirusA/Darwin/6/2021(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.03MG/ML/i|IHSS
636|1003|Y|N|N||Preferred Brand|1649491-ivabradine5MGOralTablet[Corlanor]|IHSS
636|1003|Y|N|N||Preferred Brand|1649996-0.5MLInterferonbeta-1a0.044MG/MLAuto-Injector[Rebif]|IHSS
636|1003|N|N|Y||Preferred Brand|752388-InsulinLispro25UNT/ML/insulinlisproprotamine,human75UNT/MLInjectableSuspension[HumalogMix]|IHSS
636|1003|Y|N|N||Preferred Brand|1653144-0.5MLgolimumab100MG/MLAuto-Injector[Simponi]|IHSS
636|1003|N|N|Y||Preferred Brand|580261-tiotropium0.018MGInhalationPowder[Spiriva]|IHSS
636|1003|N|N|Y||Preferred Brand|351433-24HRNicotine0.292MG/HRTransdermalSystem[NicodermC-Q]|IHSS
636|1003|N|N|N||Preferred Generic|198078-Perphenazine8MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|198086-Phenobarbital16.2MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Brand|311036-insulin,regular,human100UNT/MLInjectableSolution[HumulinR]|IHSS
636|1003|N|N|Y||Preferred Brand|2607750-influenzaAvirusA/Norway/16606/2021(H3N2)antigen158000000UNT/ML/influenzaAvirusA/Victoria/1/2020(H1N1)antigen158000000|IHSS
636|1003|Y|N|N||Preferred Brand|1654079-0.5MLustekinumab90MG/MLInjection[Stelara]|IHSS
636|1003|N|N|Y||Preferred Brand|2605543-0.5MLinfluenzaAvirusA/Darwin/9/2021(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.03MG/ML/i|IHSS
636|1003|N|N|N||Preferred Generic|722134-Amlodipine5MG/valsartan160MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1657980-10MLtocilizumab20MG/MLInjection[Actemra]|IHSS
636|1003|N|N|Y||Preferred Brand|2605549-0.5MLinfluenzaAvirusA/Darwin/9/2021(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.03MG/ML/i|IHSS
636|1003|N|N|Y||Preferred Brand|1656356-sacubitril97MG/valsartan103MGOralTablet[Entresto]|IHSS
636|1003|Y|N|N||Preferred Brand|1657976-4MLtocilizumab20MG/MLInjection[Actemra]|IHSS
636|1003|Y|N|N||Preferred Brand|1659183-1MLalirocumab75MG/MLAuto-Injector[Praluent]|IHSS
636|1003|N|N|Y||Preferred Brand|2605051-0.5MLinfluenzaAvirusA/Darwin/9/2021(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.03MG/ML/i|IHSS
636|1003|Y|N|N||Preferred Brand|1660938-60ACTUATformoterolfumarate0.005MG/ACTUAT/mometasonefuroate0.2MG/ACTUATMeteredDoseInhaler[Dulera]|IHSS
636|1003|N|N|Y||Preferred Brand|2599543-Paxlovid150MG/100MGDosePack|IHSS
636|1003|N|N|Y||Preferred Brand|2587899-Paxlovid5-Day|IHSS
636|1003|N|N|N||Preferred Generic|198102-vitaminK15MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1721685-1MLEpoetinAlfa10000UNT/MLInjection[Epogen]|IHSS
636|1003|N|N|Y||Preferred Brand|2166928-10ACTUATolodaterol0.0025MG/ACTUAT/tiotropium0.0025MG/ACTUATInhalationSpray[Stiolto]|IHSS
636|1003|N|N|Y||Preferred Brand|211140-PentosanPolysulfate100MGOralCapsule[Elmiron]|IHSS
636|1003|Y|N|N||Preferred Brand|1718928-olanzapine405MGInjection[Zyprexa]|IHSS
636|1003|N|N|Y||Preferred Brand|2050059-0.5MLHepatitisBSurfaceAntigenVaccine0.04MG/MLPrefilledSyringe[Heplisav-B]|IHSS
636|1003|N|N|N||Preferred Generic|748804-{21(EthinylEstradiol0.035MG/EthynodiolDiacetate1MGOralTablet)/7(InertIngredients1MGOralTablet)}Pack|IHSS
636|1003|N|N|N||Preferred Generic|198105-Pindolol5MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Brand|2053927-sodiumzirconiumcyclosilicate10000MGPowderforOralSuspension[Lokelma]|IHSS
636|1003|N|N|N||Preferred Generic|198141-Prazosin5MGOralCapsule|IHSS
636|1003|N|N|Y||Preferred Brand|2000136-Vancomycin50MG/MLOralSolution[Firvanq]|IHSS
636|1003|N|N|Y||Preferred Brand|1992428-Eliquis30-DayStarterPack|IHSS
636|1003|Y|N|N||Preferred Brand|1728095-romiplostim0.25MGInjection[Nplate]|IHSS
636|1003|N|N|Y||Preferred Brand|1797888-Nicotine0.5MG/ACTUATMeteredDoseNasalSpray[Nicotrol]|IHSS
636|1003|N|N|N||Preferred Generic|748878-{21(EthinylEstradiol0.03MG/Levonorgestrel0.15MGOralTablet)/7(InertIngredients1MGOralTablet)}Pack|IHSS
636|1003|Y|N|N||Preferred Brand|1729033-selexipag1.4MGOralTablet[Uptravi]|IHSS
636|1003|N|N|Y||Preferred Brand|1986830-0.5MLVaricellazostervirusglycoproteinE,recombinant0.1MG/MLInjection[Shingrix]|IHSS
636|1003|N|N|Y||Preferred Brand|1658102-1MLhepatitisAvirusstrainCR326Fantigen,inactivated50UNT/MLInjection[Vaqta]|IHSS
636|1003|N|N|N||Preferred Generic|749157-{7(EthinylEstradiol0.025MG/norgestimate0.18MGOralTablet)/7(EthinylEstradiol0.025MG/norgestimate0.215MGOralTablet)/7(Et|IHSS
636|1003|N|N|N||Preferred Generic|749206-sevelamercarbonate800MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Brand|1667882-60ACTUATtiotropium0.00125MG/ACTUATInhalationSpray[Spiriva]|IHSS
636|1003|Y|N|N||Preferred Brand|1732165-incobotulinumtoxinA200UNTInjection[Xeomin]|IHSS
636|1003|N|N|Y||Preferred Brand|1658157-1MLHepatitisBSurfaceAntigenVaccine0.02MG/MLInjection[Engerix-B]|IHSS
636|1003|N|N|Y||Preferred Brand|1658106-0.5MLhepatitisAvirusstrainCR326Fantigen,inactivated50UNT/MLInjection[Vaqta]|IHSS
636|1003|N|N|N||Preferred Generic|1085686-TriamcinoloneAcetonide5MG/MLTopicalCream|IHSS
636|1003|N|N|N||Preferred Generic|749784-{7(EthinylEstradiol0.035MG/norgestimate0.18MGOralTablet)/7(EthinylEstradiol0.035MG/norgestimate0.215MGOralTablet)/7(Et|IHSS
636|1003|Y|N|Y||Preferred Generic|891893-MorphineSulfate60MGExtendedReleaseOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|749848-{21(Desogestrel0.15MG/EthinylEstradiol0.03MGOralTablet)/7(InertIngredients1MGOralTablet)}Pack|IHSS
636|1003|Y|N|Y||Preferred Generic|891874-MorphineSulfate100MGExtendedReleaseOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|749860-{21(EthinylEstradiol0.035MG/norgestimate0.25MGOralTablet)/7(InertIngredients1MGOralTablet)}Pack|IHSS
636|1003|N|N|N||Preferred Brand|2055815-DORAVIRINE100MG/Lamivudine300MG/Tenofovirdisoproxilfumarate300MGOralTablet[Delstrigo]|IHSS
636|1003|N|N|N||Preferred Generic|751553-{28(EthinylEstradiol0.02MG/Levonorgestrel0.09MGOralTablet)}Pack|IHSS
636|1003|Y|N|Y||Preferred Generic|313451-Tretinoin0.00025MG/MGTopicalGel|IHSS
636|1003|N|N|N||Preferred Generic|751901-{84(EthinylEstradiol0.03MG/Levonorgestrel0.15MGOralTablet)/7(InertIngredients1MGOralTablet)}Pack|IHSS
636|1003|N|N|N||Preferred Generic|1738495-ParoxetineHydrochloride20MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|754761-etravirine100MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Brand|1547582-0.5MLStreptococcuspneumoniaetype1capsularpolysaccharideantigen0.05MG/ML/Streptococcuspneumoniaetype10Acapsularpolysac|IHSS
636|1003|N|N|N||Preferred Generic|755497-Albuterol0.4MG/MLOralSolution|IHSS
636|1003|Y|N|Y||Preferred Generic|310140-eprosartan600MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|756209-Zidovudine10MG/MLOralSolution|IHSS
636|1003|Y|N|N||Preferred Generic|999986-Amlodipine10MG/Hydrochlorothiazide12.5MG/Olmesartanmedoxomil40MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|759743-{21(Desogestrel0.15MG/EthinylEstradiol0.02MGOralTablet)/5(EthinylEstradiol0.01MGOralTablet)/2(InertIngredients1MGOralT|IHSS
636|1003|N|N|N||Preferred Generic|1738483-ParoxetineHydrochloride10MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|762675-{21(Methylprednisolone4MGOralTablet)}Pack|IHSS
636|1003|N|N|Y||Preferred Brand|1300378-0.5MLBordetellapertussisfilamentoushemagglutininvaccine,inactivated0.016MG/ML/Bordetellapertussispertactinvaccine,ina|IHSS
636|1003|N|N|N||Preferred Generic|763181-{21(Prednisone5MGOralTablet)}Pack|IHSS
636|1003|Y|N|N||Preferred Generic|999996-Amlodipine5MG/Hydrochlorothiazide12.5MG/Olmesartanmedoxomil40MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|763185-{21(Prednisone10MGOralTablet)}Pack|IHSS
636|1003|N|N|Y||Preferred Brand|1292459-0.5MLVaricella-ZosterVirusVaccineLive(Oka-Merck)strain2700UNT/MLInjection[Varivax]|IHSS
636|1003|N|N|N||Preferred Generic|810096-{7(EthinylEstradiol0.01MGOralTablet)/84(EthinylEstradiol0.02MG/Levonorgestrel0.1MGOralTablet)}Pack|IHSS
636|1003|Y|N|N||Preferred Generic|998189-everolimus2.5MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|828320-Cyclobenzaprinehydrochloride5MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|968766-PhentermineHydrochloride15MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|828348-Cyclobenzaprinehydrochloride10MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Brand|1190919-0.5MLdiphtheriatoxoidvaccine,inactivated4UNT/ML/tetanustoxoidvaccine,inactivated10UNT/MLPrefilledSyringe[Tenivac]|IHSS
636|1003|N|N|N||Preferred Generic|830795-24HRDiltiazemHydrochloride360MGExtendedReleaseOralCapsule|IHSS
636|1003|Y|N|N||Preferred Generic|876529-Amlodipine5MG/telmisartan80MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|830801-24HRDiltiazemHydrochloride300MGExtendedReleaseOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|1731345-deferoxaminemesylate2000MGInjection|IHSS
636|1003|N|N|N||Preferred Generic|830837-24HRDiltiazemHydrochloride240MGExtendedReleaseOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|999613-SulfacetamideSodium100MG/ML/Sulfur50MG/MLMedicatedLiquidSoap|IHSS
636|1003|N|N|N||Preferred Generic|830845-24HRDiltiazemHydrochloride180MGExtendedReleaseOralCapsule|IHSS
636|1003|Y|N|N||Preferred Generic|900164-24HRlamotrigine25MGExtendedReleaseOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|830861-24HRDiltiazemHydrochloride120MGExtendedReleaseOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|997226-Donepezilhydrochloride5MGDisintegratingOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|831054-DiltiazemHydrochloride120MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|897021-12HRdalfampridine10MGExtendedReleaseOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|831102-DiltiazemHydrochloride90MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|896236-120ACTUATFluticasonepropionate0.045MG/ACTUAT/salmeterol0.021MG/ACTUATMeteredDoseInhaler|IHSS
636|1003|N|N|N||Preferred Generic|831103-DiltiazemHydrochloride60MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|997220-Donepezilhydrochloride10MGDisintegratingOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|831109-CromolynSodium40MG/MLOphthalmicSolution|IHSS
636|1003|N|N|N||Preferred Generic|996520-DextromethorphanHydrobromide2MG/ML/Guaifenesin20MG/MLOralSolution|IHSS
636|1003|N|N|N||Preferred Generic|831261-CromolynSodium20MG/MLOralSolution|IHSS
636|1003|Y|N|N||Preferred Generic|876519-Amlodipine10MG/telmisartan80MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|831359-24HRDiltiazemHydrochloride420MGExtendedReleaseOralCapsule|IHSS
636|1003|Y|N|N||Preferred Generic|864761-MethadoneHydrochloride1MG/MLOralSolution|IHSS
636|1003|N|N|N||Preferred Generic|833008-DesmopressinAcetate0.2MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|996561-Memantinehydrochloride10MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|833217-DiltiazemHydrochloride30MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|861960-armodafinil200MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|833528-Amiodaronehydrochloride200MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|995666-MeclizineHydrochloride25MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|834040-PenicillinVPotassium50MG/MLOralSolution|IHSS
636|1003|N|N|N||Preferred Generic|284184-Didanosine250MGDelayedReleaseOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|834046-PenicillinVPotassium25MG/MLOralSolution|IHSS
636|1003|Y|N|N||Preferred Generic|861402-PhenoxybenzamineHydrochloride10MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|834061-PenicillinVPotassium250MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|753436-9HRMethylphenidate1.11MG/HRTransdermalSystem|IHSS
636|1003|N|N|N||Preferred Generic|834102-PenicillinVPotassium500MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|1659263-1MLheparinsodium,porcine5000UNT/MLInjection|IHSS
636|1003|N|N|N||Preferred Generic|834127-chlorhexidinegluconate1.2MG/MLMouthwash|IHSS
636|1003|N|N|N||Preferred Generic|995258-HydroxyzineHydrochloride25MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|835564-ImipramineHydrochloride25MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|855626-Twice-Dailydiclofenacepolamine0.013MG/MGMedicatedPatch|IHSS
636|1003|N|N|N||Preferred Generic|835568-ImipramineHydrochloride50MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|995232-HydroxyzinePamoate100MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|835593-ImipramineHydrochloride10MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|848151-Amlodipine10MG/Hydrochlorothiazide25MG/valsartan160MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|835726-Acamprosatecalcium333MGDelayedReleaseOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|848135-Amlodipine10MG/Hydrochlorothiazide25MG/valsartan320MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|835894-cyclosporine,modified25MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|995218-HydroxyzineHydrochloride10MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|835913-MefloquineHydrochloride250MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|993557-24HRBupropionHydrochloride300MGExtendedReleaseOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|835925-cyclosporine,modified50MGOralCapsule|IHSS
636|1003|Y|N|N||Preferred Generic|833234-mesalamine800MGDelayedReleaseOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|836358-IpratropiumBromide0.2MG/MLInhalationSolution|IHSS
636|1003|Y|N|N||Preferred Generic|824301-rufinamide400MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|848176-AugmentedBetamethasone0.5MG/MLTopicalCream|IHSS
636|1003|N|N|N||Preferred Generic|993687-BupropionHydrochloride100MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|849389-AmantadineHydrochloride100MGOralCapsule|IHSS
636|1003|Y|N|N||Preferred Generic|794639-lubiprostone0.008MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|849395-AmantadineHydrochloride100MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|993541-24HRBupropionHydrochloride150MGExtendedReleaseOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|849506-DesmopressinAcetate0.01MG/ACTUATNasalSpray|IHSS
636|1003|N|N|N||Preferred Generic|282755-telmisartan20MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|849515-DesmopressinAcetate0.1MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|753441-9HRMethylphenidate3.33MG/HRTransdermalSystem|IHSS
636|1003|N|N|N||Preferred Generic|852877-QuinidineSulfate200MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|991336-Chlorpromazinehydrochloride50MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|852913-QuinidineSulfate300MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|727339-0.5MLSumatriptan12MG/MLPrefilledSyringe|IHSS
636|1003|N|N|N||Preferred Generic|854801-DiclofenacSodium1MG/MLOphthalmicSolution|IHSS
636|1003|Y|N|N||Preferred Generic|724863-armodafinil50MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|854901-BisoprololFumarate10MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|992447-PromethazineHydrochloride25MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|854905-BisoprololFumarate5MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|700885-temozolomide180MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|854908-BisoprololFumarate10MG/Hydrochlorothiazide6.25MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|992432-PromethazineHydrochloride1.25MG/MLOralSolution|IHSS
636|1003|N|N|N||Preferred Generic|854916-BisoprololFumarate2.5MG/Hydrochlorothiazide6.25MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|259966-Methylprednisolone4MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|854919-BisoprololFumarate5MG/Hydrochlorothiazide6.25MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|672149-lapatinib250MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|855168-levocetirizinedihydrochloride0.5MG/MLOralSolution|IHSS
636|1003|Y|N|N||Preferred Generic|608328-rasagiline1MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|855172-levocetirizinedihydrochloride5MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|991194-Chlorpromazinehydrochloride25MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|855288-WarfarinSodium1MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|2532159-PMDDfluoxetine10MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|855296-WarfarinSodium10MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|616749-12HRranolazine500MGExtendedReleaseOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|855302-WarfarinSodium2MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|151226-topiramate50MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|855312-WarfarinSodium2.5MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|603206-erlotinib150MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|855318-WarfarinSodium3MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|602910-lenalidomide10MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|855324-WarfarinSodium4MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|251322-Ethosuximide50MG/MLOralSolution|IHSS
636|1003|N|N|N||Preferred Generic|855332-WarfarinSodium5MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|205328-Lamivudine100MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|855338-WarfarinSodium6MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|151029-mometasonefuroate0.001MG/MGTopicalOintment|IHSS
636|1003|N|N|N||Preferred Generic|855344-WarfarinSodium7.5MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|977880-AmilorideHydrochloride5MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|855474-alclometasonedipropionate0.5MG/MLTopicalCream|IHSS
636|1003|Y|N|N||Preferred Generic|577776-candesartancilexetil16MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|855480-alclometasonedipropionate0.0005MG/MGTopicalOintment|IHSS
636|1003|N|N|N||Preferred Generic|905395-HydralazineHydrochloride50MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|855664-DiclofenacSodium25MGDelayedReleaseOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|545835-LeuprolideAcetate5MG/MLInjectableSolution|IHSS
636|1003|N|N|N||Preferred Generic|855812-prasugrel10MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|485434-entecavir0.5MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|855818-prasugrel5MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|905377-HydralazineHydrochloride37.5MG/IsosorbideDinitrate20MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|855906-DiclofenacSodium50MGDelayedReleaseOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|905222-HydralazineHydrochloride100MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|855926-DiclofenacSodium75MGDelayedReleaseOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|476362-mesalamine500MGExtendedReleaseOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|856364-TrazodoneHydrochloride150MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|403879-imatinib400MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|856373-TrazodoneHydrochloride100MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|905225-HydralazineHydrochloride25MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|856377-TrazodoneHydrochloride50MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|349435-voriconazole50MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|856422-Hydrochlorothiazide25MG/PropranololHydrochloride40MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|905199-HydralazineHydrochloride10MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|856429-Hydrochlorothiazide25MG/PropranololHydrochloride80MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|241834-cyclosporine,modified100MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|856448-PropranololHydrochloride10MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|349410-Treprostinil5MG/MLInjectableSolution|IHSS
636|1003|N|N|N||Preferred Generic|856457-PropranololHydrochloride20MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|903884-FluvoxamineMaleate100MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|856519-PropranololHydrochloride40MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|349094-Budesonide0.125MG/MLInhalationSuspension|IHSS
636|1003|N|N|N||Preferred Generic|856556-PropranololHydrochloride60MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|317160-temozolomide100MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|856578-PropranololHydrochloride80MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|904458-PravastatinSodium10MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|856706-AmitriptylineHydrochloride10MG/Perphenazine2MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|313209-temozolomide20MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|856720-AmitriptylineHydrochloride10MG/Perphenazine4MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|904396-Alendronicacid35MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|856724-PropranololHydrochloride4MG/MLOralSolution|IHSS
636|1003|N|N|N||Preferred Generic|239191-Amoxicillin50MG/MLOralSuspension|IHSS
636|1003|N|N|N||Preferred Generic|856733-PropranololHydrochloride8MG/MLOralSolution|IHSS
636|1003|Y|N|N||Preferred Generic|311204-Itraconazole100MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|856762-AmitriptylineHydrochloride100MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|252559-Budesonide0.5MG/MLInhalationSuspension|IHSS
636|1003|N|N|N||Preferred Generic|856773-AmitriptylineHydrochloride150MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|903703-liothyroninesodium0.05MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|856783-AmitriptylineHydrochloride10MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|238600-seleniumsulfide25MG/MLMedicatedShampoo|IHSS
636|1003|N|N|N||Preferred Generic|856797-AmitriptylineHydrochloride25MG/Perphenazine2MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|2606490-pirfenidone534MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|856825-AmitriptylineHydrochloride25MG/Perphenazine4MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|1376336-prednisoloneacetate10MG/MLOphthalmicSuspension|IHSS
636|1003|N|N|N||Preferred Generic|856834-AmitriptylineHydrochloride25MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|245136-72HRFentanyl0.1MG/HRTransdermalSystem|IHSS
636|1003|N|N|N||Preferred Generic|856840-AmitriptylineHydrochloride50MG/Perphenazine4MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|240912-Granisetron1MG/MLInjectableSolution|IHSS
636|1003|N|N|N||Preferred Generic|856845-AmitriptylineHydrochloride50MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|238151-mesalamine66.7MG/MLEnema|IHSS
636|1003|N|N|N||Preferred Generic|856853-AmitriptylineHydrochloride75MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|897640-Verapamilhydrochloride180MGExtendedReleaseOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|857169-FosinoprilSodium10MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|205316-topiramate15MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|857183-FosinoprilSodium20MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|200327-capecitabine150MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|857187-FosinoprilSodium40MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|898367-Benazeprilhydrochloride20MG/Hydrochlorothiazide12.5MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|857297-ClomipramineHydrochloride25MGOralCapsule|IHSS
636|1003|Y|N|N||Preferred Generic|1988974-24HRpregabalin165MGExtendedReleaseOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|857301-ClomipramineHydrochloride50MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|898359-Amlodipine5MG/Benazeprilhydrochloride40MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|857305-ClomipramineHydrochloride75MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|206842-IsosorbideDinitrate20MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|857321-BethanecholChloride10MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|198228-Sulfadiazine500MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|857328-BethanecholChloride25MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|197843-Isotretinoin10MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|857336-BethanecholChloride5MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|898346-Amlodipine10MG/Benazeprilhydrochloride40MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|857340-BethanecholChloride50MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|205304-telmisartan40MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|857416-ClemastineFumarate1.34MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|197845-Isotretinoin40MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|857461-ClemastineFumarate2.68MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|1367410-Ergocalciferol1.25MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|857677-TerbutalineSulfate2.5MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|197696-72HRFentanyl0.075MG/HRTransdermalSystem|IHSS
636|1003|N|N|N||Preferred Generic|857683-TerbutalineSulfate5MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|197554-Danazol100MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|858613-Nicardipinehydrochloride20MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|205290-efavirenz200MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|858616-Nicardipinehydrochloride30MGOralCapsule|IHSS
636|1003|Y|N|N||Preferred Generic|1799212-sofosbuvir400MG/velpatasvir100MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|858747-Ursodiol300MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|897624-24HRVerapamilhydrochloride240MGExtendedReleaseOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|858804-EnalaprilMaleate2.5MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|205284-leflunomide10MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|858810-EnalaprilMaleate20MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|1918042-abirateroneacetate500MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|858813-EnalaprilMaleate5MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|1362712-MexiletineHydrochloride200MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|858817-EnalaprilMaleate10MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|1868014-pirfenidone267MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|858824-EnalaprilMaleate5MG/Hydrochlorothiazide12.5MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|1860137-Abuse-Deterrent12HROxycodoneHydrochloride40MGExtendedReleaseOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|858828-EnalaprilMaleate10MG/Hydrochlorothiazide25MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|204423-Hydrocortisone10MG/ML/Neomycin3.5MG/ML/PolymyxinB10000UNT/MLOticSolution|IHSS
636|1003|N|N|N||Preferred Generic|859186-selegilinehydrochloride5MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Brand|105551-Busulfan2MGOralTablet[Myleran]|IHSS
636|1003|N|N|N||Preferred Generic|859193-selegilinehydrochloride5MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|1745091-Lidocaine0.05MG/MGMedicatedPatch|IHSS
636|1003|N|N|N||Preferred Generic|859419-Rosuvastatincalcium40MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|1734399-1MLGranisetron1MG/MLInjection|IHSS
636|1003|N|N|N||Preferred Generic|859424-Rosuvastatincalcium5MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|203105-Hydrocortisone0.01MG/MGTopicalOintment|IHSS
636|1003|N|N|N||Preferred Generic|859747-Rosuvastatincalcium10MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|1607796-deferasirox90MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|859751-Rosuvastatincalcium20MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|200371-Citalopram20MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|859835-FluphenazineHydrochloride0.5MG/MLOralSolution|IHSS
636|1003|N|N|N||Preferred Generic|895487-Fluticasonepropionate0.00005MG/MGTopicalOintment|IHSS
636|1003|N|N|N||Preferred Generic|859841-FluphenazineHydrochloride10MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|1607784-deferasirox180MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|860215-MegestrolAcetate20MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|2122659-Mavenclad4TabletPack|IHSS
636|1003|N|N|N||Preferred Generic|860221-MegestrolAcetate40MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|1359861-Budesonide0.16MG/ACTUAT/formoterolfumarate0.0045MG/ACTUATMeteredDoseInhaler|IHSS
636|1003|N|N|N||Preferred Generic|860225-MegestrolAcetate40MG/MLOralSuspension|IHSS
636|1003|N|N|N||Preferred Generic|885219-benztropinemesylate0.5MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|860805-Azelastinehydrochloride0.5MG/MLOphthalmicSolution|IHSS
636|1003|Y|N|N||Preferred Generic|153823-candesartancilexetil8MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|860918-FluphenazineHydrochloride5MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|884707-Estradiol0.01MGVaginalInsert|IHSS
636|1003|N|N|N||Preferred Generic|860975-24HRMetforminhydrochloride500MGExtendedReleaseOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|1437969-Cyclophosphamide50MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|860981-24HRMetforminhydrochloride750MGExtendedReleaseOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|1424899-14ACTUATfluticasonefuroate0.1MG/ACTUAT/vilanterol0.025MG/ACTUATDryPowderInhaler|IHSS
636|1003|N|N|N||Preferred Generic|861004-Metforminhydrochloride1000MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|884308-Nystatin100UNT/MGTopicalOintment|IHSS
636|1003|N|N|N||Preferred Generic|861007-Metforminhydrochloride500MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|866514-MetoprololTartrate50MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|861010-Metforminhydrochloride850MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|1310533-teriflunomide7MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|861064-Sertraline20MG/MLOralSolution|IHSS
636|1003|Y|N|N||Preferred Generic|1307427-sildenafil10MG/MLOralSuspension|IHSS
636|1003|N|N|N||Preferred Generic|861132-24HRAlfuzosinhydrochloride10MGExtendedReleaseOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|866924-MetoprololTartrate25MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|861156-12HRPropafenoneHydrochloride225MGExtendedReleaseOralCapsule|IHSS
636|1003|Y|N|N||Preferred Generic|1299909-Tiagabinehydrochloride16MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|861164-12HRPropafenoneHydrochloride325MGExtendedReleaseOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|866511-MetoprololTartrate100MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|861171-12HRPropafenoneHydrochloride425MGExtendedReleaseOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|200064-letrozole2.5MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|861200-Brimonidinetartrate2MG/MLOphthalmicSolution|IHSS
636|1003|Y|N|N||Preferred Generic|1291085-hydrocortisoneacetate30MGRectalSuppository|IHSS
636|1003|N|N|N||Preferred Generic|861416-Azithromycin1000MGPowderforOralSuspension|IHSS
636|1003|N|N|N||Preferred Generic|866018-buspironehydrochloride15MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|861424-PropafenoneHydrochloride150MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|1111641-1MLglatirameracetate20MG/MLPrefilledSyringe|IHSS
636|1003|N|N|N||Preferred Generic|861427-PropafenoneHydrochloride225MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|1095229-FlavoxateHydrochloride100MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|861430-PropafenoneHydrochloride300MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|866111-buspironehydrochloride7.5MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|861448-ClobetasolPropionate0.0005MG/MGTopicalOintment|IHSS
636|1003|Y|N|N||Preferred Generic|1011736-aliskiren150MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|861495-ClobetasolPropionate0.5MG/MLTopicalCream|IHSS
636|1003|N|N|N||Preferred Generic|866090-buspironehydrochloride30MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|861657-24HRNitroglycerin0.1MG/HRTransdermalSystem|IHSS
636|1003|N|N|N||Preferred Generic|200031-carvedilol6.25MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|861743-Glyburide1.25MG/Metforminhydrochloride250MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|1010600-Buprenorphine2MG/Naloxone0.5MGSublingualFilm|IHSS
636|1003|N|N|N||Preferred Generic|861748-Glyburide2.5MG/Metforminhydrochloride500MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|884619-eltrombopag75MGOralTablet[Promacta]|IHSS
636|1003|N|N|N||Preferred Generic|861753-Glyburide5MG/Metforminhydrochloride500MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|865123-FluphenazineHydrochloride2.5MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|861848-FluphenazineHydrochloride5MG/MLOralSolution|IHSS
636|1003|N|N|N||Preferred Generic|199890-topiramate200MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|863599-Oxybutyninchloride1MG/MLOralSolution|IHSS
636|1003|Y|N|N||Preferred Brand|901614-Aztreonam75MG/MLInhalationSolution[Cayston]|IHSS
636|1003|N|N|N||Preferred Generic|863619-24HROxybutyninchloride10MGExtendedReleaseOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|1358776-{21(EthinylEstradiol0.02MG/norethindroneacetate1MGOralTablet)}Pack|IHSS
636|1003|N|N|N||Preferred Generic|863628-24HROxybutyninchloride15MGExtendedReleaseOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|864820-Oxybutyninchloride0.1MG/MGTopicalGel[Gelnique]|IHSS
636|1003|N|N|N||Preferred Generic|863636-24HROxybutyninchloride5MGExtendedReleaseOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|860244-interferonbeta-1b0.3MGInjection[Extavia]|IHSS
636|1003|N|N|N||Preferred Generic|863664-Oxybutyninchloride5MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|867506-pazopanib200MGOralTablet[Votrient]|IHSS
636|1003|Y|N|N||Preferred Brand|861043-2.7MLpramlintideacetate1MG/MLPenInjector[Symlin]|IHSS
636|1003|Y|N|N||Preferred Generic|1731077-fosaprepitant150MGInjection|IHSS
636|1003|Y|N|N||Preferred Brand|858057-0.75MLpaliperidonepalmitate156MG/MLPrefilledSyringe[Invega]|IHSS
636|1003|Y|N|N||Preferred Brand|858053-1.5MLpaliperidonepalmitate156MG/MLPrefilledSyringe[Invega]|IHSS
636|1003|N|N|N||Preferred Brand|1147337-emtricitabine200MG/Rilpivirine25MG/Tenofovirdisoproxilfumarate300MGOralTablet[Complera]|IHSS
636|1003|Y|N|N||Preferred Brand|857799-Treprostinil0.6MG/MLInhalationSolution[Tyvaso]|IHSS
636|1003|N|N|N||Preferred Generic|1359023-{21(EthinylEstradiol0.03MG/norethindroneacetate1.5MGOralTablet)/7(Ferrousfumarate75MGOralTablet)}Pack|IHSS
636|1003|Y|N|N||Preferred Brand|858366-KetorolacTromethamine4.5MG/MLOphthalmicSolution[Acuvail]|IHSS
636|1003|Y|N|N||Preferred Brand|858040-saxagliptin5MGOralTablet[Onglyza]|IHSS
636|1003|Y|N|N||Preferred Brand|854302-1.5MLSomatropin6.67MG/MLCartridge[Omnitrope]|IHSS
636|1003|Y|N|N||Preferred Generic|1001004-PilocarpineHydrochloride7.5MGOralTablet|IHSS
636|1003|N|N|N||Preferred Brand|616444-mycophenolatemofetil200MG/MLOralSuspension[Cellcept]|IHSS
636|1003|Y|N|N||Preferred Brand|854848-lisdexamfetaminedimesylate60MGOralCapsule[Vyvanse]|IHSS
636|1003|Y|N|N||Preferred Generic|1000913-PilocarpineHydrochloride5MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|854840-lisdexamfetaminedimesylate40MGOralCapsule[Vyvanse]|IHSS
636|1003|Y|N|N||Preferred Brand|854832-lisdexamfetaminedimesylate20MGOralCapsule[Vyvanse]|IHSS
636|1003|N|N|N||Preferred Generic|200032-carvedilol12.5MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|799830-dasatinib100MGOralTablet[Sprycel]|IHSS
636|1003|N|N|N||Preferred Brand|1999026-Balcoltra28DayPack|IHSS
636|1003|Y|N|N||Preferred Generic|1091839-Roflumilast0.5MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|849599-1MLcertolizumabpegol200MG/MLPrefilledSyringe[Cimzia]|IHSS
636|1003|N|N|N||Preferred Generic|864661-efavirenz600MG/Lamivudine300MG/Tenofovirdisoproxilfumarate300MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|847917-60ACTUATexenatide0.005MG/ACTUATPenInjector[Byetta]|IHSS
636|1003|Y|N|N||Preferred Brand|845512-everolimus10MGOralTablet[Afinitor]|IHSS
636|1003|Y|N|N||Preferred Generic|1119400-everolimus7.5MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|1242231-lenalidomide2.5MGOralCapsule|IHSS
636|1003|Y|N|N||Preferred Brand|828696-Zolpidemtartrate5MG/ACTUATOralSpray[Zolpimist]|IHSS
636|1003|Y|N|N||Preferred Brand|825429-eltrombopag50MGOralTablet[Promacta]|IHSS
636|1003|Y|N|N||Preferred Generic|1299903-Tiagabinehydrochloride12MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|802652-1MLEtanercept50MG/MLPrefilledSyringe[Enbrel]|IHSS
636|1003|Y|N|N||Preferred Generic|1299911-Tiagabinehydrochloride2MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|200082-Lamivudine150MG/Zidovudine300MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|809159-0.5MLEtanercept50MG/MLPrefilledSyringe[Enbrel]|IHSS
636|1003|Y|N|N||Preferred Brand|668606-Vorinostat100MGOralCapsule[Zolinza]|IHSS
636|1003|N|N|N||Preferred Brand|1426601-Minastrin24FeChewable28DayPack|IHSS
636|1003|Y|N|N||Preferred Generic|1307056-Buprenorphine4MG/Naloxone1MGSublingualFilm|IHSS
636|1003|Y|N|N||Preferred Brand|763106-poliovirusvaccineinactivated,type1(Mahoney)80UNT/ML/poliovirusvaccineinactivated,type2(MEF-1)16UNT/ML/poliovirusvaccin|IHSS
636|1003|N|N|N||Preferred Generic|866419-24HRmetoprololsuccinate200MGExtendedReleaseOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|758027-0.5MLInterferonbeta-1a0.088MG/MLPrefilledSyringe[Rebif]|IHSS
636|1003|Y|N|N||Preferred Brand|748740-Topotecan1MGOralCapsule[Hycamtin]|IHSS
636|1003|Y|N|N||Preferred Generic|1366550-24HRBudesonide9MGExtendedReleaseOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|884189-ClonidineHydrochloride0.3MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|746609-nilotinib200MGOralCapsule[Tasigna]|IHSS
636|1003|Y|N|N||Preferred Brand|731250-0.3MLdarbepoetinalfa0.2MG/MLPrefilledSyringe[Aranesp]|IHSS
636|1003|N|N|N||Preferred Generic|200133-12HRCarbamazepine200MGExtendedReleaseOralCapsule|IHSS
636|1003|Y|N|N||Preferred Brand|731231-0.3MLdarbepoetinalfa0.5MG/MLPrefilledSyringe[Aranesp]|IHSS
636|1003|N|N|N||Preferred Generic|1359859-Fluticasonepropionate0.25MG/ACTUAT/salmeterol0.05MG/ACTUATDryPowderInhaler|IHSS
636|1003|Y|N|N||Preferred Generic|1487074-DiclofenacSodium20MG/MLTopicalSolution|IHSS
636|1003|Y|N|N||Preferred Brand|731235-0.4MLdarbepoetinalfa0.5MG/MLPrefilledSyringe[Aranesp]|IHSS
636|1003|Y|N|N||Preferred Generic|1599949-60ACTUATTestosterone30MG/ACTUATTopicalSolution|IHSS
636|1003|Y|N|N||Preferred Brand|731227-0.4MLdarbepoetinalfa0.1MG/MLPrefilledSyringe[Aranesp]|IHSS
636|1003|Y|N|N||Preferred Brand|727816-0.5MLInterferonbeta-1a0.06MG/MLPrefilledSyringe[Avonex]|IHSS
636|1003|Y|N|N||Preferred Generic|1547561-Isotretinoin25MGOralCapsule|IHSS
636|1003|Y|N|N||Preferred Brand|724142-24HRRotigotine0.167MG/HRTransdermalSystem[Neupro]|IHSS
636|1003|Y|N|N||Preferred Generic|1550940-Colchicine0.6MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|886662-FlecainideAcetate50MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|724156-24HRRotigotine0.25MG/HRTransdermalSystem[Neupro]|IHSS
636|1003|Y|N|N||Preferred Brand|700418-Thalidomide150MGOralCapsule[Thalomid]|IHSS
636|1003|N|N|N||Preferred Generic|200346-cefdinir300MGOralCapsule|IHSS
636|1003|Y|N|N||Preferred Generic|1607792-deferasirox360MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|706872-Azithromycin10MG/MLOphthalmicSolution[AzaSite]|IHSS
636|1003|N|N|N||Preferred Generic|895994-120ACTUATFluticasonepropionate0.044MG/ACTUATMeteredDoseInhaler|IHSS
636|1003|Y|N|N||Preferred Brand|706829-Risperidone50MGInjection[Risperdal]|IHSS
636|1003|Y|N|N||Preferred Brand|706825-Risperidone12.5MGInjection[Risperdal]|IHSS
636|1003|N|N|N||Preferred Generic|895987-Fluticasonepropionate0.5MG/MLTopicalCream|IHSS
636|1003|N|N|N||Preferred Generic|991086-DicyclomineHydrochloride20MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|643722-lenalidomide25MGOralCapsule[Revlimid]|IHSS
636|1003|Y|N|N||Preferred Brand|643177-dasatinib70MGOralTablet[Sprycel]|IHSS
636|1003|Y|N|N||Preferred Generic|1728055-5MLpalonosetron0.05MG/MLInjection|IHSS
636|1003|Y|N|N||Preferred Brand|616287-sunitinib25MGOralCapsule[Sutent]|IHSS
636|1003|Y|N|N||Preferred Generic|1737461-PamidronateDisodium90MGInjection|IHSS
636|1003|N|N|N||Preferred Brand|688242-Estrogens,Conjugated(USP)0.625MG/MLVaginalCream[Premarin]|IHSS
636|1003|Y|N|N||Preferred Brand|616292-sunitinib50MGOralCapsule[Sutent]|IHSS
636|1003|Y|N|N||Preferred Brand|540181-alosetron0.5MGOralTablet[Lotronex]|IHSS
636|1003|N|N|N||Preferred Generic|896766-Labetalolhydrochloride300MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|1811180-icosapentethyl500MGOralCapsule|IHSS
636|1003|Y|N|N||Preferred Brand|616114-lenalidomide10MGOralCapsule[Revlimid]|IHSS
636|1003|N|N|N||Preferred Brand|705008-Cefixime40MG/MLOralSuspension[Suprax]|IHSS
636|1003|Y|N|N||Preferred Brand|607579-entecavir0.05MG/MLOralSolution[Baraclude]|IHSS
636|1003|Y|N|N||Preferred Brand|582595-Iloprost0.01MG/MLInhalationSolution[Ventavis]|IHSS
636|1003|Y|N|N||Preferred Generic|1868018-pirfenidone801MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|2613769-0.6MLpegfilgrastim-fpgk10MG/MLPrefilledSyringe[Stimufend]|IHSS
636|1003|Y|N|N||Preferred Generic|1874559-24HRdesvenlafaxinesuccinate50MGExtendedReleaseOralTablet|IHSS
636|1003|N|N|N||Preferred Brand|2003255-Lamivudine300MG/Tenofovirdisoproxilfumarate300MGOralTablet[Cimduo]|IHSS
636|1003|Y|N|N||Preferred Brand|404449-Thalidomide100MGOralCapsule[Thalomid]|IHSS
636|1003|Y|N|N||Preferred Generic|1597129-5000MGTestosterone0.01MG/MGTopicalGel|IHSS
636|1003|Y|N|N||Preferred Brand|352297-1MLpeginterferonalfa-2a0.18MG/MLInjection[Pegasys]|IHSS
636|1003|Y|N|N||Preferred Brand|352046-1MLdarbepoetinalfa0.06MG/MLInjection[Aranesp]|IHSS
636|1003|N|N|N||Preferred Generic|205285-leflunomide20MGOralTablet|IHSS
636|1003|N|N|N||Preferred Brand|723827-fosamprenavir50MG/MLOralSuspension[Lexiva]|IHSS
636|1003|Y|N|N||Preferred Brand|352044-1MLdarbepoetinalfa0.025MG/MLInjection[Aranesp]|IHSS
636|1003|Y|N|N||Preferred Brand|2630669-OrenitramMonth2TitrationKit|IHSS
636|1003|N|N|N||Preferred Generic|897659-Verapamilhydrochloride120MGExtendedReleaseOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|2619428-voxelotor300MGOralTablet[Oxbryta]|IHSS
636|1003|N|N|N||Preferred Generic|897666-Verapamilhydrochloride120MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|197730-Furosemide10MG/MLOralSolution|IHSS
636|1003|Y|N|N||Preferred Brand|2626385-fingolimod0.5MGDisintegratingOralTablet[Tascenso]|IHSS
636|1003|Y|N|N||Preferred Brand|2478437-tofacitinib1MG/MLOralSolution[Xeljanz]|IHSS
636|1003|Y|N|N||Preferred Generic|197844-Isotretinoin20MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Brand|1433879-dolutegravir50MGOralTablet[Tivicay]|IHSS
636|1003|Y|N|N||Preferred Brand|2613569-tadalafil4MG/MLOralSuspension[Tadliq]|IHSS
636|1003|Y|N|N||Preferred Generic|197364-Amoxapine150MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|2610302-fingolimod0.25MGDisintegratingOralTablet[Tascenso]|IHSS
636|1003|Y|N|N||Preferred Brand|2604622-10MLrisankizumab-rzaa60MG/MLInjection[Skyrizi]|IHSS
636|1003|N|N|N||Preferred Generic|205305-telmisartan80MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|198182-Pyrimethamine25MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|2596960-24HRupadacitinib45MGExtendedReleaseOralTablet[Rinvoq]|IHSS
636|1003|Y|N|N||Preferred Brand|2594797-Mayzent1MGStarterPack|IHSS
636|1003|Y|N|N||Preferred Generic|198243-Temazepam7.5MGOralCapsule|IHSS
636|1003|Y|N|N||Preferred Brand|2584475-corticotropin80UNT/MLInjectableSolution[Cortrophin]|IHSS
636|1003|Y|N|N||Preferred Generic|1988977-24HRpregabalin330MGExtendedReleaseOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|226343-Dexamethasonephosphate1MG/MLOphthalmicSolution|IHSS
636|1003|Y|N|N||Preferred Brand|2588074-voxelotor300MGTabletforOralSuspension[Oxbryta]|IHSS
636|1003|N|N|N||Preferred Brand|748856-Yaz28DayPack|IHSS
636|1003|Y|N|N||Preferred Brand|2572371-varenicline0.03MG/ACTUATNasalSpray[Tyrvaya]|IHSS
636|1003|Y|N|N||Preferred Brand|2557910-glecaprevir50MG/pibrentasvir20MGOralPellet[Mavyret]|IHSS
636|1003|N|N|N||Preferred Generic|237723-Ergocalciferol0.2MG/MLOralSolution|IHSS
636|1003|Y|N|N||Preferred Brand|2540699-1MLrisankizumab-rzaa150MG/MLPrefilledSyringe[Skyrizi]|IHSS
636|1003|N|N|N||Preferred Generic|1373745-24HRNevirapine100MGExtendedReleaseOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|205324-modafinil200MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|2541237-24HRmirabegron8MG/MLExtendedReleaseSuspension[Myrbetriq]|IHSS
636|1003|Y|N|N||Preferred Brand|2531134-HumiraPen80MG/0.8ML-StarterPackageforPediatricUlcerativeColitis(4count)|IHSS
636|1003|Y|N|N||Preferred Generic|2123194-PulmonaryHypertensiontadalafil20MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|898719-Benazeprilhydrochloride40MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|2536752-24HRviloxazine150MGExtendedReleaseOralCapsule[Qelbree]|IHSS
636|1003|Y|N|N||Preferred Generic|250820-Vigabatrin500MGPowderforOralSolution|IHSS
636|1003|Y|N|N||Preferred Brand|2536554-24HRviloxazine100MGExtendedReleaseOralCapsule[Qelbree]|IHSS
636|1003|Y|N|N||Preferred Brand|2532320-ponesimod20MGOralTablet[Ponvory]|IHSS
636|1003|Y|N|N||Preferred Generic|245135-72HRFentanyl0.05MG/HRTransdermalSystem|IHSS
636|1003|Y|N|N||Preferred Brand|2122661-Mavenclad10TabletPack|IHSS
636|1003|Y|N|N||Preferred Generic|260218-modafinil100MGOralTablet|IHSS
636|1003|N|N|N||Preferred Brand|1149647-CoalTar0.02MG/MGTopicalOintment[MG217Psoriasis]|IHSS
636|1003|Y|N|N||Preferred Brand|2475852-vericiguat10MGOralTablet[Verquvo]|IHSS
636|1003|Y|N|N||Preferred Generic|2056929-5MLpalonosetron0.05MG/MLPrefilledSyringe|IHSS
636|1003|Y|N|N||Preferred Brand|2474007-olopatadine7MG/MLOphthalmicSolution[Pataday]|IHSS
636|1003|Y|N|N||Preferred Brand|2467575-berotralstat110MGOralCapsule[Orladeyo]|IHSS
636|1003|N|N|N||Preferred Generic|238920-Betamethasone0.5MG/MLTopicalCream|IHSS
636|1003|Y|N|N||Preferred Generic|310437-Galantamine8MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|2463737-epoetinalfa-epbx20000UNT/MLInjectableSolution[Retacrit]|IHSS
636|1003|Y|N|N||Preferred Brand|2395775-30ACTUATfluticasonefuroate0.2MG/ACTUAT/umeclidinium0.0625MG/ACTUAT/vilanterol0.025MG/ACTUATDryPowderInhaler[Trelegy]|IHSS
636|1003|Y|N|N||Preferred Generic|313165-0.5MLSumatriptan12MG/MLInjection|IHSS
636|1003|Y|N|N||Preferred Brand|2387331-120ACTUATbudesonide0.16MG/ACTUAT/formoterolfumarate0.0048MG/ACTUAT/glycopyrrolate0.009MG/ACTUATMeteredDoseInhaler[Bre|IHSS
636|1003|Y|N|N||Preferred Generic|313210-temozolomide250MGOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|239238-Griseofulvin25MG/MLOralSuspension|IHSS
636|1003|Y|N|N||Preferred Brand|2390954-0.4MLofatumumab50MG/MLPenInjector[Kesimpta]|IHSS
636|1003|Y|N|N||Preferred Generic|349408-Treprostinil10MG/MLInjectableSolution|IHSS
636|1003|Y|N|N||Preferred Brand|2373941-bedaquiline20MGOralTablet[Sirturo]|IHSS
636|1003|Y|N|N||Preferred Brand|2362182-opicapone50MGOralCapsule[Ongentys]|IHSS
636|1003|N|N|N||Preferred Generic|240029-Cholecalciferol0.125MGOralCapsule|IHSS
636|1003|Y|N|N||Preferred Brand|2359290-24HRempagliflozin12.5MG/linagliptin2.5MG/metforminhydrochloride1000MGExtendedReleaseOralTablet[Trijardy]|IHSS
636|1003|N|N|N||Preferred Generic|1421461-{24(EthinylEstradiol0.02MG/norethindroneacetate1MGOralCapsule)/4(Ferrousfumarate75MGOralCapsule)}Pack|IHSS
636|1003|Y|N|N||Preferred Generic|349253-bosentan62.5MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|2359353-24HRempagliflozin25MG/linagliptin5MG/metforminhydrochloride1000MGExtendedReleaseOralTablet[Trijardy]|IHSS
636|1003|Y|N|N||Preferred Brand|2282320-Rimegepant75MGDisintegratingOralTablet[Nurtec]|IHSS
636|1003|N|N|N||Preferred Generic|904932-ibandronicacid150MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|349434-voriconazole200MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|2288431-ZepsoiaStarterKit(7-DayStarterPackand0.92MG30countBottle)|IHSS
636|1003|N|N|N||Preferred Generic|242446-Ofloxacin3MG/MLOticSolution|IHSS
636|1003|Y|N|N||Preferred Brand|2287905-1.5MLfremanezumab-vfrm150MG/MLAuto-Injector[Ajovy]|IHSS
636|1003|Y|N|N||Preferred Brand|2282414-bempedoicacid180MGOralTablet[Nexletol]|IHSS
636|1003|N|N|N||Preferred Generic|1426600-{24(EthinylEstradiol0.02MG/norethindroneacetate1MGChewableTablet)/4(Ferrousfumarate75MGOralTablet)}Pack|IHSS
636|1003|N|N|N||Preferred Brand|807283-Levonorgestrel0.000833MG/HRIntrauterineSystem[Mirena]|IHSS
636|1003|Y|N|N||Preferred Brand|2268231-ubrogepant50MGOralTablet[Ubrelvy]|IHSS
636|1003|Y|N|N||Preferred Brand|2265689-Voxelotor500MGOralTablet[Oxbryta]|IHSS
636|1003|N|N|N||Preferred Generic|242679-abacavir300MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|2262713-MicronizedIsotretinoin16MGOralCapsule[Absorica]|IHSS
636|1003|N|N|N||Preferred Generic|1437702-Albuterol0.833MG/ML/IpratropiumBromide0.167MG/MLInhalationSolution|IHSS
636|1003|Y|N|N||Preferred Generic|477130-Hydrochlorothiazide25MG/telmisartan80MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|2262719-MicronizedIsotretinoin24MGOralCapsule[Absorica]|IHSS
636|1003|Y|N|N||Preferred Brand|2203893-sofosbuvir200MGOralTablet[Sovaldi]|IHSS
636|1003|Y|N|N||Preferred Generic|485423-24HRdarifenacin7.5MGExtendedReleaseOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|244967-PolymyxinB10000UNT/ML/Trimethoprim1MG/MLOphthalmicSolution|IHSS
636|1003|Y|N|N||Preferred Brand|2257013-trikafta100MG/50MG/75MGand150MGTabletPack|IHSS
636|1003|Y|N|N||Preferred Generic|562266-Clindamycin15MG/MLOralSolution|IHSS
636|1003|Y|N|N||Preferred Brand|2256943-lasmiditan100MGOralTablet[Reyvow]|IHSS
636|1003|Y|N|N||Preferred Brand|2203897-ledipasvir45MG/sofosbuvir200MGOralTablet[Harvoni]|IHSS
636|1003|Y|N|N||Preferred Generic|485489-Temazepam22.5MGOralCapsule|IHSS
636|1003|Y|N|N||Preferred Brand|2123314-Mayzent2MGStarterPack|IHSS
636|1003|N|N|N||Preferred Brand|2045382-30ACTUATfluticasonefuroate0.05MG/ACTUATDryPowderInhaler[Arnuity]|IHSS
636|1003|Y|N|N||Preferred Generic|578018-bromfenac0.9MG/MLOphthalmicSolution|IHSS
636|1003|Y|N|N||Preferred Brand|2196900-24HRupadacitinib15MGExtendedReleaseOralTablet[Rinvoq]|IHSS
636|1003|N|N|N||Preferred Generic|979464-Hydrochlorothiazide12.5MG/LosartanPotassium100MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|2182340-1MLEtanercept50MG/MLCartridge[Enbrel]|IHSS
636|1003|Y|N|N||Preferred Brand|2173822-1MLmepolizumab100MG/MLPrefilledSyringe[Nucala]|IHSS
636|1003|N|N|N||Preferred Generic|979092-HydroxychloroquineSulfate200MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|603208-erlotinib25MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|2170613-1MLgalcanezumab-gnlm100MG/MLPrefilledSyringe[Emgality]|IHSS
636|1003|Y|N|N||Preferred Brand|2168596-ivabradine1MG/MLOralSolution[Corlanor]|IHSS
636|1003|N|N|N||Preferred Generic|979471-Hydrochlorothiazide25MG/LosartanPotassium100MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|213197-Becaplermin0.0001MG/MGTopicalGel[Regranex]|IHSS
636|1003|Y|N|N||Preferred Generic|597772-deferasirox500MGTabletforOralSuspension|IHSS
636|1003|Y|N|N||Preferred Generic|603203-erlotinib100MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|213360-Thalidomide50MGOralCapsule[Thalomid]|IHSS
636|1003|N|Y|Y||Preferred Generic|311671-Metolazone5MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|636664-rasagiline0.5MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|642452-lanthanumcarbonate750MGChewableTablet|IHSS
636|1003|Y|N|N||Preferred Brand|2122650-Mavenclad7TabletPack|IHSS
636|1003|N|N|N||Preferred Generic|992153-methenaminemandelate1000MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|2122642-Mavenclad9TabletPack|IHSS
636|1003|Y|N|N||Preferred Brand|212218-EpoetinAlfa20000UNT/MLInjectableSolution[Epogen]|IHSS
636|1003|Y|N|N||Preferred Generic|597770-deferasirox250MGTabletforOralSuspension|IHSS
636|1003|Y|N|N||Preferred Generic|724861-armodafinil250MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|2121096-siponimod0.25MGOralTablet[Mayzent]|IHSS
636|1003|Y|N|N||Preferred Brand|2120195-1MLerenumab-aooe140MG/MLAuto-Injector[Aimovig]|IHSS
636|1003|N|N|N||Preferred Brand|808118-prednisolone5MGOralTablet[MILLIPRED]|IHSS
636|1003|Y|N|N||Preferred Brand|2107355-prucalopride2MGOralTablet[Motegrity]|IHSS
636|1003|N|N|N||Preferred Generic|1547771-Tetracainehydrochloride5MG/MLOphthalmicSolution|IHSS
636|1003|Y|N|N||Preferred Generic|644088-aprepitant40MGOralCapsule|IHSS
636|1003|Y|N|N||Preferred Brand|2119389-Spravato84MGDoseKit|IHSS
636|1003|Y|N|N||Preferred Generic|824295-rufinamide200MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|2106362-rifamycinSV194MGDelayedReleaseOralTablet[Aemcolo]|IHSS
636|1003|Y|N|N||Preferred Brand|2102705-0.6MLpegfilgrastim-cbqv10MG/MLPrefilledSyringe[Udenyca]|IHSS
636|1003|Y|N|N||Preferred Generic|724859-armodafinil150MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|207059-interferonbeta-1b0.3MGInjection[Betaseron]|IHSS
636|1003|Y|N|N||Preferred Generic|725023-24HRrivastigmine0.396MG/HRTransdermalSystem|IHSS
636|1003|N|N|N||Preferred Generic|979468-Hydrochlorothiazide12.5MG/LosartanPotassium50MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|207370-Penicillamine250MGOralTablet[Depen]|IHSS
636|1003|Y|N|N||Preferred Brand|205917-1MLEpoetinAlfa2000UNT/MLInjection[Epogen]|IHSS
636|1003|Y|N|N||Preferred Generic|753440-9HRMethylphenidate2.22MG/HRTransdermalSystem|IHSS
636|1003|N|N|N||Preferred Brand|830463-1MLrabiesvirusvaccineflury-lepstrain2.5UNT/MLInjection[RabAvert]|IHSS
636|1003|Y|N|N||Preferred Brand|205923-1MLEpoetinAlfa4000UNT/MLInjection[Epogen]|IHSS
636|1003|Y|N|N||Preferred Generic|753438-9HRMethylphenidate1.67MG/HRTransdermalSystem|IHSS
636|1003|Y|N|N||Preferred Brand|205921-1MLEpoetinAlfa3000UNT/MLInjection[Epogen]|IHSS
636|1003|Y|N|N||Preferred Brand|205918-1MLEpoetinAlfa2000UNT/MLInjection[Procrit]|IHSS
636|1003|N|N|N||Preferred Generic|283077-prednisolone3MG/MLOralSolution|IHSS
636|1003|Y|N|N||Preferred Generic|864718-MethadoneHydrochloride5MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|205912-EpoetinAlfa10000UNT/MLInjectableSolution[Epogen]|IHSS
636|1003|Y|N|N||Preferred Brand|2058946-1MLomalizumab150MG/MLPrefilledSyringe[Xolair]|IHSS
636|1003|Y|N|N||Preferred Generic|810077-24HRFesoterodineFumarate8MGExtendedReleaseOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|2057219-1.6MLfilgrastim-aafi0.3MG/MLInjection[Nivestym]|IHSS
636|1003|Y|N|N||Preferred Generic|833213-dexlansoprazole60MGDelayedReleaseOralCapsule|IHSS
636|1003|N|N|N||Preferred Generic|993503-12HRBupropionHydrochloride100MGExtendedReleaseOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|2058877-1MLgalcanezumab-gnlm120MG/MLAuto-Injector[Emgality]|IHSS
636|1003|Y|N|N||Preferred Brand|2053512-ivacaftor125MG/lumacaftor100MGOralGranules[ORKAMBI]|IHSS
636|1003|N|N|N||Preferred Brand|830470-1MLrabiesvirusvaccinewistarstrainPM-1503-3M(Human),Inactivated2.5UNT/MLInjection[Imovax]|IHSS
636|1003|Y|N|N||Preferred Generic|845515-everolimus5MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|2056700-1.5MLfremanezumab-vfrm150MG/MLPrefilledSyringe[Ajovy]|IHSS
636|1003|N|N|N||Preferred Generic|993943-Acetaminophen325MG/butalbital50MG/Caffeine40MG/CodeinePhosphate30MGOralCapsule|IHSS
636|1003|Y|N|N||Preferred Brand|2055026-Cyclosporine0.9MG/MLOphthalmicSolution[Cequa]|IHSS
636|1003|Y|N|N||Preferred Brand|2053519-ivacaftor188MG/lumacaftor150MGOralGranules[ORKAMBI]|IHSS
636|1003|Y|N|N||Preferred Generic|848956-Ciprofloxacin2MG/MLOticSolution|IHSS
636|1003|Y|N|N||Preferred Brand|1990869-0.85MLexenatide2.35MG/MLAuto-Injector[Bydureon]|IHSS
636|1003|Y|N|N||Preferred Generic|850091-24HRlamotrigine50MGExtendedReleaseOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|995253-HydroxyzinePamoate25MGOralCapsule|IHSS
636|1003|Y|N|N||Preferred Brand|2047623-1MLepoetinalfa-epbx40000UNT/MLInjection[Retacrit]|IHSS
636|1003|Y|N|N||Preferred Generic|597768-deferasirox125MGTabletforOralSuspension|IHSS
636|1003|Y|N|N||Preferred Brand|2047608-1MLepoetinalfa-epbx3000UNT/MLInjection[Retacrit]|IHSS
636|1003|Y|N|N||Preferred Brand|2047596-1MLepoetinalfa-epbx10000UNT/MLInjection[Retacrit]|IHSS
636|1003|N|N|N||Preferred Generic|995281-HydroxyzineHydrochloride50MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Generic|861370-sevelamercarbonate2400MGPowderforOralSuspension|IHSS
636|1003|Y|N|N||Preferred Brand|2045638-1MLerenumab-aooe70MG/MLAuto-Injector[Aimovig]|IHSS
636|1003|Y|N|N||Preferred Brand|2003757-1.14MLsarilumab132MG/MLAuto-Injector[Kevzara]|IHSS
636|1003|Y|N|N||Preferred Generic|861597-PentamidineIsethionate50MG/MLInhalationSolution|IHSS
636|1003|Y|N|N||Preferred Brand|1999314-hydroxyurea100MGOralTablet[Siklos]|IHSS
636|1003|Y|N|N||Preferred Generic|863038-bepotastinebesilate15MG/MLOphthalmicSolution|IHSS
636|1003|N|N|N||Preferred Generic|284215-Clindamycin300MGOralCapsule|IHSS
636|1003|Y|N|N||Preferred Brand|1999316-hydroxyurea1000MGOralTablet[Siklos]|IHSS
636|1003|N|N|N||Preferred Generic|1095712-24HRNevirapine400MGExtendedReleaseOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1989085-bosentan32MGTabletforOralSuspension[Tracleer]|IHSS
636|1003|Y|N|N||Preferred Brand|1946520-3-Month1.5MLLeuprolideAcetate20MG/MLPrefilledSyringe[Lupron]|IHSS
636|1003|Y|N|N||Preferred Generic|864706-MethadoneHydrochloride10MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1925504-dapagliflozin10MG/saxagliptin5MGOralTablet[Qtern]|IHSS
636|1003|Y|N|N||Preferred Generic|876514-Amlodipine10MG/telmisartan40MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|995599-EthambutolHydrochloride100MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1927290-infliximab-abda100MGInjection[Renflexis]|IHSS
636|1003|Y|N|N||Preferred Brand|1921081-1.56MLabaloparatide2MG/MLPenInjector[Tymlos]|IHSS
636|1003|N|N|N||Preferred Brand|836368-200ACTUATIpratropiumBromide0.017MG/ACTUATMeteredDoseInhaler[Atrovent]|IHSS
636|1003|Y|N|N||Preferred Generic|881341-adefovirdipivoxil10MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1923347-1.14MLsarilumab175MG/MLPrefilledSyringe[Kevzara]|IHSS
636|1003|N|N|N||Preferred Generic|996824-MethylergonovineMaleate0.2MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1921468-HumiraPen80MG/0.8MLand40MG/0.4ML-Psoriasis/UveitisStarterPackage(3count)|IHSS
636|1003|Y|N|N||Preferred Brand|1921240-0.8MLadalimumab100MG/MLAuto-Injector[Humira]|IHSS
636|1003|Y|N|N||Preferred Generic|898715-pregabalin20MG/MLOralSolution|IHSS
636|1003|Y|N|N||Preferred Brand|1870952-deflazacort30MGOralTablet[Emflaza]|IHSS
636|1003|Y|N|N||Preferred Generic|900156-24HRlamotrigine200MGExtendedReleaseOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|997501-Fexofenadinehydrochloride60MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1876609-naldemedine0.2MGOralTablet[Symproic]|IHSS
636|1003|Y|N|N||Preferred Generic|860901-galantaminehydrobromide4MG/MLOralSolution|IHSS
636|1003|Y|N|N||Preferred Brand|1873087-HumiraPrefilledSyringe80MG/0.8MLStarterPack-PediatricCrohn'sDisease(3count)|IHSS
636|1003|Y|N|N||Preferred Brand|1871469-lisdexamfetaminedimesylate50MGChewableTablet[Vyvanse]|IHSS
636|1003|N|N|Y||Preferred Brand|106892-insulinisophane,human70UNT/ML/insulin,regular,human30UNT/MLInjectableSuspension[Humulin]|IHSS
636|1003|N|N|Y||Preferred Brand|1190916-0.5MLdiphtheriatoxoidvaccine,inactivated4UNT/ML/tetanustoxoidvaccine,inactivated10UNT/MLInjection[Tenivac]|IHSS
636|1003|Y|N|N||Preferred Brand|1871465-lisdexamfetaminedimesylate10MGChewableTablet[Vyvanse]|IHSS
636|1003|Y|N|N||Preferred Brand|1871461-lisdexamfetaminedimesylate30MGChewableTablet[Vyvanse]|IHSS
636|1003|N|N|N||Preferred Generic|308182-Amoxicillin250MGOralCapsule|IHSS
636|1003|Y|N|N||Preferred Brand|1870956-deflazacort18MGOralTablet[Emflaza]|IHSS
636|1003|N|N|N||Preferred Generic|1731350-deferoxaminemesylate500MGInjection|IHSS
636|1003|Y|N|N||Preferred Generic|999967-Amlodipine5MG/Hydrochlorothiazide12.5MG/Olmesartanmedoxomil20MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1870960-deflazacort36MGOralTablet[Emflaza]|IHSS
636|1003|Y|N|N||Preferred Brand|1732157-incobotulinumtoxinA50UNTInjection[Xeomin]|IHSS
636|1003|Y|N|N||Preferred Generic|999991-Amlodipine10MG/Hydrochlorothiazide25MG/Olmesartanmedoxomil40MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Brand|1300370-0.5MLBordetellapertussisfilamentoushemagglutininvaccine,inactivated0.016MG/ML/Bordetellapertussispertactinvaccine,ina|IHSS
636|1003|Y|N|N||Preferred Brand|1858833-12HRTreprostinil5MGExtendedReleaseOralTablet[Orenitram]|IHSS
636|1003|Y|N|N||Preferred Generic|905172-ProtriptylineHydrochloride5MGOralTablet|IHSS
636|1003|Y|N|N||Preferred Brand|1855527-HumiraPediatricCrohn'sDiseaseStarterPackage(2count)|IHSS
636|1003|Y|N|N||Preferred Brand|1806942-carfilzomib60MGInjection[Kyprolis]|IHSS
636|1003|N|N|Y||Preferred Brand|1364441-apixaban2.5MGOralTablet[Eliquis]|IHSS
636|1003|Y|N|Y||Preferred Generic|198300-Tretinoin1MG/MLTopicalCream|IHSS
636|1003|Y|N|N||Preferred Brand|1801519-Methylnaltrexonebromide150MGOralTablet[Relistor]|IHSS
636|1003|Y|N|N||Preferred Brand|1799230-1MLabatacept125MG/MLAuto-Injector[Orencia]|IHSS
636|1003|Y|N|Y||Preferred Generic|313450-Tretinoin0.0001MG/MGTopicalGel|IHSS
636|1003|Y|N|N||Preferred Brand|1790546-infliximab-dyyb100MGInjection[Inflectra]|IHSS
636|1003|Y|N|Y||Preferred Generic|577033-sildenafil20MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Brand|1593140-0.5MLNeisseriameningitidisserogroupBrecombinantLP2086A05proteinvariantantigen0.12MG/ML/Neisseriameningitidisserogroup|IHSS
636|1003|Y|N|N||Preferred Brand|1796091-24HRLinagliptin2.5MG/Metforminhydrochloride1000MGExtendedReleaseOralTablet[Jentadueto]|IHSS
636|1003|N|N|N||Preferred Generic|749780-{3(Azithromycin500MGOralTablet)}Pack|IHSS
636|1003|Y|N|N||Preferred Brand|1747194-0.4MLMethotrexate56.3MG/MLAuto-Injector[Otrexup]|IHSS
636|1003|Y|N|N||Preferred Brand|1747181-0.4MLMethotrexate31.3MG/MLAuto-Injector[Otrexup]|IHSS
636|1003|N|N|Y||Preferred Brand|1597099-0.5MLL1protein,Humanpapillomavirustype11Vaccine0.08MG/ML/L1protein,Humanpapillomavirustype16Vaccine0.12MG/ML/L1protei|IHSS
636|1003|Y|N|N||Preferred Brand|1745108-1MLixekizumab80MG/MLAuto-Injector[Taltz]|IHSS
636|1003|N|N|Y||Preferred Brand|1597103-0.5MLL1protein,Humanpapillomavirustype11Vaccine0.08MG/ML/L1protein,Humanpapillomavirustype16Vaccine0.12MG/ML/L1protei|IHSS
636|1003|Y|N|Y||Preferred Generic|891888-MorphineSulfate30MGExtendedReleaseOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|351114-5MLzoledronicacid0.8MG/MLInjection|IHSS
636|1003|N|N|N||Preferred Generic|200257-repaglinide0.5MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|248420-mesalamine1000MGRectalSuppository|IHSS
636|1003|N|N|N||Preferred Generic|283858-ropinirole3MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|308177-Amoxicillin125MGChewableTablet|IHSS
636|1003|N|N|N||Preferred Generic|308194-Amoxicillin875MGOralTablet|IHSS
636|1003|N|N|N||Preferred Generic|308459-Azithromycin20MG/MLOralSuspension|IHSS
636|1003|N|N|N||Preferred Generic|308493-Bacitracin0.4UNT/MG/Neomycin0.0035MG/MG/PolymyxinB10UNT/MGOphthalmicOintment|IHSS
636|1003|N|N|N||Preferred Generic|1738503-ParoxetineHydrochloride30MGOralTablet|IHSS
636|1003|N|N|Y||Preferred Brand|1601407-0.5MLmeningococcalgroupBvaccine0.1MG/ML/NeisseriameningitidisserogroupBrecombinantFHBPfusionproteinantigen0.1MG/ML/Ne|IHSS
636|1003|N|N|N||Preferred Brand|1000158-0.65MLmedroxyprogesteroneacetate160MG/MLPrefilledSyringe[depo-subQprovera]|IHSS
636|1003|Y|N|N||Preferred Brand|1732165-incobotulinumtoxinA200UNTInjection[Xeomin]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|749780-{3(Azithromycin500MGOralTablet)}Pack|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1732161-incobotulinumtoxinA100UNTInjection[Xeomin]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1732157-incobotulinumtoxinA50UNTInjection[Xeomin]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198116-PotassiumChloride20MEQExtendedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|749761-{7(EthinylEstradiol0.01MGOralTablet)/84(EthinylEstradiol0.03MG/Levonorgestrel0.15MGOralTablet)}Pack|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1729076-UptraviTitrationPack|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1729065-selexipag0.8MGOralTablet[Uptravi]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|749206-sevelamercarbonate800MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1729061-selexipag0.6MGOralTablet[Uptravi]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1729057-selexipag0.4MGOralTablet[Uptravi]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1095224-{21(EthinylEstradiol0.035MG/Norethindrone0.4MGChewableTablet)/7(Ferrousfumarate75MGChewableTablet)}Pack|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198108-Piroxicam20MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|749157-{7(EthinylEstradiol0.025MG/norgestimate0.18MGOralTablet)/7(EthinylEstradiol0.025MG/norgestimate0.215MGOralTablet)/7(Et|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1729053-selexipag0.2MGOralTablet[Uptravi]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1729047-selexipag1.6MGOralTablet[Uptravi]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|748961-{28(Norethindrone0.35MGOralTablet)}Pack|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1729033-selexipag1.4MGOralTablet[Uptravi]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1729029-selexipag1.2MGOralTablet[Uptravi]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198107-Piroxicam10MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|748878-{21(EthinylEstradiol0.03MG/Levonorgestrel0.15MGOralTablet)/7(InertIngredients1MGOralTablet)}Pack|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1729013-selexipag1MGOralTablet[Uptravi]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1728099-romiplostim0.5MGInjection[Nplate]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|748868-{21(EthinylEstradiol0.02MG/Levonorgestrel0.1MGOralTablet)/7(InertIngredients1MGOralTablet)}Pack|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1728095-romiplostim0.25MGInjection[Nplate]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1726846-0.4MLadalimumab100MG/MLPrefilledSyringe[Humira]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|2590643-emtricitabine120MG/tenofoviralafenamide15MGOralTablet[Descovy]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1094543-Briellyn28DayPack|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198105-Pindolol5MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|748832-{6(EthinylEstradiol0.03MG/Levonorgestrel0.05MGOralTablet)/10(EthinylEstradiol0.03MG/Levonorgestrel0.125MGOralTablet)/5|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1726639-ponatinib30MGOralTablet[Iclusig]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1721690-1MLEpoetinAlfa10000UNT/MLInjection[Procrit]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|748806-{21(EthinylEstradiol0.05MG/EthynodiolDiacetate1MGOralTablet)/7(InertIngredients1MGOralTablet)}Pack|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1721685-1MLEpoetinAlfa10000UNT/MLInjection[Epogen]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1720606-mepolizumab100MGInjection[Nucala]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198104-Pindolol10MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|748804-{21(EthinylEstradiol0.035MG/EthynodiolDiacetate1MGOralTablet)/7(InertIngredients1MGOralTablet)}Pack|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1718936-olanzapine210MGInjection[Zyprexa]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1718932-olanzapine300MGInjection[Zyprexa]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|748800-{21(drospirenone3MG/EthinylEstradiol0.03MGOralTablet)/7(InertIngredients1MGOralTablet)}Pack|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1718928-olanzapine405MGInjection[Zyprexa]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1666385-Buprenorphine2.9MG/Naloxone0.71MGSublingualTablet[Zubsolv]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1094107-Phenazopyridinehydrochloride100MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198102-vitaminK15MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|748798-{24(drospirenone3MG/EthinylEstradiol0.02MGOralTablet)/4(InertIngredients1MGOralTablet)}Pack|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1666334-Ticagrelor60MGOralTablet[Brilinta]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1665906-1MLevolocumab140MG/MLPrefilledSyringe[Repatha]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|746645-lopinavir100MG/Ritonavir25MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1660938-60ACTUATformoterolfumarate0.005MG/ACTUAT/mometasonefuroate0.2MG/ACTUATMeteredDoseInhaler[Dulera]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1660934-60ACTUATformoterolfumarate0.005MG/ACTUAT/mometasonefuroate0.1MG/ACTUATMeteredDoseInhaler[Dulera]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198089-Phenobarbital60MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|728225-maraviroc300MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1659818-aripiprazole300MGInjection[Abilify]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1659814-aripiprazole400MGInjection[Abilify]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|728223-maraviroc150MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1659183-1MLalirocumab75MG/MLAuto-Injector[Praluent]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1659161-1MLalirocumab150MG/MLAuto-Injector[Praluent]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|1796083-dolutegravir25MGOralTablet[Tivicay]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|2589618-0.5MLnaloxonehydrochloride10MG/MLPrefilledSyringe[Zimhi]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1094104-Phenazopyridinehydrochloride200MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198086-Phenobarbital16.2MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|727316-NDA0194300.3MLEpinephrine0.5MG/MLAuto-Injector|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1657982-20MLtocilizumab20MG/MLInjection[Actemra]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1657980-10MLtocilizumab20MG/MLInjection[Actemra]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|722137-Amlodipine5MG/valsartan320MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1657976-4MLtocilizumab20MG/MLInjection[Actemra]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1657212-omalizumab150MGInjection[Xolair]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198083-Phenobarbital100MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|722134-Amlodipine5MG/valsartan160MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1655934-ivacaftor125MG/lumacaftor200MGOralTablet[ORKAMBI]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1654955-1MLdarbepoetinalfa0.2MG/MLInjection[Aranesp]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|722131-Amlodipine10MG/valsartan320MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1654079-0.5MLustekinumab90MG/MLInjection[Stelara]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1653243-1MLsecukinumab150MG/MLAuto-Injector[Cosentyx]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1090807-Psyllium3400MGPowderforOralSuspension[Konsyl]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198078-Perphenazine8MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|722126-Amlodipine10MG/valsartan160MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1653225-1MLEtanercept50MG/MLAuto-Injector[Enbrel]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1653166-1MLgolimumab100MG/MLAuto-Injector[Simponi]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|702519-Phenobarbital4MG/MLOralSolution|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1653144-0.5MLgolimumab100MG/MLAuto-Injector[Simponi]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1650901-0.5MLInterferonbeta-1a0.06MG/MLAuto-Injector[Avonex]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198077-Perphenazine4MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|686924-carvedilol3.125MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1650282-RebifRebidoseTitrationPack|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1650004-0.5MLInterferonbeta-1a0.088MG/MLAuto-Injector[Rebif]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|686418-ErythromycinEthylsuccinate80MG/MLOralSuspension|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1649996-0.5MLInterferonbeta-1a0.044MG/MLAuto-Injector[Rebif]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1649605-PlegridyPenStarterPack|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|2588080-3MLcabotegravir200MG/MLInjection[Apretude]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1085745-TriamcinoloneAcetonide1MG/MLTopicalLotion|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198076-Perphenazine2MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|686400-ErythromycinEthylsuccinate40MG/MLOralSuspension|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1649593-0.5MLpeginterferonbeta-1a0.25MG/MLAuto-Injector[Plegridy]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1649495-ivabradine7.5MGOralTablet[Corlanor]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|646456-Nystatin100UNT/MGTopicalPowder|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1649491-ivabradine5MGOralTablet[Corlanor]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1606870-ivacaftor75MGOralGranules[Kalydeco]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198075-Perphenazine16MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|643066-efavirenz600MG/emtricitabine200MG/Tenofovirdisoproxilfumarate300MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1606866-ivacaftor50MGOralGranules[Kalydeco]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1605455-Otezla28-DayStarterPack|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|628953-PotassiumChloride10MEQExtendedReleaseOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1605172-0.4MLdarbepoetinalfa0.025MG/MLPrefilledSyringe[Aranesp]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1605075-0.8MLFILGRASTIM-SNDZ0.6MG/MLPrefilledSyringe[Zarxio]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1085741-TriamcinoloneAcetonide0.25MG/MLTopicalLotion|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198049-Ofloxacin300MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|617993-Amoxicillin120MG/ML/Clavulanate8.58MG/MLOralSuspension|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1605071-0.5MLFILGRASTIM-SNDZ0.6MG/MLPrefilledSyringe[Zarxio]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1602607-2MLaripiprazole200MG/MLPrefilledSyringe[Abilify]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|617430-Amoxicillin80MG/ML/Clavulanate11.4MG/MLOralSuspension|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1602604-1.5MLaripiprazole200MG/MLPrefilledSyringe[Abilify]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1602120-empagliflozin25MG/Linagliptin5MGOralTablet[Glyxambi]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198047-Nortriptyline75MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|617423-Amoxicillin40MG/ML/Clavulanate5.7MG/MLOralSuspension|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1601373-naloxegol25MGOralTablet[Movantik]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1599797-1MLsecukinumab150MG/MLPrefilledSyringe[Cosentyx]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|617316-Amoxicillin400MG/Clavulanate57MGChewableTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1598268-3MLliraglutide6MG/MLPenInjector[Saxenda]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1597575-Buprenorphine8.6MG/Naloxone2.1MGSublingualTablet[Zubsolv]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|1358781-Loestrin1/2021DayPack|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|1796079-dolutegravir10MGOralTablet[Tivicay]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|2584356-bictegravir30MG/emtricitabine120MG/tenofoviralafenamide15MGOralTablet[Biktarvy]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1085686-TriamcinoloneAcetonide5MG/MLTopicalCream|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198046-Nortriptyline50MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|617312-atorvastatin10MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1597570-Buprenorphine11.4MG/Naloxone2.9MGSublingualTablet[Zubsolv]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1597130-5000MGTestosterone0.01MG/MGTopicalGel[Androgel]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|617311-atorvastatin40MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1597124-2500MGTestosterone0.01MG/MGTopicalGel[Androgel]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1596023-ferriccitrate1000MGOralTablet[Auryxia]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198045-Nortriptyline10MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|617310-atorvastatin20MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1593858-lisdexamfetaminedimesylate10MGOralCapsule[Vyvanse]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1593835-24HRdapagliflozin10MG/Metforminhydrochloride500MGExtendedReleaseOralTablet[Xigduo]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|617309-Amoxicillin200MG/Clavulanate28.5MGChewableTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1593833-24HRdapagliflozin5MG/Metforminhydrochloride1000MGExtendedReleaseOralTablet[Xigduo]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1593831-24HRdapagliflozin5MG/Metforminhydrochloride500MGExtendedReleaseOralTablet[Xigduo]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1085644-TriamcinoloneAcetonide0.25MG/MLTopicalCream|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198040-Nitroglycerin0.6MGSublingualTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|617296-Amoxicillin500MG/Clavulanate125MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1593775-24HRdapagliflozin10MG/Metforminhydrochloride1000MGExtendedReleaseOralTablet[Xigduo]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1592752-nintedanib150MGOralCapsule[Ofev]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|602964-aripiprazole2MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1592748-nintedanib100MGOralCapsule[Ofev]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1551923-naloxegol12.5MGOralTablet[Movantik]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198039-Nitroglycerin0.4MGSublingualTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|602393-abacavir600MG/Lamivudine300MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1551886-lanthanumcarbonate750MGOralPowder[Fosrenol]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1551884-lanthanumcarbonate1000MGOralPowder[Fosrenol]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|598025-Amoxicillin250MGChewableTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1551474-12HRBupropionHydrochloride90MG/Naltrexonehydrochloride8MGExtendedReleaseOralTablet[Contrave]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1546198-PlegridyStarterPack|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|2540709-naloxonehydrochloride80MG/MLNasalSpray[Kloxxado]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1085640-TriamcinoloneAcetonide0.005MG/MGTopicalOintment|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198038-Nitroglycerin0.3MGSublingualTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|598006-Erythromycin250MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1546189-0.5MLpeginterferonbeta-1a0.25MG/MLPrefilledSyringe[Plegridy]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1545668-empagliflozin25MGOralTablet[Jardiance]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|597730-lopinavir200MG/Ritonavir50MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1545664-empagliflozin10MGOralTablet[Jardiance]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1545174-hydrocortisoneacetate100MG/MLRectalFoam[Cortifoam]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198033-Nifedipine20MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|596843-lansoprazole15MGDelayedReleaseOralCapsule|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1544404-0.15MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1544402-0.6MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|583170-Salsalate750MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1544398-0.5MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1544396-0.45MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1085636-TriamcinoloneAcetonide0.001MG/MGTopicalOintment|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198032-Nifedipine10MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|582926-podofilox5MG/MLTopicalSolution|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1544394-0.4MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1544390-0.35MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|562704-ropinirole4MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1544388-0.3MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1544386-0.25MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198024-Niacin500MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|562524-12HRAcetazolamide500MGExtendedReleaseOralCapsule|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1544383-0.2MLMethotrexate50MG/MLAuto-Injector[Rasuvo]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1541928-sunitinib37.5MGOralCapsule[Sutent]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|562510-SodiumFluoride2MG/MLMouthwash|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1492746-apremilast30MGOralTablet[Otezla]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1488679-12HRTreprostinil2.5MGExtendedReleaseOralTablet[Orenitram]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|1747697-emtricitabine200MG/tenofoviralafenamide25MGOralTablet[Descovy]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|2539032-Nextstellis28Day|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1085633-TriamcinoloneAcetonide0.00025MG/MGTopicalOintment|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198014-Naproxen500MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|562508-Amoxicillin875MG/Clavulanate125MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1488675-12HRTreprostinil1MGExtendedReleaseOralTablet[Orenitram]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1488671-12HRTreprostinil0.25MGExtendedReleaseOralTablet[Orenitram]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|562251-Amoxicillin250MG/Clavulanate125MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1488667-12HRTreprostinil0.125MGExtendedReleaseOralTablet[Orenitram]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1486981-dapagliflozin5MGOralTablet[Farxiga]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198013-Naproxen250MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|544455-Lactulose667MG/MLOralSolution[Generlac]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1486977-dapagliflozin10MGOralTablet[Farxiga]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1484296-sucroferricoxyhydroxide500MGChewableTablet[Velphoro]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|543546-Nystatin100000UNT/MLTopicalCream|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1482814-1MLgolimumab100MG/MLPrefilledSyringe[Simponi]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1482513-eslicarbazepineacetate200MGOralTablet[Aptiom]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|106387-Permethrin50MG/MLTopicalCream|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198012-Naproxen375MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|486515-SodiumChloride0.154MEQ/MLIrrigationSolution|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1442143-Macitentan10MGOralTablet[Opsumit]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1441530-0.9MLtocilizumab180MG/MLPrefilledSyringe[Actemra]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|486152-24HRNitroglycerin0.4MG/HRTransdermalSystem|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1441424-0.4MLMethotrexate62.5MG/MLAuto-Injector[Otrexup]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1441418-0.4MLMethotrexate50MG/MLAuto-Injector[Otrexup]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198008-Nadolol80MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|486148-24HRNitroglycerin0.2MG/HRTransdermalSystem|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1441413-0.4MLMethotrexate37.5MG/MLAuto-Injector[Otrexup]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1441407-0.4MLMethotrexate25MG/MLAuto-Injector[Otrexup]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|486146-24HRNitroglycerin0.6MG/HRTransdermalSystem|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1439903-riociguat2.5MGOralTablet[Adempas]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1439901-riociguat2MGOralTablet[Adempas]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|2465331-TyblumeChewable28DayPack|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|106351-SilverSulfadiazine10MG/MLTopicalCream|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198007-Nadolol40MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|486131-BenzoylPeroxide0.1MG/MGTopicalGel|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1439899-riociguat1.5MGOralTablet[Adempas]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1439896-riociguat1MGOralTablet[Adempas]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|485023-MycophenolicAcid360MGDelayedReleaseOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1439894-riociguat0.5MGOralTablet[Adempas]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1435117-28ACTUATTeriparatide0.02MG/ACTUATPenInjector[Forteo]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198006-Nadolol20MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|485020-MycophenolicAcid180MGDelayedReleaseOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1431647-4MLgolimumab12.5MG/MLInjection[Simponi]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1431104-Buprenorphine5.7MG/Naloxone1.4MGSublingualTablet[Zubsolv]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|483325-Levonorgestrel1.5MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1431083-Buprenorphine1.4MG/Naloxone0.36MGSublingualTablet[Zubsolv]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1429367-lenalidomide20MGOralCapsule[Revlimid]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|106336-Ketoconazole20MG/MLMedicatedShampoo|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197987-Minoxidil2.5MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|477372-solifenacinsuccinate10MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1429284-NeostigmineMethylsulfate1MG/MLInjectableSolution[Bloxiverz]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1429282-NeostigmineMethylsulfate0.5MG/MLInjectableSolution[Bloxiverz]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|477367-solifenacinsuccinate5MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1375922-bromfenac0.7MG/MLOphthalmicSolution[Prolensa]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1365866-nepafenac3MG/MLOphthalmicSuspension[Ilevro]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197986-Minoxidil10MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|476809-Mirtazapine7.5MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1364515-Bedaquiline100MGOralTablet[Sirturo]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1364477-teduglutide5MGInjection[Gattex]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|476576-cefdinir50MG/MLOralSuspension|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1364362-ponatinib45MGOralTablet[Iclusig]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1364358-ponatinib15MGOralTablet[Iclusig]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|1099897-GeneressFe28DayPack|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|1358770-LoestrinFe1/2028DayPack|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|1741739-emtricitabine200MG/Rilpivirine25MG/tenofoviralafenamide25MGOralTablet[Odefsey]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|2396259-Twirla3CountWeeklyTransdermalSystem|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|106258-Hydrocortisone10MG/MLTopicalCream|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197973-Methylprednisolone8MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|476556-emtricitabine200MG/Tenofovirdisoproxilfumarate300MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1357547-tofacitinib5MGOralTablet[Xeljanz]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1313061-24HRPhentermine11.25MG/topiramate69MGExtendedReleaseOralCapsule[Qsymia]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|432402-cinacalcet30MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1310147-everolimus5MGTabletforOralSuspension[Afinitor]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1310144-everolimus3MGTabletforOralSuspension[Afinitor]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197971-Methylprednisolone32MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|432401-cinacalcet60MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1310138-everolimus2MGTabletforOralSuspension[Afinitor]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1307635-bosutinib500MGOralTablet[Bosulif]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|432400-cinacalcet90MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1307630-bosutinib100MGOralTablet[Bosulif]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1302856-24HRPhentermine15MG/topiramate92MGExtendedReleaseOralCapsule[Qsymia]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|105585-Methotrexate2.5MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197963-Hydrochlorothiazide15MG/Methyldopa250MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|429503-Hydrochlorothiazide12.5MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1302845-24HRPhentermine3.75MG/topiramate23MGExtendedReleaseOralCapsule[Qsymia]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1302833-24HRPhentermine7.5MG/topiramate46MGExtendedReleaseOralCapsule[Qsymia]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|429212-Clozapine50MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1300803-24HRmirabegron50MGExtendedReleaseOralTablet[Myrbetriq]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1251922-24HRRotigotine0.333MG/HRTransdermalSystem[Neupro]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197960-Hydrochlorothiazide25MG/Methyldopa250MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|403967-zonisamide50MGOralCapsule|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1251918-24HRRotigotine0.125MG/HRTransdermalSystem[Neupro]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1251914-24HRRotigotine0.0417MG/HRTransdermalSystem[Neupro]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|403966-zonisamide25MGOralCapsule|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1245003-eltrombopag12.5MGOralTablet[Promacta]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1244064-0.4MLMethylnaltrexonebromide20MG/MLPrefilledSyringe[Relistor]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|2385353-citricacid0.01MG/MG/lacticacid0.018MG/MG/potassiumbitartrate0.004MG/MGVaginalGel[Phexxi]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|105583-Fluorouracil50MG/MLTopicalCream|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197958-Methyldopa500MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|403888-MicroencapsulatedPotassiumChloride15MEQExtendedReleaseOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1244062-0.6MLMethylnaltrexonebromide20MG/MLPrefilledSyringe[Relistor]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1243330-Tenofovirdisoproxilfumarate200MGOralTablet[Viread]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|403875-emtricitabine200MGOralCapsule|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1243326-Tenofovirdisoproxilfumarate150MGOralTablet[Viread]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1243229-Tenofovirdisoproxilfumarate250MGOralTablet[Viread]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197956-Methyldopa250MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|403855-Hydrochlorothiazide25MG/Olmesartanmedoxomil40MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1243052-ivacaftor150MGOralTablet[Kalydeco]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1243040-Linagliptin2.5MG/Metforminhydrochloride850MGOralTablet[Jentadueto]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|403854-Hydrochlorothiazide12.5MG/Olmesartanmedoxomil40MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1243033-Linagliptin2.5MG/Metforminhydrochloride500MGOralTablet[Jentadueto]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1243026-Linagliptin2.5MG/Metforminhydrochloride1000MGOralTablet[Jentadueto]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1053753-Nystatin100000UNT/ML/TriamcinoloneAcetonide1MG/MLTopicalCream|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197944-Methocarbamol750MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|403853-Hydrochlorothiazide12.5MG/Olmesartanmedoxomil20MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1242233-lenalidomide2.5MGOralCapsule[Revlimid]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1235157-azilsartanmedoxomil40MG/Chlorthalidone25MGOralTablet[Edarbyclor]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|403818-moxifloxacin5MG/MLOphthalmicSolution|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1235150-azilsartanmedoxomil40MG/Chlorthalidone12.5MGOralTablet[Edarbyclor]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1190179-2MLSodiumHyaluronate10MG/MLPrefilledSyringe[Euflexxa]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197943-Methocarbamol500MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|402698-24HRFelodipine2.5MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1149617-COLLAGENASE0.25UNT/MGTopicalOintment[Santyl]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1148506-crizotinib250MGOralCapsule[Xalkori]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|402696-24HRFelodipine5MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1148502-crizotinib200MGOralCapsule[Xalkori]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1145932-1MLabatacept125MG/MLPrefilledSyringe[Orencia]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|1721619-cobicistat150MG/elvitegravir150MG/emtricitabine200MG/tenofoviralafenamide10MGOralTablet[Genvoya]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|2380551-12HRfostemsavir600MGExtendedReleaseOralTablet[Rukobia]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1053697-Nystatin100UNT/MG/TriamcinoloneAcetonide0.001MG/MGTopicalOintment|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197942-Methimazole5MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|402695-24HRFelodipine10MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1116639-Ticagrelor90MGOralTablet[Brilinta]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1115473-1.5MLLeuprolideAcetate7.5MG/MLPrefilledSyringe[Lupron]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|402506-12HRCarbamazepine400MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1115468-1.5MLLeuprolideAcetate15MG/MLPrefilledSyringe[Lupron]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1115464-1MLLeuprolideAcetate7.5MG/MLPrefilledSyringe[Lupron]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197941-Methimazole10MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|402505-12HRCarbamazepine200MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1115459-1MLLeuprolideAcetate3.75MG/MLPrefilledSyringe[Lupron]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1115456-1MLLeuprolideAcetate15MG/MLPrefilledSyringe[Lupron]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|402247-Atazanavir200MGOralCapsule|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1115449-1MLLeuprolideAcetate11.25MG/MLPrefilledSyringe[Lupron]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1115259-1.5MLLeuprolideAcetate30MG/MLPrefilledSyringe[Lupron]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|105292-isoniazid10MG/MLOralSolution|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197940-Methazolamide50MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|402246-Atazanavir150MGOralCapsule|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1114096-Vandetanib300MGOralTablet[Caprelsa]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1114074-Vandetanib100MGOralTablet[Caprelsa]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|402131-aripiprazole5MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1100706-Linagliptin5MGOralTablet[Tradjenta]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1091654-azilsartanmedoxomil80MGOralTablet[Edarbi]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197939-Methazolamide25MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|391937-Lactulose667MG/MLOralSolution|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1091650-azilsartanmedoxomil40MGOralTablet[Edarbi]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1049595-Abuse-Deterrent12HROxycodoneHydrochloride60MGExtendedReleaseOralTablet[Oxycontin]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|387003-Levetiracetam1000MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1049576-Abuse-Deterrent12HROxycodoneHydrochloride30MGExtendedReleaseOralTablet[Oxycontin]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1049545-Abuse-Deterrent12HROxycodoneHydrochloride15MGExtendedReleaseOralTablet[Oxycontin]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|2374566-dolutegravir5MGTabletforOralSuspension[Tivicay]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1052658-etravirine200MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197931-mercaptopurine50MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|381056-IsosorbideDinitrate10MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1046402-1.7MLdenosumab70MG/MLInjection[Xgeva]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1045408-dasatinib80MGOralTablet[Sprycel]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|360110-Sirolimus2MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1045404-dasatinib140MGOralTablet[Sprycel]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1043582-24HRMetforminhydrochloride500MG/saxagliptin5MGExtendedReleaseOralTablet[Kombiglyze]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197919-Melphalan2MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|359601-Guaifenesin400MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1043574-24HRMetforminhydrochloride1000MG/saxagliptin5MGExtendedReleaseOralTablet[Kombiglyze]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1043567-24HRMetforminhydrochloride1000MG/saxagliptin2.5MGExtendedReleaseOralTablet[Kombiglyze]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|359296-calciumacetate667MGOralCapsule|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1040058-DextromethorphanHydrobromide20MG/QuinidineSulfate10MGOralCapsule[Nuedexta]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1040025-Corticotropin80UNT/MLInjectableSolution[Acthar]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1050493-{21(drospirenone3MG/EthinylEstradiol0.03MG/levomefolatecalcium0.451MGOralTablet)/7(levomefolatecalcium0.451MGOralTabl|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197905-Lovastatin40MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|353538-24HRIsosorbideMononitrate60MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1011755-aliskiren300MG/Hydrochlorothiazide25MGOralTablet[TekturnaHCT]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1011752-aliskiren300MG/Hydrochlorothiazide12.5MGOralTablet[TekturnaHCT]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|351250-Escitalopram20MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1011715-aliskiren150MG/Hydrochlorothiazide25MGOralTablet[TekturnaHCT]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1011712-aliskiren150MG/Hydrochlorothiazide12.5MGOralTablet[TekturnaHCT]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197904-Lovastatin20MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|351249-Escitalopram5MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1002300-nilotinib150MGOralCapsule[Tasigna]|IHSSCOBRA
636|1003|N|Y|Y||Preferred Generic|854868-Rabeprazolesodium20MGDelayedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|351172-Dutasteride0.5MGOralCapsule|IHSSCOBRA
636|1003|N|Y|Y||Preferred Generic|606726-Esomeprazole20MGDelayedReleaseOralCapsule|IHSSCOBRA
636|1003|N|Y|Y||Preferred Generic|351134-zolmitriptan5MGDisintegratingOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|1313887-Phenytoin50MGChewableTablet[Dilantin]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|1650201-LayolisFe28DayPack|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|2267310-Copper313MGDrugImplant[ParaGard]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1049909-DiphenhydramineHydrochloride25MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197903-Lovastatin10MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|351137-Albuterol0.21MG/MLInhalationSolution|IHSSCOBRA
636|1003|N|Y|Y||Preferred Generic|314266-Tacrolimus0.001MG/MGTopicalOintment|IHSSCOBRA
636|1003|N|Y|Y||Preferred Generic|314227-Sumatriptan20MG/ACTUATNasalSpray|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|351136-Albuterol0.417MG/MLInhalationSolution|IHSSCOBRA
636|1003|N|Y|Y||Preferred Generic|313189-Tacrolimus0.0003MG/MGTopicalOintment|IHSSCOBRA
636|1003|N|Y|Y||Preferred Generic|313159-Sumatriptan5MG/ACTUATNasalSpray|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197893-LithiumCarbonate600MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|351114-5MLzoledronicacid0.8MG/MLInjection|IHSSCOBRA
636|1003|N|Y|Y||Preferred Generic|311671-Metolazone5MGOralTablet|IHSSCOBRA
636|1003|N|Y|Y||Preferred Generic|284201-zolmitriptan2.5MGDisintegratingOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|349553-aripiprazole20MGOralTablet|IHSSCOBRA
636|1003|N|Y|Y||Preferred Generic|200194-zolmitriptan5MGOralTablet|IHSSCOBRA
636|1003|N|Y|Y||Preferred Generic|200193-zolmitriptan2.5MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|104884-Metoclopramide1MG/MLOralSolution|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197892-LithiumCarbonate450MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|349547-aripiprazole30MGOralTablet|IHSSCOBRA
636|1003|N|Y|Y||Preferred Generic|197979-Metolazone2.5MGOralTablet|IHSSCOBRA
636|1003|N|Y|Y||Preferred Generic|197978-Metolazone10MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|349545-aripiprazole10MGOralTablet|IHSSCOBRA
636|1003|N|Y|Y||Preferred Generic|1797865-mometasonefuroate0.05MG/ACTUATMeteredDoseNasalSpray|IHSSCOBRA
636|1003|N|Y|Y||Preferred Brand|2601785-0.5MLtirzepatide15MG/MLAuto-Injector[Mounjaro]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197891-LithiumCarbonate300MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|349491-Lamivudine300MGOralTablet|IHSSCOBRA
636|1003|N|Y|Y||Preferred Brand|2601776-0.5MLtirzepatide25MG/MLAuto-Injector[Mounjaro]|IHSSCOBRA
636|1003|N|Y|Y||Preferred Brand|2601770-0.5MLtirzepatide20MG/MLAuto-Injector[Mounjaro]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|349490-aripiprazole15MGOralTablet|IHSSCOBRA
636|1003|N|Y|Y||Preferred Brand|2601764-0.5MLtirzepatide5MG/MLAuto-Injector[Mounjaro]|IHSSCOBRA
636|1003|N|Y|Y||Preferred Brand|2601758-0.5MLtirzepatide30MG/MLAuto-Injector[Mounjaro]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|2178792-0.3MLEpinephrine0.5MG/MLPrefilledSyringe[Symjepi]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1047905-HyoscyamineSulfate0.125MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197890-LithiumCarbonate300MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|349477-efavirenz600MGOralTablet|IHSSCOBRA
636|1003|N|Y|Y||Preferred Brand|2601746-0.5MLtirzepatide10MG/MLAuto-Injector[Mounjaro]|IHSSCOBRA
636|1003|N|Y|Y||Preferred Brand|2200658-semaglutide7MGOralTablet[Rybelsus]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|349420-desloratadine5MGOralTablet|IHSSCOBRA
636|1003|N|Y|Y||Preferred Brand|2200654-semaglutide3MGOralTablet[Rybelsus]|IHSSCOBRA
636|1003|N|Y|Y||Preferred Brand|2200650-semaglutide14MGOralTablet[Rybelsus]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197889-LithiumCarbonate300MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|349405-Olmesartanmedoxomil40MGOralTablet|IHSSCOBRA
636|1003|N|Y|Y||Preferred Brand|1716223-patiromer25200MGPowderforOralSuspension[Veltassa]|IHSSCOBRA
636|1003|N|Y|Y||Preferred Brand|1716219-patiromer16800MGPowderforOralSuspension[Veltassa]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|349401-Olmesartanmedoxomil20MGOralTablet|IHSSCOBRA
636|1003|N|Y|Y||Preferred Brand|1716215-patiromer8400MGPowderforOralSuspension[Veltassa]|IHSSCOBRA
636|1003|N|Y|N||Preferred Generic|997406-12HRFexofenadinehydrochloride60MG/PseudoephedrineHydrochloride120MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1047895-HyoscyamineSulfate0.125MG/MLOralSolution|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197887-Hydrochlorothiazide25MG/Lisinopril20MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|349373-Olmesartanmedoxomil5MGOralTablet|IHSSCOBRA
636|1003|N|Y|N||Preferred Generic|996615-24HRMemantinehydrochloride7MGExtendedReleaseOralCapsule|IHSSCOBRA
636|1003|N|Y|N||Preferred Generic|996609-24HRMemantinehydrochloride28MGExtendedReleaseOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|349332-Escitalopram10MGOralTablet|IHSSCOBRA
636|1003|N|Y|N||Preferred Generic|996603-24HRMemantinehydrochloride21MGExtendedReleaseOralCapsule|IHSSCOBRA
636|1003|N|Y|N||Preferred Generic|996594-24HRMemantinehydrochloride14MGExtendedReleaseOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197886-Hydrochlorothiazide12.5MG/Lisinopril20MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|349251-Tenofovirdisoproxilfumarate300MGOralTablet|IHSSCOBRA
636|1003|N|Y|N||Preferred Generic|857564-24HRtrospiumchloride60MGExtendedReleaseOralCapsule|IHSSCOBRA
636|1003|N|Y|N||Preferred Generic|857560-trospiumchloride20MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|349208-Sirolimus1MGOralTablet|IHSSCOBRA
636|1003|N|Y|N||Preferred Generic|855194-tolterodinetartrate2MGOralTablet|IHSSCOBRA
636|1003|N|Y|N||Preferred Generic|855189-24HRtolterodinetartrate4MGExtendedReleaseOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|1605257-Levonorgestrel0.000813MG/HRIntrauterineSystem[Liletta]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|2173508-Nonoxynol-91000MGVaginalSponge[TodaySponge]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1047881-HyoscyamineSulfate0.025MG/MLOralSolution|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197885-Hydrochlorothiazide12.5MG/Lisinopril10MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|348472-Theophylline600MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|N|Y|N||Preferred Generic|855182-24HRtolterodinetartrate2MGExtendedReleaseOralCapsule|IHSSCOBRA
636|1003|N|Y|N||Preferred Generic|855178-tolterodinetartrate1MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|343033-Dexamethasone0.75MGOralTablet|IHSSCOBRA
636|1003|N|Y|N||Preferred Generic|825130-24HRmesalamine375MGExtendedReleaseOralCapsule|IHSSCOBRA
636|1003|N|Y|N||Preferred Generic|810090-Carbidopa18.75MG/entacapone200MG/Levodopa75MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197863-Leucovorin5MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|328161-Methylprednisolone16MGOralTablet|IHSSCOBRA
636|1003|N|Y|N||Preferred Generic|810083-Carbidopa31.25MG/entacapone200MG/Levodopa125MGOralTablet|IHSSCOBRA
636|1003|N|Y|N||Preferred Generic|745791-200ACTUATLevalbuterol0.045MG/ACTUATMeteredDoseInhaler|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|328160-Cyclosporine100MGOralCapsule|IHSSCOBRA
636|1003|N|Y|N||Preferred Generic|730988-Carbidopa50MG/entacapone200MG/Levodopa200MGOralTablet|IHSSCOBRA
636|1003|N|Y|N||Preferred Generic|686429-mesalamine1200MGDelayedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1046985-HyoscyamineSulfate0.125MGDisintegratingOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197862-Leucovorin25MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|317573-pioglitazone15MGOralTablet|IHSSCOBRA
636|1003|N|Y|N||Preferred Generic|606730-Esomeprazole40MGDelayedReleaseOralCapsule|IHSSCOBRA
636|1003|N|Y|N||Preferred Generic|562806-Pimecrolimus10MG/MLTopicalCream|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|317173-Captopril25MGOralTablet|IHSSCOBRA
636|1003|N|Y|N||Preferred Generic|403852-Carbidopa37.5MG/entacapone200MG/Levodopa150MGOralTablet|IHSSCOBRA
636|1003|N|Y|N||Preferred Generic|403851-Carbidopa25MG/entacapone200MG/Levodopa100MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197861-Leucovorin15MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|317136-Nortriptyline25MGOralCapsule|IHSSCOBRA
636|1003|N|Y|N||Preferred Generic|403850-Carbidopa12.5MG/entacapone200MG/Levodopa50MGOralTablet|IHSSCOBRA
636|1003|N|Y|N||Preferred Generic|349590-Levalbuterol0.103MG/MLInhalationSolution|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|317128-Misoprostol0.2MGOralTablet|IHSSCOBRA
636|1003|N|Y|N||Preferred Generic|349556-ezetimibe10MGOralTablet|IHSSCOBRA
636|1003|N|Y|N||Preferred Generic|317094-entacapone200MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|2171002-Slynd28DayPack|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1043690-hydrocortisoneacetate10MG/MLTopicalCream|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197860-Leucovorin10MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|317110-24HRIsosorbideMononitrate30MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|N|Y|N||Preferred Generic|313921-calcipotriene0.05MG/MLTopicalCream|IHSSCOBRA
636|1003|N|Y|N||Preferred Generic|311787-moxifloxacin400MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|315213-SodiumFluoride2.2MGChewableTablet|IHSSCOBRA
636|1003|N|Y|N||Preferred Generic|311347-linezolid600MGOralTablet|IHSSCOBRA
636|1003|N|Y|N||Preferred Generic|311345-linezolid20MG/MLOralSuspension|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197855-Ketoprofen50MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|315187-Prednisone1MG/MLOralSolution|IHSSCOBRA
636|1003|N|Y|N||Preferred Generic|311286-Levalbuterol0.21MG/MLInhalationSolution|IHSSCOBRA
636|1003|N|Y|N||Preferred Generic|310600-Griseofulvin500MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|315183-PotassiumChloride8MEQExtendedReleaseOralCapsule|IHSSCOBRA
636|1003|N|Y|N||Preferred Generic|308865-calcipotriene0.05MG/MLTopicalSolution|IHSSCOBRA
636|1003|N|Y|N||Preferred Generic|284008-travoprost0.04MG/MLOphthalmicSolution|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|103457-Fluocinonide0.0005MG/MGTopicalOintment|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197854-Ketoprofen25MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|315134-Levocarnitine100MG/MLOralSolution|IHSSCOBRA
636|1003|N|Y|N||Preferred Generic|2572292-0.4MLcyclosporine0.5MG/MLOphthalmicSuspension|IHSSCOBRA
636|1003|N|Y|N||Preferred Generic|242831-Griseofulvin125MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|315107-24HRGlipizide10MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|N|Y|N||Preferred Generic|242754-Levalbuterol0.417MG/MLInhalationSolution|IHSSCOBRA
636|1003|N|Y|N||Preferred Generic|239239-Griseofulvin250MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197853-Ketoconazole200MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|315090-Erythromycin333MGDelayedReleaseOralTablet|IHSSCOBRA
636|1003|N|Y|N||Preferred Generic|204119-Malathion5MG/MLTopicalLotion|IHSSCOBRA
636|1003|N|Y|N||Preferred Generic|198373-calcipotriene0.00005MG/MGTopicalOintment|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|314277-venlafaxine50MGOralTablet|IHSSCOBRA
636|1003|N|Y|N||Preferred Generic|197984-Minocycline100MGOralCapsule|IHSSCOBRA
636|1003|N|Y|N||Preferred Generic|197551-Cycloserine250MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|1005928-ulipristalacetate30MGOralTablet[Ella]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|1090807-Psyllium3400MGPowderforOralSuspension[Konsyl]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|1313884-Phenytoin25MG/MLOralSuspension[Dilantin]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|1601660-Atazanavir300MG/cobicistat150MGOralTablet[Evotaz]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|213291-ParoxetineHydrochloride2MG/MLOralSuspension[Paxil]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|103456-Fluocinonide0.5MG/MLTopicalCream|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197840-IsosorbideDinitrate40MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|314241-Theophylline450MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|N|Y|N||Preferred Generic|197508-Cimetidine800MGOralTablet|IHSSCOBRA
636|1003|N|Y|N||Preferred Generic|197507-Cimetidine400MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|314238-Tropicamide10MG/MLOphthalmicSolution|IHSSCOBRA
636|1003|N|Y|N||Preferred Generic|197506-Cimetidine300MGOralTablet|IHSSCOBRA
636|1003|N|Y|N||Preferred Generic|197505-Cimetidine200MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197839-IsosorbideDinitrate30MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|314234-Sucralfate1000MGOralTablet|IHSSCOBRA
636|1003|N|Y|N||Preferred Generic|197419-Bumetanide2MGOralTablet|IHSSCOBRA
636|1003|N|Y|N||Preferred Generic|197418-Bumetanide1MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|314231-Simvastatin10MGOralTablet|IHSSCOBRA
636|1003|N|Y|N||Preferred Generic|197417-Bumetanide0.5MGOralTablet|IHSSCOBRA
636|1003|N|Y|N||Preferred Generic|1855389-Levalbuterol2.5MG/MLInhalationSolution|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|103403-Hydrocortisone10MG/MLTopicalLotion|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197832-isoniazid300MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|314230-Sirolimus1MG/MLOralSolution|IHSSCOBRA
636|1003|N|Y|N||Preferred Generic|1797863-flunisolide0.025MG/ACTUATMeteredDoseNasalSpray|IHSSCOBRA
636|1003|N|Y|N||Preferred Generic|1368954-mesalamine400MGDelayedReleaseOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|314215-rivastigmine4.5MGOralCapsule|IHSSCOBRA
636|1003|N|Y|N||Preferred Generic|1368438-alogliptin25MG/pioglitazone45MGOralTablet|IHSSCOBRA
636|1003|N|Y|N||Preferred Generic|1368431-alogliptin25MG/pioglitazone30MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197818-Indomethacin50MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|314214-rivastigmine1.5MGOralCapsule|IHSSCOBRA
636|1003|N|Y|N||Preferred Generic|1368424-alogliptin25MG/pioglitazone15MGOralTablet|IHSSCOBRA
636|1003|N|Y|N||Preferred Generic|1368410-alogliptin12.5MG/pioglitazone30MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|314208-ropinirole1MGOralTablet|IHSSCOBRA
636|1003|N|Y|N||Preferred Generic|1368392-alogliptin12.5MG/Metforminhydrochloride500MGOralTablet|IHSSCOBRA
636|1003|N|Y|N||Preferred Generic|1368385-alogliptin12.5MG/Metforminhydrochloride1000MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|213284-hydroxyurea400MGOralCapsule[Droxia]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|103401-Hydrocortisone0.025MG/MGTopicalOintment|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197817-Indomethacin25MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|314203-quinapril40MGOralTablet|IHSSCOBRA
636|1003|N|Y|N||Preferred Generic|1368034-alogliptin12.5MGOralTablet|IHSSCOBRA
636|1003|N|Y|N||Preferred Generic|1368018-alogliptin6.25MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|314182-PotassiumChloride2.67MEQ/MLOralSolution|IHSSCOBRA
636|1003|N|Y|N||Preferred Generic|1368006-alogliptin25MGOralTablet|IHSSCOBRA
636|1003|N|Y|N||Preferred Generic|1246673-Ivermectin5MG/MLTopicalLotion|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197816-Indapamide2.5MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|314165-prednisolone10MG/MLOphthalmicSolution|IHSSCOBRA
636|1003|N|Y|N||Preferred Generic|1085816-spinosad9MG/MLMedicatedShampoo|IHSSCOBRA
636|1003|N|Y|N||Preferred Brand|861821-Metforminhydrochloride500MG/sitagliptin50MGOralTablet[Janumet]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|314131-Niacin250MGExtendedReleaseOralCapsule|IHSSCOBRA
636|1003|N|Y|N||Preferred Brand|861771-Metforminhydrochloride1000MG/sitagliptin50MGOralTablet[Janumet]|IHSSCOBRA
636|1003|N|Y|N||Preferred Brand|835721-Ethionamide250MGOralTablet[Trecator]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1020477-DiphenhydramineHydrochloride50MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197815-Indapamide1.25MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|314111-Mirtazapine30MGOralTablet|IHSSCOBRA
636|1003|N|Y|N||Preferred Brand|833151-Savella4-WeekTitrationPack|IHSSCOBRA
636|1003|N|Y|N||Preferred Brand|833149-Milnacipranhydrochloride25MGOralTablet[Savella]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|314106-Metronidazole250MGOralTablet|IHSSCOBRA
636|1003|N|Y|N||Preferred Brand|833146-Milnacipranhydrochloride50MGOralTablet[Savella]|IHSSCOBRA
636|1003|N|Y|N||Preferred Brand|833143-Milnacipranhydrochloride12.5MGOralTablet[Savella]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197807-Ibuprofen800MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|314078-Loxapine10MGOralCapsule|IHSSCOBRA
636|1003|N|Y|N||Preferred Brand|833139-Milnacipranhydrochloride100MGOralTablet[Savella]|IHSSCOBRA
636|1003|N|Y|N||Preferred Brand|665044-sitagliptin50MGOralTablet[Januvia]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|314077-Lisinopril20MGOralTablet|IHSSCOBRA
636|1003|N|Y|N||Preferred Brand|665040-sitagliptin25MGOralTablet[Januvia]|IHSSCOBRA
636|1003|N|Y|N||Preferred Brand|665036-sitagliptin100MGOralTablet[Januvia]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|1600710-cobicistat150MG/darunavir800MGOralTablet[Prezcobix]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|213283-hydroxyurea300MGOralCapsule[Droxia]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1014676-cetirizinehydrochloride5MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197806-Ibuprofen600MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|314076-Lisinopril10MGOralTablet|IHSSCOBRA
636|1003|N|Y|N||Preferred Brand|2599365-3MLsemaglutide2.68MG/MLPenInjector[Ozempic]|IHSSCOBRA
636|1003|N|Y|N||Preferred Brand|2398842-3MLsemaglutide1.34MG/MLPenInjector[Ozempic]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|314075-Loxapine50MGOralCapsule|IHSSCOBRA
636|1003|N|Y|N||Preferred Brand|2395785-0.5MLdulaglutide9MG/MLAuto-Injector[Trulicity]|IHSSCOBRA
636|1003|N|Y|N||Preferred Brand|2395779-0.5MLdulaglutide6MG/MLAuto-Injector[Trulicity]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197805-Ibuprofen400MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|314072-latanoprost0.05MG/MLOphthalmicSolution|IHSSCOBRA
636|1003|N|Y|N||Preferred Brand|213307-Ciprofloxacin0.003MG/MGOphthalmicOintment[Ciloxan]|IHSSCOBRA
636|1003|N|Y|N||Preferred Brand|212381-aminosalicylicacid4000MGOralGranules[PaserD/R]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|314055-IsosorbideDinitrate5MGOralTablet|IHSSCOBRA
636|1003|N|Y|N||Preferred Brand|1992837-ertugliflozin5MG/sitagliptin100MGOralTablet[Steglujan]|IHSSCOBRA
636|1003|N|Y|N||Preferred Brand|1992832-ertugliflozin15MG/sitagliptin100MGOralTablet[Steglujan]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1014673-cetirizinehydrochloride1MG/MLOralSolution|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197803-Ibuprofen20MG/MLOralSuspension|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|314035-Haloperidol10MGOralTablet|IHSSCOBRA
636|1003|N|Y|N||Preferred Brand|1992821-ertugliflozin15MGOralTablet[Steglatro]|IHSSCOBRA
636|1003|N|Y|N||Preferred Brand|1992816-ertugliflozin5MGOralTablet[Steglatro]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|314034-Haloperidol2MGOralTablet|IHSSCOBRA
636|1003|N|Y|N||Preferred Brand|1992703-ertugliflozin7.5MG/Metforminhydrochloride500MGOralTablet[Segluromet]|IHSSCOBRA
636|1003|N|Y|N||Preferred Brand|1992700-ertugliflozin7.5MG/Metforminhydrochloride1000MGOralTablet[Segluromet]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197797-hydroxyurea500MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|314006-24HRGlipizide5MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|N|Y|N||Preferred Brand|1992695-ertugliflozin2.5MG/Metforminhydrochloride500MGOralTablet[Segluromet]|IHSSCOBRA
636|1003|N|Y|N||Preferred Brand|1992691-ertugliflozin2.5MG/Metforminhydrochloride1000MGOralTablet[Segluromet]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|314000-Glyburide1.5MGOralTablet|IHSSCOBRA
636|1003|N|Y|N||Preferred Brand|1551306-0.5MLdulaglutide3MG/MLAuto-Injector[Trulicity]|IHSSCOBRA
636|1003|N|Y|N||Preferred Brand|1551300-0.5MLdulaglutide1.5MG/MLAuto-Injector[Trulicity]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|213282-hydroxyurea200MGOralCapsule[Droxia]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1014571-12HRcetirizinehydrochloride5MG/PseudoephedrineHydrochloride120MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197787-Hydrocortisone5MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|313989-Fluoxetine40MGOralCapsule|IHSSCOBRA
636|1003|N|Y|N||Preferred Brand|1356673-BenzylAlcohol0.05ML/MLTopicalLotion[Ulesfia]|IHSSCOBRA
636|1003|N|Y|N||Preferred Brand|1243848-24HRMetforminhydrochloride500MG/sitagliptin50MGExtendedReleaseOralTablet[Janumet]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|313988-Furosemide40MGOralTablet|IHSSCOBRA
636|1003|N|Y|N||Preferred Brand|1243843-24HRMetforminhydrochloride1000MG/sitagliptin50MGExtendedReleaseOralTablet[Janumet]|IHSSCOBRA
636|1003|N|Y|N||Preferred Brand|1243833-24HRMetforminhydrochloride1000MG/sitagliptin100MGExtendedReleaseOralTablet[Janumet]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197785-Hydrocortisone25MG/MLTopicalLotion|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|313979-fludrocortisoneacetate0.1MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|999961-Glycopyrrolate0.2MG/MLOralSolution|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|998679-168HRClonidine0.0125MG/HRTransdermalSystem|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|313919-salmoncalcitonin200UNT/ACTUATNasalSpray|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|998675-168HRClonidine0.00833MG/HRTransdermalSystem|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|998671-168HRClonidine0.00417MG/HRTransdermalSystem|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1014314-TriamcinoloneAcetonide1MG/MLTopicalCream|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197783-Hydrocortisone20MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|313850-Amoxicillin40MG/MLOralSuspension|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|995868-CodeinePhosphate2MG/ML/Guaifenesin20MG/MLOralSolution|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|993890-Acetaminophen300MG/CodeinePhosphate60MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|313797-Amoxicillin25MG/MLOralSuspension|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|993781-Acetaminophen300MG/CodeinePhosphate30MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|993770-Acetaminophen300MG/CodeinePhosphate15MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197782-Hydrocortisone10MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|313786-AceticAcid20MG/ML/Hydrocortisone10MG/MLOticSolution|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|993755-Acetaminophen24MG/ML/CodeinePhosphate2.4MG/MLOralSolution|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|993470-midodrinehydrochloride5MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|313586-venlafaxine75MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|993466-midodrinehydrochloride2.5MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|993462-midodrinehydrochloride10MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|1306298-cobicistat150MG/elvitegravir150MG/emtricitabine200MG/Tenofovirdisoproxilfumarate300MGOralTablet[Stribild]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|1598989-Atazanavir50MGOralPowder[Reyataz]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|212957-Cyclosporine100MG/MLOralSolution[Sandimmune]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1013629-{24(drospirenone3MG/EthinylEstradiol0.02MG/levomefolatecalcium0.451MGOralTablet)/4(levomefolatecalcium0.451MGOralTabl|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197770-Hydrochlorothiazide50MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|313585-24HRvenlafaxine75MGExtendedReleaseOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|992668-homatropinemethylbromide0.3MG/ML/HydrocodoneBitartrate1MG/MLOralSolution|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|991528-DextromethorphanHydrobromide3MG/ML/PromethazineHydrochloride1.25MG/MLOralSolution|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|313584-venlafaxine37.5MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|991486-CodeinePhosphate2MG/ML/PromethazineHydrochloride1.25MG/MLOralSolution|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|966920-POLYETHYLENEGLYCOL3350236000MG/PotassiumChloride2970MG/SodiumBicarbonate6740MG/SodiumChloride5860MG/sodiumsulfate22740|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197754-Haloperidol20MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|313583-24HRvenlafaxine37.5MGExtendedReleaseOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|905516-ChlordiazepoxideHydrochloride5MGOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|905495-ChlordiazepoxideHydrochloride25MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|313582-venlafaxine25MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|905369-ChlordiazepoxideHydrochloride10MGOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|904589-SotalolHydrochloride240MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1012021-Prednisolonesodiumphosphate2.5MG/ML/SulfacetamideSodium100MG/MLOphthalmicSolution|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197746-Guanfacine2MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|313581-24HRvenlafaxine150MGExtendedReleaseOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|904447-Alendronicacid0.933MG/MLOralSolution|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|904419-Alendronicacid10MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|313580-venlafaxine100MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|899557-dexmethylphenidatehydrochloride2.5MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|899548-dexmethylphenidatehydrochloride10MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197745-Guanfacine1MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|313565-valacyclovir500MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|899518-dexmethylphenidatehydrochloride5MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|897749-HydromorphoneHydrochloride3MGRectalSuppository|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|313564-valacyclovir1000MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|897710-HydromorphoneHydrochloride8MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|897702-HydromorphoneHydrochloride4MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|212373-Estrogens,Esterified(USP)1.25MGOralTablet[Menest]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1010878-LidocaineHydrochloride40MG/MLMucousMembraneTopicalSolution|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197741-Guaifenesin200MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|313521-Tropicamide5MG/MLOphthalmicSolution|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|897696-HydromorphoneHydrochloride2MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|897630-24HRVerapamilhydrochloride360MGExtendedReleaseOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|313428-Toremifene60MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|895670-24HRquetiapine150MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|894780-MorphineSulfate4MG/MLOralSolution|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197737-Glyburide1.25MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|313366-Thiothixene5MGOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|892672-MorphineSulfate30MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|892625-MorphineSulfate20MG/MLOralSolution|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|313364-Thiothixene2MGOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|892589-MorphineSulfate2MG/MLOralSolution|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|892582-MorphineSulfate15MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1006688-SulfacetamideSodium100MG/MLTopicalLotion|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197732-Furosemide80MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|313362-Thiothixene1MGOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|884386-DextroamphetamineSulfate5MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|884385-DextroamphetamineSulfate10MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|313361-Thiothixene10MGOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|866042-NeomycinSulfate500MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|863559-valganciclovir50MG/MLOralSolution|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197701-Fluconazole50MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|313354-Thioridazine10MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|862025-24HRGuanfacine4MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|862019-24HRGuanfacine3MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|313306-Theophylline5.33MG/MLOralSolution|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|862013-24HRGuanfacine2MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|862006-24HRGuanfacine1MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|1598658-Levonorgestrel1.5MGOralTablet[Aftera]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|2122526-dolutegravir50MG/Lamivudine300MGOralTablet[Dovato]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1005856-SulfacetamideSodium100MG/ML/Sulfur50MG/MLTopicalLotion|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197699-Fluconazole150MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|313291-Theophylline400MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|861237-24HRAmphetamineaspartate1.25MG/AmphetamineSulfate1.25MG/Dextroamphetaminesaccharate1.25MG/DextroamphetamineSulfate1.25|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|861232-24HRAmphetamineaspartate7.5MG/AmphetamineSulfate7.5MG/Dextroamphetaminesaccharate7.5MG/DextroamphetamineSulfate7.5MGEx|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|313227-terconazole8MG/MLVaginalCream|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|861227-24HRAmphetamineaspartate6.25MG/AmphetamineSulfate6.25MG/Dextroamphetaminesaccharate6.25MG/DextroamphetamineSulfate6.25|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|861225-24HRAmphetamineaspartate5MG/AmphetamineSulfate5MG/Dextroamphetaminesaccharate5MG/DextroamphetamineSulfate5MGExtendedRe|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197687-Etoposide50MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|313226-terconazole4MG/MLVaginalCream|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|861223-24HRAmphetamineaspartate3.75MG/AmphetamineSulfate3.75MG/Dextroamphetaminesaccharate3.75MG/DextroamphetamineSulfate3.75|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|861221-24HRAmphetamineaspartate2.5MG/AmphetamineSulfate2.5MG/Dextroamphetaminesaccharate2.5MG/DextroamphetamineSulfate2.5MGEx|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|313219-Terazosin5MGOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|857366-EconazoleNitrate10MG/MLTopicalCream|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|857005-Acetaminophen325MG/HydrocodoneBitartrate7.5MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1000897-PilocarpineHydrochloride40MG/MLOphthalmicSolution|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197686-Etodolac400MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|313217-Terazosin2MGOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|857002-Acetaminophen325MG/HydrocodoneBitartrate5MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|856999-Acetaminophen325MG/HydrocodoneBitartrate10MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|313215-Terazosin1MGOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|856940-Acetaminophen21.7MG/ML/HydrocodoneBitartrate0.5MG/MLOralSolution|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|856569-24HRPropranololHydrochloride80MGExtendedReleaseOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197685-Etodolac300MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|313195-Tamoxifen20MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|856535-24HRPropranololHydrochloride60MGExtendedReleaseOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|856481-24HRPropranololHydrochloride160MGExtendedReleaseOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|313190-Tacrolimus0.5MGOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|856460-24HRPropranololHydrochloride120MGExtendedReleaseOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|855633-DiclofenacSodium0.01MG/MGTopicalGel|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|212232-Estrogens,Esterified(USP)0.625MGOralTablet[Menest]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1000862-PilocarpineHydrochloride20MG/MLOphthalmicSolution|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197684-Etodolac200MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|313142-Sulfasalazine500MGDelayedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|854894-Zolpidemtartrate6.25MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|854880-Zolpidemtartrate12.5MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|313134-Sulfamethoxazole40MG/ML/Trimethoprim8MG/MLOralSuspension|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|854876-Zolpidemtartrate5MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|854873-Zolpidemtartrate10MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197682-Ethosuximide250MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|313123-Sucralfate100MG/MLOralSuspension|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|854252-1MLEnoxaparinsodium150MG/MLPrefilledSyringe|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|854248-1MLEnoxaparinsodium100MG/MLPrefilledSyringe|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|313110-Stavudine40MGOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|854245-0.8MLEnoxaparinsodium150MG/MLPrefilledSyringe|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|854241-0.8MLEnoxaparinsodium100MG/MLPrefilledSyringe|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1000673-SulfacetamideSodium0.1MG/MGOphthalmicOintment|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197659-Estradiol2MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|313109-Stavudine30MGOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|854238-0.6MLEnoxaparinsodium100MG/MLPrefilledSyringe|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|854235-0.4MLEnoxaparinsodium100MG/MLPrefilledSyringe|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|313108-Stavudine20MGOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|854228-0.3MLEnoxaparinsodium100MG/MLPrefilledSyringe|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|853201-24HRquetiapine50MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197658-Estradiol1MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|313107-Stavudine15MGOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|847252-3MLInsulinLispro25UNT/ML/insulinlisproprotamine,human75UNT/MLPenInjector|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|847191-3MLinsulinaspartprotamine,human70UNT/ML/insulinaspart,human30UNT/MLPenInjector|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|313096-Spironolactone25MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|846378-24HRLevetiracetam750MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|845488-Ramipril1.25MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|108396-20MLZidovudine10MG/MLInjection[Retrovir]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|1293864-ErgotamineTartrate2MGSublingualTablet[Ergomar]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|1595478-amylase84000UNT/lipase20000UNT/protease63000UNTDelayedReleaseOralCapsule[Zenpep]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|212118-Nelfinavir250MGOralTablet[Viracept]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1000647-PilocarpineHydrochloride10MG/MLOphthalmicSolution|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197657-Estradiol0.5MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|313036-SodiumFluoride1.1MGChewableTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|835829-testosteronecypionate100MG/MLInjectableSolution|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|835603-tramadolhydrochloride50MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|312997-SodiumChloride9MG/MLInhalationSolution|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|834022-KetorolacTromethamine10MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|830861-24HRDiltiazemHydrochloride120MGExtendedReleaseOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197650-Erythromycin500MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|312962-Simvastatin5MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|830845-24HRDiltiazemHydrochloride180MGExtendedReleaseOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|830837-24HRDiltiazemHydrochloride240MGExtendedReleaseOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|312961-Simvastatin20MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|830801-24HRDiltiazemHydrochloride300MGExtendedReleaseOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|810000-lacosamide50MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1000153-1MLmedroxyprogesteroneacetate150MG/MLPrefilledSyringe|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197628-Doxazosin8MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|312941-Sertraline50MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|809996-lacosamide200MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|809992-lacosamide150MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|312940-Sertraline25MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|809987-lacosamide100MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|807832-24HRLevetiracetam500MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197627-Doxazosin4MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|312938-Sertraline100MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|801966-4MLDiazepam5MG/MLRectalGel|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|801961-2MLDiazepam5MG/MLRectalGel|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|312899-Salsalate500MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|801957-0.5MLDiazepam5MG/MLRectalGel|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|798133-Erythromycin20MG/MLMedicatedPad[Ery]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|212039-Estrogens,Esterified(USP)0.3MGOralTablet[Menest]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1000141-medroxyprogesteroneacetate5MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197626-Doxazosin2MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|312849-ropinirole5MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|797274-Clindamycin10MG/MLMedicatedPad|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|749788-{56(varenicline1MGOralTablet)}Pack|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|312847-ropinirole2MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|728113-Oseltamivir45MGOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|728109-Oseltamivir30MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197625-Doxazosin1MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|312846-ropinirole0.5MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|721796-24HRquetiapine400MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|721794-24HRquetiapine300MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|312845-ropinirole0.25MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|721791-24HRquetiapine200MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|687043-Amphetamineaspartate3.125MG/AmphetamineSulfate3.125MG/Dextroamphetaminesaccharate3.125MG/DextroamphetamineSulfate3.125|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1000135-medroxyprogesteroneacetate2.5MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197624-Disulfiram500MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|312836-rivastigmine6MGOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|686379-celecoxib50MGOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|645037-Risperidone0.25MGDisintegratingOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|312835-rivastigmine3MGOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|636671-varenicline0.5MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|636045-Hydrochlorothiazide25MG/valsartan320MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197623-Disulfiram250MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|312750-quinapril5MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|636042-Hydrochlorothiazide12.5MG/valsartan320MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|616705-Risperidone4MGDisintegratingOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|312749-quinapril20MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|616698-Risperidone3MGDisintegratingOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|616487-quetiapine50MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|1595473-amylase63000UNT/lipase15000UNT/protease47000UNTDelayedReleaseOralCapsule[Zenpep]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|209002-prednisolone1.2MG/MLOphthalmicSuspension[PredMild]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1000126-1MLmedroxyprogesteroneacetate150MG/MLInjection|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197622-Dipyridamole50MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|312748-quinapril10MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|616483-quetiapine400MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|608143-atomoxetine80MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|312641-Progesterone200MGOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|608139-atomoxetine100MGOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|596934-duloxetine60MGDelayedReleaseOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197606-Digoxin0.25MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|312635-Prochlorperazine5MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|596930-duloxetine30MGDelayedReleaseOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|596926-duloxetine20MGDelayedReleaseOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|312617-Prednisone5MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|577961-Amphetamineaspartate5MG/AmphetamineSulfate5MG/Dextroamphetaminesaccharate5MG/DextroamphetamineSulfate5MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|577957-Amphetamineaspartate3.75MG/AmphetamineSulfate3.75MG/Dextroamphetaminesaccharate3.75MG/DextroamphetamineSulfate3.75MGOr|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1000114-medroxyprogesteroneacetate10MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197604-Digoxin0.125MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|312615-Prednisone20MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|577208-Omega-3AcidEthylEsters(USP)1000MGOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|577127-pregabalin225MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|312614-prednisolone1MG/MLOralSolution|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|541892-Amphetamineaspartate2.5MG/AmphetamineSulfate2.5MG/Dextroamphetaminesaccharate2.5MG/DextroamphetamineSulfate2.5MGOralTa|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|541878-Amphetamineaspartate1.25MG/AmphetamineSulfate1.25MG/Dextroamphetaminesaccharate1.25MG/DextroamphetamineSulfate1.25MGOr|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197596-Dicloxacillin500MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|312594-Prazosin2MGOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|541363-Amphetamineaspartate7.5MG/AmphetamineSulfate7.5MG/Dextroamphetaminesaccharate7.5MG/DextroamphetamineSulfate7.5MGOralTa|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|485465-Eszopiclone3MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|312593-Prazosin1MGOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|485442-Eszopiclone2MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|485440-Eszopiclone1MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|208949-Estrogens,Conjugated(USP)0.9MGOralTablet[Premarin]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1000097-doxepin75MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197595-Dicloxacillin250MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|312529-PotassiumChloride8MEQExtendedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|483450-pregabalin75MGOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|483448-pregabalin50MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|312515-PotassiumChloride1.33MEQ/MLOralSolution|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|483446-pregabalin200MGOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|483444-pregabalin300MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197583-Dexamethasone6MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|312504-PotassiumChloride10MEQExtendedReleaseOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|483442-pregabalin25MGOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|483440-pregabalin150MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|312441-pioglitazone45MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|483438-pregabalin100MGOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|477562-Fenofibrate48MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1000076-doxepin50MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197582-Dexamethasone4MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|312440-pioglitazone30MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|477560-Fenofibrate145MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|403923-168HREstradiol0.0025MG/HRTransdermalSystem|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|312362-Phenobarbital30MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|403922-168HREstradiol0.00156MG/HRTransdermalSystem|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|403884-Levetiracetam100MG/MLOralSolution|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197581-Dexamethasone2MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|312357-Phenobarbital15MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|403825-Risperidone0.5MGDisintegratingOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|401954-Risperidone2MGDisintegratingOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|312347-Phenelzine15MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|401953-Risperidone1MGDisintegratingOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|359818-Nicotine4MGOralLozenge|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|1250723-etravirine25MGOralTablet[Intelence]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|1595462-amylase42000UNT/lipase10000UNT/protease32000UNTDelayedReleaseOralCapsule[Zenpep]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|208551-thyroid(USP)300MGOralTablet[ArmourThyroid]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1000070-doxepin25MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197580-Dexamethasone1.5MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|312301-Pentoxifylline400MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|359817-Nicotine2MGOralLozenge|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|351297-insulinaspartprotamine,human70UNT/ML/insulinaspart,human30UNT/MLInjectableSuspension|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|312138-oxcarbazepine600MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|351267-Buprenorphine8MG/Naloxone2MGSublingualTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|351266-Buprenorphine2MG/Naloxone0.5MGSublingualTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197579-Dexamethasone1MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|312137-oxcarbazepine300MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|351265-Buprenorphine8MGSublingualTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|351264-Buprenorphine2MGSublingualTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|312136-oxcarbazepine150MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|351246-montelukast4MGOralGranules|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|351133-Fenofibrate54MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1000064-doxepin150MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197577-Dexamethasone0.5MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|312059-Nystatin500000UNTOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|349595-atomoxetine60MGOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|349594-atomoxetine40MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|312055-Nystatin100000UNT/MLOralSuspension|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|349593-atomoxetine25MGOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|349592-atomoxetine18MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197575-Desoximetasone0.0025MG/MGTopicalOintment|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|312036-Nortriptyline2MG/MLOralSolution|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|349591-atomoxetine10MGOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|349514-celecoxib400MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|311995-NITROFURANTOIN,MACROCRYSTALS50MGOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|349483-valsartan40MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|349353-Hydrochlorothiazide25MG/valsartan160MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|208549-thyroid(USP)240MGOralTablet[ArmourThyroid]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1000058-doxepin100MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197558-Dapsone25MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|311994-NITROFURANTOIN,MACROCRYSTALS25MGOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|349287-Fenofibrate160MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|349201-valsartan160MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|311989-Nitrofurantoin5MG/MLOralSuspension|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|349200-valsartan320MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|349199-valsartan80MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197557-Dapsone100MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|311960-Niacin500MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|349198-Clonazepam0.5MGDisintegratingOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|349197-Clonazepam2MGDisintegratingOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|311959-Niacin500MGExtendedReleaseOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|349196-Clonazepam1MGDisintegratingOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|349195-Clonazepam0.25MGDisintegratingOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1000054-doxepin10MG/MLOralSolution|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197553-Cyclosporine25MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|311955-Niacin250MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|349194-Clonazepam0.125MGDisintegratingOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|318202-Erythromycin20MG/MLTopicalSolution|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|311943-Nevirapine10MG/MLOralSuspension|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|317174-quetiapine200MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|315223-Sumatriptan25MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197536-Clozapine25MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|311893-nabumetone750MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|314286-ziprasidone20MGOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|314285-zonisamide100MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|311892-nabumetone500MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|314211-Risperidone4MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|314209-rizatriptan10MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|1595457-amylase24000UNT/lipase5000UNT/protease17000UNTDelayedReleaseOralCapsule[Zenpep]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|208547-thyroid(USP)180MGOralTablet[ArmourThyroid]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1000048-doxepin10MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197535-Clozapine100MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|311753-mometasonefuroate1MG/MLTopicalCream|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|314200-pantoprazole40MGDelayedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|314154-olanzapine10MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|311727-Misoprostol0.1MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|314135-naratriptan2.5MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|313778-ziprasidone80MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197518-Clindamycin150MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|311726-Mirtazapine45MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|313777-ziprasidone60MGOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|313776-ziprasidone40MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|311725-Mirtazapine15MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|313762-zaleplon5MGOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|313761-zaleplon10MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|978950-Natazia28DayPack|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197517-Clarithromycin500MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|311704-Mifepristone200MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|313571-Vancomycin250MGOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|313570-Vancomycin125MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|311681-Metronidazole500MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|313566-valganciclovir450MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|313415-Tobramycin3MG/MLOphthalmicSolution|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197516-Clarithromycin250MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|311679-Metronidazole0.0075MG/MGTopicalGel|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|313413-tizanidine4MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|313412-tizanidine2MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|311678-Metronidazole7.5MG/MLTopicalCream|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|313222-terbinafine250MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|313161-Sumatriptan50MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|208543-thyroid(USP)90MGOralTablet[ArmourThyroid]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|977440-everolimus0.75MGOralTablet[Zortress]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197500-Chlorthalidone50MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|311668-Metoclopramide5MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|313160-Sumatriptan100MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|312840-rizatriptan5MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|311666-Metoclopramide10MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|312832-Risperidone3MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|312831-Risperidone2MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197499-Chlorthalidone25MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|311487-Melphalan50MGInjection|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|312830-Risperidone1MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|312829-Risperidone0.5MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|311486-meloxicam7.5MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|312828-Risperidone0.25MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|312745-quetiapine300MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|977436-everolimus0.5MGOralTablet[Zortress]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197454-Cephalexin500MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|311386-Loxapine5MGOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|312744-quetiapine25MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|312743-quetiapine100MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|311385-Loxapine25MGOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|312087-Ondansetron8MGDisintegratingOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|312086-Ondansetron8MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197449-Cefaclor500MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|311372-Loratadine10MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|312079-olanzapine7.5MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|312078-olanzapine5MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|311355-LithiumCarbonate150MGOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|312077-olanzapine15MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|312075-Ofloxacin3MG/MLOphthalmicSolution|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|1000491-Prempro0.3/1.528DayPack|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|1000500-Prempro0.625/528DayPack|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|105590-Thioguanine40MGOralTablet[Tabloid]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|1236632-darunavir100MG/MLOralSuspension[Prezista]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|1595292-amylase14000UNT/lipase3000UNT/protease10000UNTDelayedReleaseOralCapsule[Zenpep]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|208540-thyroid(USP)60MGOralTablet[ArmourThyroid]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|977431-everolimus0.25MGOralTablet[Zortress]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197445-Carbidopa25MG/Levodopa250MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|311354-Lisinopril5MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|311975-Nicotine4MGChewingGum|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|311918-naratriptan1MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|311353-Lisinopril2.5MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|311759-montelukast4MGChewableTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|311265-lamotrigine5MGChewableTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197444-Carbidopa25MG/Levodopa100MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|311296-Levofloxacin750MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|311207-Ivermectin3MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|310793-Hydrochlorothiazide12.5MG/irbesartan300MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|311290-Levetiracetam750MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|310792-Hydrochlorothiazide12.5MG/irbesartan150MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|310467-Gentamicin3MG/MLOphthalmicSolution|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|966282-LevothyroxineSodium0.088MGOralTablet[Synthroid]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197443-Carbidopa10MG/Levodopa100MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|311289-Levetiracetam500MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|310465-Gentamicin0.001MG/MGTopicalOintment|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|310289-Fenofibrate200MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|311288-Levetiracetam250MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|310288-Fenofibrate134MGOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|310191-estradiolvalerate40MG/MLInjectableSolution|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197433-calciumacetate667MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|311277-lansoprazole30MGDelayedReleaseOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|310190-estradiolvalerate20MG/MLInjectableSolution|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|310152-Erythromycin0.02MG/MGTopicalGel|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|311264-lamotrigine25MGChewableTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|310149-Erythromycin0.005MG/MGOphthalmicOintment|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|309333-Clindamycin10MG/MLTopicalSolution|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|208535-thyroid(USP)30MGOralTablet[ArmourThyroid]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|966271-LevothyroxineSodium0.137MGOralTablet[Synthroid]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197411-Bromocriptine2.5MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|311197-IsosorbideMononitrate20MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|309332-Clindamycin0.01MG/MGTopicalGel|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|309314-Citalopram40MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|311196-24HRIsosorbideMononitrate120MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|309309-Ciprofloxacin500MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|309307-Ciprofloxacin3MG/MLOphthalmicSolution|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197409-Betamethasone0.001MG/MGTopicalOintment|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|311192-IsosorbideMononitrate10MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|283639-olanzapine20MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|283417-benzonatate200MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|311166-isoniazid100MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|283407-Mirtazapine30MGDisintegratingOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|2621571-Sensor3MLinsulinlispro100UNT/MLPenInjector|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|966251-LevothyroxineSodium0.2MGOralTablet[Synthroid]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197408-Betamethasone1MG/MLTopicalLotion|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|310891-Hydrocortisone25MG/MLTopicalCream|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|261962-Ramipril10MGOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|259081-12HRAspirin25MG/Dipyridamole200MGExtendedReleaseOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|310818-Hydrochlorothiazide50MG/Triamterene75MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|2563976-insulinglargine-yfgn100UNT/MLInjectableSolution|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|2563971-3MLinsulinglargine-yfgn100UNT/MLPenInjector|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197407-Betamethasone1MG/MLTopicalCream|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|310812-Hydrochlorothiazide25MG/Triamterene37.5MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|251872-pantoprazole20MGDelayedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|248478-84HREstradiol0.00104MG/HRTransdermalSystem|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|310809-Hydrochlorothiazide25MG/quinapril20MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|244374-BenzoylPeroxide0.05MG/MG/Erythromycin0.03MG/MGTopicalGel|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|242892-84HREstradiol0.00417MG/HRTransdermalSystem|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|1594673-amylase105000UNT/lipase25000UNT/protease79000UNTDelayedReleaseOralCapsule[Zenpep]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|208513-Estrogens,Conjugated(USP)0.3MGOralTablet[Premarin]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|966250-LevothyroxineSodium0.1MGOralTablet[Synthroid]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197405-Betamethasone0.0005MG/MGTopicalOintment|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|310798-Hydrochlorothiazide25MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|242891-84HREstradiol0.00208MG/HRTransdermalSystem|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|242462-cilostazol50MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|310797-Hydrochlorothiazide12.5MG/quinapril20MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|242461-cilostazol100MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|242438-montelukast5MGChewableTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197392-Baclofen20MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|310796-Hydrochlorothiazide12.5MG/quinapril10MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|242333-168HREstradiol0.00104MG/HRTransdermalSystem|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|242120-InsulinLispro100UNT/MLInjectableSolution|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|310687-Hydrocortisone10MG/ML/Neomycin3.5MG/ML/PolymyxinB10000UNT/MLOticSuspension|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|241946-84HREstradiol0.00156MG/HRTransdermalSystem|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|241527-168HREstradiol0.00312MG/HRTransdermalSystem|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|966247-LevothyroxineSodium0.05MGOralTablet[Synthroid]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197391-Baclofen10MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|310672-Haloperidol5MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|238004-168HREstradiol0.00417MG/HRTransdermalSystem|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|238003-168HREstradiol0.00208MG/HRTransdermalSystem|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|310671-Haloperidol1MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|2123111-NDA020503200ACTUATAlbuterol0.09MG/ACTUATMeteredDoseInhaler|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|205323-celecoxib200MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197388-Azathioprine50MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|310670-Haloperidol0.5MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|205322-celecoxib100MGOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|2047882-1MLtestosteronecypionate200MG/MLInjection|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|310604-Guaifenesin20MG/MLOralSolution|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|203088-Ketoconazole20MG/MLTopicalCream|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|200345-Simvastatin80MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|207864-crotamiton100MG/MLTopicalCream[Eurax]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|966218-LevothyroxineSodium0.3MGOralTablet[Synthroid]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197383-Atenolol50MG/Chlorthalidone25MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|310594-Gramicidin0.025MG/ML/Neomycin1.75MG/ML/PolymyxinB10000UNT/MLOphthalmicSolution|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|200329-Omeprazole40MGDelayedReleaseOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|200311-Fenofibrate67MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|310539-Glyburide6MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|200285-Hydrochlorothiazide12.5MG/valsartan160MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|200284-Hydrochlorothiazide12.5MG/valsartan80MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197382-Atenolol100MG/Chlorthalidone25MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|310537-Glyburide5MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|200224-montelukast10MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|2001568-BXRating24HRMethylphenidateHydrochloride54MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|310536-Glyburide3MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|2001566-BXRating24HRMethylphenidateHydrochloride36MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|2001565-BXRating24HRMethylphenidateHydrochloride27MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|966205-LevothyroxineSodium0.175MGOralTablet[Synthroid]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197381-Atenolol50MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|310534-Glyburide2.5MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|2001564-BXRating24HRMethylphenidateHydrochloride18MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|200096-irbesartan300MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|310490-Glipizide5MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|200095-irbesartan150MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|200094-irbesartan75MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197380-Atenolol25MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|310489-24HRGlipizide2.5MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|200034-olanzapine2.5MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|199381-potassiumcitrate10MEQExtendedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|310488-Glipizide10MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|199376-potassiumcitrate5MEQExtendedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|199370-Ciprofloxacin100MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|1235595-raltegravir25MGChewableTablet[ISENTRESS]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|1547672-30ACTUATfluticasonefuroate0.2MG/ACTUATDryPowderInhaler[Arnuity]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|207588-Procarbazine50MGOralCapsule[Matulane]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|966201-LevothyroxineSodium0.15MGOralTablet[Synthroid]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197379-Atenolol100MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|310459-Gemfibrozil600MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|198342-Urea400MG/MLTopicalCream|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|198318-Triazolam0.25MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|310442-Ganciclovir500MGInjection|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|198317-Triazolam0.125MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|198252-tetracyclinehydrochloride500MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197362-ammoniumlactate120MG/MLTopicalLotion|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|310434-gabapentin800MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|198250-tetracyclinehydrochloride250MGOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|198242-Temazepam30MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|310433-gabapentin600MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|198241-Temazepam15MGOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|198189-Ramipril5MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|966191-LevothyroxineSodium0.125MGOralTablet[Synthroid]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197361-Amlodipine5MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|310429-Furosemide20MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|198188-Ramipril2.5MGOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|198052-Ondansetron4MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|310410-FolicAcid1MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|198051-Omeprazole20MGDelayedReleaseOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|198036-24HRNifedipine90MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197320-Allopurinol300MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|310386-Fluoxetine4MG/MLOralSolution|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|198035-24HRNifedipine60MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|198034-24HRNifedipine30MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|310385-Fluoxetine20MGOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|197902-Lorazepam2MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|197901-Lorazepam1MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|207373-Mitotane500MGOralTablet[Lysodren]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|966171-LevothyroxineSodium0.075MGOralTablet[Synthroid]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197319-Allopurinol100MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|310384-Fluoxetine10MGOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|197900-Lorazepam0.5MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|197739-Glycopyrrolate2MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|310380-Fluorouracil50MG/MLTopicalSolution|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|197738-Glycopyrrolate1MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|197735-Gentamicin1MG/MLTopicalCream|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197318-Albuterol4MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|310379-Fluorouracil20MG/MLTopicalSolution|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|197591-Diazepam5MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|197590-Diazepam2MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|310377-Fluorometholone1MG/MLOphthalmicSuspension|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|197589-Diazepam10MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|197541-Colchicine0.6MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|966158-LevothyroxineSodium0.025MGOralTablet[Synthroid]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197316-Albuterol2MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|310364-Fluocinonide0.5MG/MLTopicalSolution|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|197529-Clonazepam2MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|197528-Clonazepam1MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|310362-Fluocinonide0.0005MG/MGTopicalGel|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|197527-Clonazepam0.5MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|197519-Clindamycin10MG/MLTopicalLotion|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197311-Acyclovir400MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|310353-Fluconazole40MG/MLOralSuspension|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|197512-Ciprofloxacin750MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|197511-Ciprofloxacin250MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|310352-Fluconazole10MG/MLOralSuspension|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|197397-benzonatate100MGOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|1926331-0.5UNTDoses3MLInsulinLispro100UNT/MLPenInjector|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|1547664-14ACTUATfluticasonefuroate0.1MG/ACTUATDryPowderInhaler[Arnuity]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|207273-Nitroglycerin0.02MG/MGTopicalOintment[Nitro-Bid]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|901518-0.5MLNeisseriameningitidisserogroupAoligosaccharidediphtheriaCRM197proteinconjugatevaccine0.02MG/ML/Neisseriameningiti|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197310-Acyclovir200MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|310346-Finasteride5MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|1923426-SotalolHydrochloride80MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|1923424-SotalolHydrochloride160MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|310273-Famotidine20MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|1923422-SotalolHydrochloride120MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|1812015-Osmotic24HRNifedipine90MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197305-AceticAcid20MG/MLOticSolution|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|310261-exemestane25MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|1812013-Osmotic24HRNifedipine60MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|1812011-Osmotic24HRNifedipine30MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|310169-Estradiol0.1MG/MLVaginalCream|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|1806197-30/70Release24HRMethylphenidateHydrochloride60MGExtendedReleaseOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|1806195-50/50Release24HRMethylphenidateHydrochloride10MGExtendedReleaseOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|896027-60ACTUATFluticasonepropionate0.25MG/ACTUATDryPowderInhaler[Flovent]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197304-Acetazolamide250MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|310157-Erythromycin500MGDelayedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|1806193-30/70Release24HRMethylphenidateHydrochloride50MGExtendedReleaseOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|1806191-30/70Release24HRMethylphenidateHydrochloride40MGExtendedReleaseOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|310155-Erythromycin250MGDelayedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|1806185-50/50Release24HRMethylphenidateHydrochloride60MGExtendedReleaseOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|1650142-DoxycyclineMonohydrate100MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|197303-Acetazolamide125MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|310154-Erythromycin250MGDelayedReleaseOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|1649990-DoxycyclineMonohydrate100MGOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|1649401-DoxycyclineMonohydrate50MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|310015-dorzolamide20MG/MLOphthalmicSolution|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|1597076-60ACTUATTestosterone20.25MG/ACTUATTopicalGel|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|1596780-60ACTUATTestosterone12.5MG/ACTUATTopicalGel|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|207136-Methylprednisolone2MGOralTablet[Medrol]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|896023-60ACTUATFluticasonepropionate0.1MG/ACTUATDryPowderInhaler[Flovent]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1946772-Methotrexate25MG/MLInjectableSolution|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|310005-dofetilide0.5MGOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|1543069-Lidocaine0.05MG/MGTopicalOintment|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|1490065-RaloxifeneHydrochloride60MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|310004-dofetilide0.25MGOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|1244214-Budesonide3MGDelayedReleaseOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|1149632-84HREstradiol0.00313MG/HRTransdermalSystem|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1923432-dorzolamide20MG/ML/Timolol5MG/MLOphthalmicSolution|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|310003-dofetilide0.125MGOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|1115698-Oseltamivir6MG/MLOralSuspension|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|1111343-olopatadine2MG/MLOphthalmicSolution|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|309955-Dipyridamole75MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|1111339-olopatadine1MG/MLOphthalmicSolution|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|1091497-MethylphenidateHydrochloride5MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|896019-60ACTUATFluticasonepropionate0.05MG/ACTUATDryPowderInhaler[Flovent]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1923428-Timolol2.5MG/MLOphthalmicSolution|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|309952-Dipyridamole25MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|1091392-MethylphenidateHydrochloride20MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|1091225-8HRMethylphenidateHydrochloride20MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|309686-Dexamethasone0.1MG/MLOralSolution|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|1091150-MethylphenidateHydrochloride10MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|1091145-8HRMethylphenidateHydrochloride10MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1918209-60ACTUATfluticasonepropionate0.055MG/ACTUAT/salmeterol0.014MG/ACTUATDryPowderInhaler|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|309680-Dexamethasone1MG/ML/Neomycin3.5MG/ML/PolymyxinB10000UNT/MLOphthalmicSuspension|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|106346-Mupirocin0.02MG/MGTopicalOintment|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|1049225-Acetaminophen325MG/OxycodoneHydrochloride7.5MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|309679-Dexamethasone0.001MG/MG/Neomycin0.0035MG/MG/PolymyxinB10UNT/MGOphthalmicOintment|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|1049221-Acetaminophen325MG/OxycodoneHydrochloride5MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|1049214-Acetaminophen325MG/OxycodoneHydrochloride10MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|105553-Chlorambucil2MGOralTablet[Leukeran]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|1235591-raltegravir100MGChewableTablet[ISENTRESS]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|1546894-abacavir600MG/dolutegravir50MG/Lamivudine300MGOralTablet[Triumeq]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|206216-2MLIron-DextranComplex50MG/MLInjection[InFed]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|866049-60ACTUATsalmeterol0.05MG/ACTUATDryPowderInhaler[Serevent]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1918203-60ACTUATfluticasonepropionate0.232MG/ACTUAT/salmeterol0.014MG/ACTUATDryPowderInhaler|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|309594-vitaminB121MG/MLInjectableSolution|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|104894-Ondansetron4MGDisintegratingOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|1037179-dabigatranetexilate75MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|309374-Clozapine200MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|1037045-dabigatranetexilate150MGOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Generic|1009145-Amphetamineaspartate1.875MG/AmphetamineSulfate1.875MG/Dextroamphetaminesaccharate1.875MG/DextroamphetamineSulfate1.87|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1918194-60ACTUATfluticasonepropionate0.113MG/ACTUAT/salmeterol0.014MG/ACTUATDryPowderInhaler|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|309371-Clotrimazole10MGOralLozenge|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|901644-0.5MLStreptococcuspneumoniaeserotype1capsularantigendiphtheriaCRM197proteinconjugatevaccine0.0044MG/ML/Streptococcuspn|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|901518-0.5MLNeisseriameningitidisserogroupAoligosaccharidediphtheriaCRM197proteinconjugatevaccine0.02MG/ML/Neisseriameningiti|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|309370-Clotrimazole10MG/MLTopicalSolution|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|847213-3MLInsulinLispro50UNT/ML/insulinlisproprotamine,human50UNT/MLPenInjector[HumalogMix]|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|847199-3MLinsulinisophane,human100UNT/MLPenInjector[HumulinN]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|863841-amylase60000UNT/lipase12000UNT/protease38000UNTDelayedReleaseOralCapsule[Creon]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1870230-NDA0208000.3MLEpinephrine1MG/MLAuto-Injector|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|309367-Clotrimazole10MG/MLTopicalCream|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|847189-3MLinsulinisophane,human70UNT/ML/insulin,regular,human30UNT/MLPenInjector[Humulin]|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|836636-0.5MLhepatitisAvirusstrainCR326Fantigen,inactivated50UNT/MLPrefilledSyringe[Vaqta]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|309337-Clindamycin20MG/MLVaginalCream|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|836634-1MLhepatitisAvirusstrainCR326Fantigen,inactivated50UNT/MLPrefilledSyringe[Vaqta]|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|830263-1MLHepatitisBSurfaceAntigenVaccine0.04MG/MLInjection[Recombivax]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1806189-30/70Release24HRMethylphenidateHydrochloride30MGExtendedReleaseOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|309313-Citalopram2MG/MLOralSolution|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|830253-0.5MLHepatitisBSurfaceAntigenVaccine0.01MG/MLPrefilledSyringe[Recombivax]|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|830245-1MLHepatitisBSurfaceAntigenVaccine0.01MG/MLPrefilledSyringe[Recombivax]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|309291-ciclopirox80MG/MLTopicalSolution|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|804186-0.5MLMeaslesVirusVaccineLive,Enders'attenuatedEdmonstonstrain2000UNT/ML/MumpsVirusVaccineLive,JerylLynnStrain25000UNT/|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|803371-1MLHepatitisAVaccine(Inactivated)StrainHM175720UNT/ML/HepatitisBSurfaceAntigenVaccine0.02MG/MLPrefilledSyringe[Twinrix|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|206208-aluminumchloride200MG/MLTopicalSolution[Drysol]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|863836-amylase30000UNT/lipase6000UNT/protease19000UNTDelayedReleaseOralCapsule[Creon]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1806187-30/70Release24HRMethylphenidateHydrochloride20MGExtendedReleaseOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|309290-ciclopirox7.7MG/MLTopicalLotion|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|798482-0.5MLHepatitisAVaccine(Inactivated)StrainHM1751440UNT/MLPrefilledSyringe[Havrix]|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|798479-1MLHepatitisAVaccine(Inactivated)StrainHM1751440UNT/MLPrefilledSyringe[Havrix]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|309115-Cephalexin250MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|798428-1MLHepatitisBSurfaceAntigenVaccine0.02MG/MLPrefilledSyringe[Engerix-B]|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|797641-0.5MLNeisseriameningitidisserogroupAcapsularpolysaccharidediphtheriatoxoidproteinconjugatevaccine0.104MG/ML/Neisseriam|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1806181-30/70Release24HRMethylphenidateHydrochloride10MGExtendedReleaseOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|309114-Cephalexin500MGOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|794610-darunavir600MGOralTablet[Prezista]|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|752388-InsulinLispro25UNT/ML/insulinlisproprotamine,human75UNT/MLInjectableSuspension[HumalogMix]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|309113-Cephalexin50MG/MLOralSuspension|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|731281-InsulinLispro50UNT/ML/insulinlisproprotamine,human50UNT/MLInjectableSuspension[HumalogMix]|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|580261-tiotropium0.018MGInhalationPowder[Spiriva]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|863829-amylase120000UNT/lipase24000UNT/protease76000UNTDelayedReleaseOralCapsule[Creon]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1801298-MicroencapsulatedPotassiumChloride10MEQExtendedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|309112-Cephalexin250MGOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|351859-insulin,regular,human500UNT/MLInjectableSolution[HumulinR]|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|351433-24HRNicotine0.292MG/HRTransdermalSystem[NicodermC-Q]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|309110-Cephalexin25MG/MLOralSuspension|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|351427-24HRNicotine0.583MG/HRTransdermalSystem[NicodermC-Q]|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|311036-insulin,regular,human100UNT/MLInjectableSolution[HumulinR]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1801294-MicroencapsulatedPotassiumChloride20MEQExtendedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|309098-Cefuroxime500MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|311026-insulinisophane,human100UNT/MLInjectableSuspension[HumulinN]|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|2607750-influenzaAvirusA/Norway/16606/2021(H3N2)antigen158000000UNT/ML/influenzaAvirusA/Victoria/1/2020(H1N1)antigen158000000|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|309054-cefdinir25MG/MLOralSuspension|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|2605557-0.5MLinfluenzaAvirusA/Darwin/6/2021(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.03MG/ML/i|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|2605552-influenzaAvirusA/Darwin/9/2021(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.03MG/ML/influe|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|153183-adapalene0.001MG/MGTopicalGel[Differin]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|205669-Dexamethasone1MG/MLOphthalmicSuspension[Maxidex]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|858079-Levonorgestrel1.5MGOralTablet[PlanBOne-Step]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1801289-SmokingCessation12HRBupropionHydrochloride150MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|309049-Cefadroxil500MGOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|2605549-0.5MLinfluenzaAvirusA/Darwin/9/2021(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.03MG/ML/i|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|2605543-0.5MLinfluenzaAvirusA/Darwin/9/2021(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.03MG/ML/i|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|309045-Cefaclor250MGOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|2605540-0.5MLinfluenzaAvirusA/Darwin/6/2021(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.03MG/ML/i|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|2605106-0.7MLinfluenzaAvirusA/Darwin/9/2021(H3N2)antigen0.0857MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.0857MG/|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1797929-Budesonide0.032MG/ACTUATMeteredDoseNasalSpray|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|309044-Cefaclor25MG/MLOralSuspension|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|2605096-0.5MLinfluenzaAvirusA/Darwin/6/2021(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.03MG/ML/i|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|2605051-0.5MLinfluenzaAvirusA/Darwin/9/2021(H3N2)antigen0.03MG/ML/influenzaAvirusA/Victoria/2570/2019(H1N1)antigen0.03MG/ML/i|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|308989-Carbidopa50MG/Levodopa200MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|2603514-0.5MLmeaslesvirusvaccinelive,attenuatedSchwarzstrain5024UNT/ML/mumpsvirusvaccinelive,RIT-4385strain31684UNT/ML/rubell|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|2599543-Paxlovid150MG/100MGDosePack|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|855875-Phenytoinsodium300MGExtendedReleaseOralCapsule[Phenytek]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1797913-TriamcinoloneAcetonide0.055MG/ACTUATMeteredDoseNasalSpray|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|308988-Carbidopa25MG/Levodopa100MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|2588066-rivaroxaban1MG/MLOralSuspension[Xarelto]|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|2587899-Paxlovid5-Day|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|308979-Carbamazepine200MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|2360588-0.5MLNeisseriameningitidisserogroupAcapsularpolysaccharidetetanustoxoidproteinconjugatevaccine0.02MG/ML/Neisseriameni|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|2166928-10ACTUATolodaterol0.0025MG/ACTUAT/tiotropium0.0025MG/ACTUATInhalationSpray[Stiolto]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1797907-Fluticasonepropionate0.05MG/ACTUATMeteredDoseNasalSpray|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|308976-Carbamazepine20MG/MLOralSuspension|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|2166204-10ACTUATtiotropium0.0025MG/ACTUATInhalationSpray[Spiriva]|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|211140-PentosanPolysulfate100MGOralCapsule[Elmiron]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|308973-Carbamazepine100MGChewableTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|208821-Dexamethasone0.001MG/MG/Tobramycin0.003MG/MGOphthalmicOintment[Tobradex]|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|2059017-rivaroxaban2.5MGOralTablet[Xarelto]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|2055989-273DAYEthinylEstradiol0.000542MG/HR/segesteroneacetate0.00625MG/HRVaginalSystem[Annovera]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|855871-Phenytoinsodium30MGExtendedReleaseOralCapsule[Dilantin]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1797867-Azelastinehydrochloride0.137MG/ACTUATMeteredDoseNasalSpray|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|308964-Captopril50MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|2053927-sodiumzirconiumcyclosilicate10000MGPowderforOralSuspension[Lokelma]|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|2050059-0.5MLHepatitisBSurfaceAntigenVaccine0.04MG/MLPrefilledSyringe[Heplisav-B]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|308963-Captopril12.5MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|2047639-sodiumzirconiumcyclosilicate5000MGPowderforOralSuspension[Lokelma]|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|2000136-Vancomycin50MG/MLOralSolution[Firvanq]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1744009-emtricitabine167MG/Tenofovirdisoproxilfumarate250MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|308962-Captopril100MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|2000133-Vancomycin25MG/MLOralSolution[Firvanq]|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|1992428-Eliquis30-DayStarterPack|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|308868-Calcitriol0.0005MGOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|1992171-3MLInsulinLispro100UNT/MLPenInjector[Admelog]|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|1992169-InsulinLispro100UNT/MLInjectableSolution[Admelog]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|855863-Phenytoinsodium200MGExtendedReleaseOralCapsule[Phenytek]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1744005-emtricitabine133MG/Tenofovirdisoproxilfumarate200MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|308867-Calcitriol0.00025MGOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|1986830-0.5MLVaricellazostervirusglycoproteinE,recombinant0.1MG/MLInjection[Shingrix]|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|1797888-Nicotine0.5MG/ACTUATMeteredDoseNasalSpray[Nicotrol]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|308725-bexarotene75MGOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|1731317-3MLinsulin,regular,human500UNT/MLPenInjector[HumulinR]|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|1723478-dabigatranetexilate110MGOralCapsule[Pradaxa]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1744001-emtricitabine100MG/Tenofovirdisoproxilfumarate150MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|308724-bexarotene0.01MG/MGTopicalGel|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|1667882-60ACTUATtiotropium0.00125MG/ACTUATInhalationSpray[Spiriva]|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|1658472-0.5MLStreptococcuspneumoniaetype1capsularpolysaccharideantigen0.05MG/ML/Streptococcuspneumoniaetype10Acapsularpolysac|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|308714-Betamethasone0.5MG/ML/Clotrimazole10MG/MLTopicalCream|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|1658157-1MLHepatitisBSurfaceAntigenVaccine0.02MG/MLInjection[Engerix-B]|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|1658155-0.5MLHepatitisBSurfaceAntigenVaccine0.01MG/MLInjection[Recombivax]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|1190225-120ACTUATAlbuterol0.1MG/ACTUAT/IpratropiumBromide0.02MG/ACTUATInhalationSpray[Combivent]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|152854-Itraconazole10MG/MLOralSolution[Sporanox]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|2055815-DORAVIRINE100MG/Lamivudine300MG/Tenofovirdisoproxilfumarate300MGOralTablet[Delstrigo]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|855673-Phenytoinsodium100MGExtendedReleaseOralCapsule[Dilantin]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1738511-ParoxetineHydrochloride40MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|308694-BenzoylPeroxide0.05MG/MGTopicalGel|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|1658106-0.5MLhepatitisAvirusstrainCR326Fantigen,inactivated50UNT/MLInjection[Vaqta]|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|1658102-1MLhepatitisAvirusstrainCR326Fantigen,inactivated50UNT/MLInjection[Vaqta]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|308689-BenzoylPeroxide0.025MG/MGTopicalGel|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|1656356-sacubitril97MG/valsartan103MGOralTablet[Entresto]|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|1656351-sacubitril49MG/valsartan51MGOralTablet[Entresto]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1738503-ParoxetineHydrochloride30MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|308508-Bacitracin0.5UNT/MGOphthalmicOintment|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|1656346-sacubitril24MG/valsartan26MGOralTablet[Entresto]|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|1601407-0.5MLmeningococcalgroupBvaccine0.1MG/ML/NeisseriameningitidisserogroupBrecombinantFHBPfusionproteinantigen0.1MG/ML/Ne|IHSSCOBRA
636|1003|Y|N|Y||Preferred Generic|892646-MorphineSulfate200MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|308493-Bacitracin0.4UNT/MG/Neomycin0.0035MG/MG/PolymyxinB10UNT/MGOphthalmicOintment|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|1597103-0.5MLL1protein,Humanpapillomavirustype11Vaccine0.08MG/ML/L1protein,Humanpapillomavirustype16Vaccine0.12MG/ML/L1protei|IHSSCOBRA
636|1003|Y|N|Y||Preferred Generic|891893-MorphineSulfate60MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|Y|N|Y||Preferred Generic|891888-MorphineSulfate30MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|1597099-0.5MLL1protein,Humanpapillomavirustype11Vaccine0.08MG/ML/L1protein,Humanpapillomavirustype16Vaccine0.12MG/ML/L1protei|IHSSCOBRA
636|1003|Y|N|Y||Preferred Generic|891881-MorphineSulfate15MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|Y|N|Y||Preferred Generic|891874-MorphineSulfate100MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|850457-darunavir150MGOralTablet[Prezista]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1738495-ParoxetineHydrochloride20MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|308459-Azithromycin20MG/MLOralSuspension|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|1596445-7ACTUATumeclidinium0.0625MG/ACTUATDryPowderInhaler[Incruse]|IHSSCOBRA
636|1003|Y|N|Y||Preferred Generic|883826-TranexamicAcid650MGOralTablet|IHSSCOBRA
636|1003|Y|N|Y||Preferred Generic|860654-epinastinehydrochloride0.5MG/MLOphthalmicSolution|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|1593140-0.5MLNeisseriameningitidisserogroupBrecombinantLP2086A05proteinvariantantigen0.12MG/ML/Neisseriameningitidisserogroup|IHSSCOBRA
636|1003|Y|N|Y||Preferred Generic|835809-testosteroneenanthate200MG/MLInjectableSolution|IHSSCOBRA
636|1003|Y|N|Y||Preferred Generic|804544-difluprednate0.5MG/MLOphthalmicSuspension|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|308212-Ampicillin500MGOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|1549683-Xarelto30-DayStarterPackKit|IHSSCOBRA
636|1003|Y|N|Y||Preferred Generic|577033-sildenafil20MGOralTablet|IHSSCOBRA
636|1003|Y|N|Y||Preferred Generic|313451-Tretinoin0.00025MG/MGTopicalGel|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|1547582-0.5MLStreptococcuspneumoniaetype1capsularpolysaccharideantigen0.05MG/ML/Streptococcuspneumoniaetype10Acapsularpolysac|IHSSCOBRA
636|1003|Y|N|Y||Preferred Generic|313450-Tretinoin0.0001MG/MGTopicalGel|IHSSCOBRA
636|1003|Y|N|Y||Preferred Generic|310140-eprosartan600MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1738483-ParoxetineHydrochloride10MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|308194-Amoxicillin875MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|1364447-apixaban5MGOralTablet[Eliquis]|IHSSCOBRA
636|1003|Y|N|Y||Preferred Generic|245723-Tretinoin0.0005MG/MGTopicalGel|IHSSCOBRA
636|1003|Y|N|Y||Preferred Generic|198300-Tretinoin1MG/MLTopicalCream|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|1364441-apixaban2.5MGOralTablet[Eliquis]|IHSSCOBRA
636|1003|Y|N|Y||Preferred Generic|197636-dronabinol5MGOralCapsule|IHSSCOBRA
636|1003|Y|N|Y||Preferred Generic|197635-dronabinol2.5MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|308191-Amoxicillin500MGOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|1300468-0.5MLHaemophilusinfluenzaetypebstrain1482,capsularpolysaccharideinactivatedtetanustoxoidconjugatevaccine0.068MG/MLInj|IHSSCOBRA
636|1003|Y|N|Y||Preferred Generic|197634-dronabinol10MGOralCapsule|IHSSCOBRA
636|1003|Y|N|Y||Preferred Generic|106303-Tretinoin0.5MG/MLTopicalCream|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|1300378-0.5MLBordetellapertussisfilamentoushemagglutininvaccine,inactivated0.016MG/ML/Bordetellapertussispertactinvaccine,ina|IHSSCOBRA
636|1003|Y|N|Y||Preferred Generic|106302-Tretinoin0.25MG/MLTopicalCream|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|999996-Amlodipine5MG/Hydrochlorothiazide12.5MG/Olmesartanmedoxomil40MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|2055766-DORAVIRINE100MGOralTablet[Pifeltro]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|847749-lopinavir80MG/ML/Ritonavir20MG/MLOralSolution[Kaletra]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1731350-deferoxaminemesylate500MGInjection|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|308189-Amoxicillin80MG/MLOralSuspension|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|1300370-0.5MLBordetellapertussisfilamentoushemagglutininvaccine,inactivated0.016MG/ML/Bordetellapertussispertactinvaccine,ina|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|999991-Amlodipine10MG/Hydrochlorothiazide25MG/Olmesartanmedoxomil40MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|999986-Amlodipine10MG/Hydrochlorothiazide12.5MG/Olmesartanmedoxomil40MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|1300206-0.5MLBordetellapertussisfilamentoushemagglutininvaccine,inactivated0.01MG/ML/Bordetellapertussisfimbriae2/3vaccine,in|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|999967-Amlodipine5MG/Hydrochlorothiazide12.5MG/Olmesartanmedoxomil20MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|998189-everolimus2.5MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|308182-Amoxicillin250MGOralCapsule|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|1292459-0.5MLVaricella-ZosterVirusVaccineLive(Oka-Merck)strain2700UNT/MLInjection[Varivax]|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|997010-QuinineSulfate324MGOralCapsule|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|992395-gatifloxacin5MG/MLOphthalmicSolution|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|1190919-0.5MLdiphtheriatoxoidvaccine,inactivated4UNT/ML/tetanustoxoidvaccine,inactivated10UNT/MLPrefilledSyringe[Tenivac]|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|968766-PhentermineHydrochloride15MGOralCapsule|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|905347-DemeclocyclineHydrochloride300MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1731345-deferoxaminemesylate2000MGInjection|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|308177-Amoxicillin125MGChewableTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|1190916-0.5MLdiphtheriatoxoidvaccine,inactivated4UNT/ML/tetanustoxoidvaccine,inactivated10UNT/MLInjection[Tenivac]|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|905341-DemeclocyclineHydrochloride150MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|905172-ProtriptylineHydrochloride5MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|106892-insulinisophane,human70UNT/ML/insulin,regular,human30UNT/MLInjectableSuspension[Humulin]|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|905168-ProtriptylineHydrochloride10MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|904952-3MLibandronicacid1MG/MLPrefilledSyringe|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|308136-Amlodipine2.5MGOralTablet|IHSSCOBRA
636|1003|N|N|Y||Preferred Brand|1046920-Nicotine4MGInhalationSolution[Nicotrol]|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|903857-PyridostigmineBromide60MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|903847-PyridostigmineBromide180MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|999613-SulfacetamideSodium100MG/ML/Sulfur50MG/MLMedicatedLiquidSoap|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|903843-PyridostigmineBromide12MG/MLOralSolution|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|900164-24HRlamotrigine25MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|836368-200ACTUATIpratropiumBromide0.017MG/ACTUATMeteredDoseInhaler[Atrovent]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1725059-NaloxoneHydrochloride40MG/MLNasalSpray|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|308135-Amlodipine10MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|997501-Fexofenadinehydrochloride60MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|900156-24HRlamotrigine200MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|900038-PhentermineHydrochloride30MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|997420-Fexofenadinehydrochloride180MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|898715-pregabalin20MG/MLOralSolution|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|897021-12HRdalfampridine10MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|307730-Acyclovir40MG/MLOralSuspension|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|997226-Donepezilhydrochloride5MGDisintegratingOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|896272-120ACTUATFluticasonepropionate0.23MG/ACTUAT/salmeterol0.021MG/ACTUATMeteredDoseInhaler|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|896244-120ACTUATFluticasonepropionate0.115MG/ACTUAT/salmeterol0.021MG/ACTUATMeteredDoseInhaler|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|997220-Donepezilhydrochloride10MGDisintegratingOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|896236-120ACTUATFluticasonepropionate0.045MG/ACTUAT/salmeterol0.021MG/ACTUATMeteredDoseInhaler|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|886634-ButorphanolTartrate1MG/ACTUATMeteredDoseNasalSpray|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1665188-1MLLorazepam2MG/MLInjection|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|284988-Didanosine400MGDelayedReleaseOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|996824-MethylergonovineMaleate0.2MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|881341-adefovirdipivoxil10MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|876529-Amlodipine5MG/telmisartan80MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|996572-{21(Memantinehydrochloride10MGOralTablet)/28(Memantinehydrochloride5MGOralTablet)}Pack|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|876524-Amlodipine5MG/telmisartan40MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|876519-Amlodipine10MG/telmisartan80MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|284245-Famotidine40MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|996571-Memantinehydrochloride5MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|876514-Amlodipine10MG/telmisartan40MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|864769-MethadoneHydrochloride2MG/MLOralSolution|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|996561-Memantinehydrochloride10MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|864761-MethadoneHydrochloride1MG/MLOralSolution|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|864718-MethadoneHydrochloride5MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|150840-Estrogens,Conjugated(USP)0.625MGOralTablet[Premarin]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|205562-Estramustine140MGOralCapsule[Emcyt]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|831870-darunavir75MGOralTablet[Prezista]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1665050-Cefazolin1000MGInjection|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|284215-Clindamycin300MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|996520-DextromethorphanHydrobromide2MG/ML/Guaifenesin20MG/MLOralSolution|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|864706-MethadoneHydrochloride10MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|864681-Atovaquone62.5MG/proguanilhydrochloride25MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|995666-MeclizineHydrochloride25MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|864675-Atovaquone250MG/proguanilhydrochloride100MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|863038-bepotastinebesilate15MG/MLOphthalmicSolution|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|284184-Didanosine250MGDelayedReleaseOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|995624-MeclizineHydrochloride12.5MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|861960-armodafinil200MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|861597-PentamidineIsethionate50MG/MLInhalationSolution|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|995607-EthambutolHydrochloride400MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|861402-PhenoxybenzamineHydrochloride10MGOralCapsule|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|861375-sevelamercarbonate800MGPowderforOralSuspension|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1659263-1MLheparinsodium,porcine5000UNT/MLInjection|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|283858-ropinirole3MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|995599-EthambutolHydrochloride100MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|861370-sevelamercarbonate2400MGPowderforOralSuspension|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|860901-galantaminehydrobromide4MG/MLOralSolution|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|995281-HydroxyzineHydrochloride50MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|860771-Trimethobenzamidehydrochloride300MGOralCapsule|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|860103-KetorolacTromethamine4MG/MLOphthalmicSolution|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|283672-Citalopram10MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|995278-HydroxyzinePamoate50MGOralCapsule|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|857224-Sevelamerhydrochloride800MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|857216-Sevelamerhydrochloride400MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|995258-HydroxyzineHydrochloride25MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|855642-DiclofenacSodium0.03MG/MGTopicalGel|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|855626-Twice-Dailydiclofenacepolamine0.013MG/MGMedicatedPatch|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|830470-1MLrabiesvirusvaccinewistarstrainPM-1503-3M(Human),Inactivated2.5UNT/MLInjection[Imovax]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1655968-8MLMethotrexate25MG/MLInjection|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|283523-gabapentin50MG/MLOralSolution|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|995253-HydroxyzinePamoate25MGOralCapsule|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|850091-24HRlamotrigine50MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|850087-24HRlamotrigine100MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|995241-HydroxyzineHydrochloride2MG/MLOralSolution|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|848956-Ciprofloxacin2MG/MLOticSolution|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|848151-Amlodipine10MG/Hydrochlorothiazide25MG/valsartan160MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|283485-Mirtazapine45MGDisintegratingOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|995232-HydroxyzinePamoate100MGOralCapsule|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|848145-Amlodipine5MG/Hydrochlorothiazide25MG/valsartan160MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|848140-Amlodipine5MG/Hydrochlorothiazide12.5MG/valsartan160MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|995218-HydroxyzineHydrochloride10MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|848135-Amlodipine10MG/Hydrochlorothiazide25MG/valsartan320MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|848131-Amlodipine10MG/Hydrochlorothiazide12.5MG/valsartan160MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1648759-NITROFURANTOIN,MACROCRYSTALS100MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|283433-Melatonin10MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|993943-Acetaminophen325MG/butalbital50MG/Caffeine40MG/CodeinePhosphate30MGOralCapsule|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|845515-everolimus5MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|834241-febuxostat80MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|993856-lacosamide10MG/MLOralSolution|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|834235-febuxostat40MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|833234-mesalamine800MGDelayedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|283406-Mirtazapine15MGDisintegratingOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|993691-BupropionHydrochloride75MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|833213-dexlansoprazole60MGDelayedReleaseOralCapsule|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|833204-dexlansoprazole30MGDelayedReleaseOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|993687-BupropionHydrochloride100MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|824301-rufinamide400MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|824295-rufinamide200MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|2049677-cobicistat150MG/darunavir800MG/emtricitabine200MG/tenofoviralafenamide10MGOralTablet[Symtuza]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|830463-1MLrabiesvirusvaccineflury-lepstrain2.5UNT/MLInjection[RabAvert]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1648755-NITROFURANTOIN,MACROCRYSTALS25MG/Nitrofurantoin,Monohydrate75MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|283077-prednisolone3MG/MLOralSolution|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|993557-24HRBupropionHydrochloride300MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|810077-24HRFesoterodineFumarate8MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|810071-24HRFesoterodineFumarate4MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|993541-24HRBupropionHydrochloride150MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|803353-PhentermineHydrochloride37.5MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|802749-candesartancilexetil32MG/Hydrochlorothiazide25MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|282755-telmisartan20MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|993536-12HRBupropionHydrochloride200MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|794639-lubiprostone0.008MGOralCapsule|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|754508-{1(aprepitant125MGOralCapsule)/2(aprepitant80MGOralCapsule)}Pack|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|993518-12HRBupropionHydrochloride150MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|753441-9HRMethylphenidate3.33MG/HRTransdermalSystem|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|753440-9HRMethylphenidate2.22MG/HRTransdermalSystem|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1607990-{24(EthinylEstradiol0.025MG/Norethindrone0.8MGChewableTablet)/4(Ferrousfumarate75MGChewableTablet)}Pack|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|282401-lamotrigine25MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|993503-12HRBupropionHydrochloride100MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|753438-9HRMethylphenidate1.67MG/HRTransdermalSystem|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|753436-9HRMethylphenidate1.11MG/HRTransdermalSystem|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|992528-Terbinafinehydrochloride10MG/MLTopicalCream|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|728231-12HRranolazine1000MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|727339-0.5MLSumatriptan12MG/MLPrefilledSyringe|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|260376-Terazosin10MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|992475-PromethazineHydrochloride50MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|725023-24HRrivastigmine0.396MG/HRTransdermalSystem|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|725021-24HRrivastigmine0.192MG/HRTransdermalSystem|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|992447-PromethazineHydrochloride25MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|724863-armodafinil50MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|724861-armodafinil250MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|808118-prednisolone5MGOralTablet[MILLIPRED]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1547771-Tetracainehydrochloride5MG/MLOphthalmicSolution|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|260243-Progesterone100MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|992438-PromethazineHydrochloride12.5MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|724859-armodafinil150MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|722122-ambrisentan5MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|992432-PromethazineHydrochloride1.25MG/MLOralSolution|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|722116-ambrisentan10MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|705824-100MLzoledronicacid0.05MG/MLInjection|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|259966-Methylprednisolone4MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|992184-methenaminemandelate500MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|700885-temozolomide180MGOralCapsule|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|700883-temozolomide140MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|992153-methenaminemandelate1000MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|672149-lapatinib250MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|656659-bosentan125MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|152695-meloxicam15MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|259255-atorvastatin80MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|991336-Chlorpromazinehydrochloride50MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|644088-aprepitant40MGOralCapsule|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|643720-lenalidomide25MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|991194-Chlorpromazinehydrochloride25MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|643712-lenalidomide15MGOralCapsule|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|642452-lanthanumcarbonate750MGChewableTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|2532159-PMDDfluoxetine10MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|991188-Chlorpromazinehydrochloride200MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|639537-candesartancilexetil32MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|636664-rasagiline0.5MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|991086-DicyclomineHydrochloride20MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|616749-12HRranolazine500MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|616578-lubiprostone0.024MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|1000499-Prempro0.625/2.528DayPack|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|105551-Busulfan2MGOralTablet[Myleran]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|1149647-CoalTar0.02MG/MGTopicalOintment[MG217Psoriasis]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|1490063-Levonorgestrel1.5MGOralTablet[TakeAction]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|2045382-30ACTUATfluticasonefuroate0.05MG/ACTUATDryPowderInhaler[Arnuity]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|807283-Levonorgestrel0.000833MG/HRIntrauterineSystem[Mirena]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|151226-topiramate50MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|253039-Melatonin1MG/MLOralSolution|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|991061-DicyclomineHydrochloride10MGOralCapsule|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|608328-rasagiline1MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|603208-erlotinib25MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|991044-Chlorpromazinehydrochloride100MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|603206-erlotinib150MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|603203-erlotinib100MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|251322-Ethosuximide50MG/MLOralSolution|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|991039-Chlorpromazinehydrochloride10MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|602912-lenalidomide5MGOralCapsule|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|602910-lenalidomide10MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|979471-Hydrochlorothiazide25MG/LosartanPotassium100MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|602635-lanthanumcarbonate1000MGChewableTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|597772-deferasirox500MGTabletforOralSuspension|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|151029-mometasonefuroate0.001MG/MGTopicalOintment|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|248420-mesalamine1000MGRectalSuppository|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|979468-Hydrochlorothiazide12.5MG/LosartanPotassium50MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|597770-deferasirox250MGTabletforOralSuspension|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|597768-deferasirox125MGTabletforOralSuspension|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|979464-Hydrochlorothiazide12.5MG/LosartanPotassium100MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|597747-sorafenib200MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|579148-Galantamine12MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|248109-Ribavirin200MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|979092-HydroxychloroquineSulfate200MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|578330-candesartancilexetil32MG/Hydrochlorothiazide12.5MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|578325-candesartancilexetil16MG/Hydrochlorothiazide12.5MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|977880-AmilorideHydrochloride5MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|578018-bromfenac0.9MG/MLOphthalmicSolution|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|577776-candesartancilexetil16MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|762002-Mircette28DayPack|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1440184-hydrocortisoneacetate0.01MG/MGTopicalOintment|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|245314-Albuterol5MG/MLInhalationSolution|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|966248-LevothyroxineSodium0.112MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|577348-ramelteon8MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|577057-72HRFentanyl0.012MG/HRTransdermalSystem|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|96304-Primidone250MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|562266-Clindamycin15MG/MLOralSolution|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|545835-LeuprolideAcetate5MG/MLInjectableSolution|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|244967-PolymyxinB10000UNT/ML/Trimethoprim1MG/MLOphthalmicSolution|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|905395-HydralazineHydrochloride50MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|485489-Temazepam22.5MGOralCapsule|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|485436-entecavir1MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|905377-HydralazineHydrochloride37.5MG/IsosorbideDinitrate20MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|485434-entecavir0.5MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|485423-24HRdarifenacin7.5MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1437702-Albuterol0.833MG/ML/IpratropiumBromide0.167MG/MLInhalationSolution|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|242680-abacavir20MG/MLOralSolution|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|905283-TrihexyphenidylHydrochloride5MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|485421-24HRdarifenacin15MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|477347-lanthanumcarbonate500MGChewableTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|905273-TrihexyphenidylHydrochloride0.4MG/MLOralSolution|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|477130-Hydrochlorothiazide25MG/telmisartan80MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|476362-mesalamine500MGExtendedReleaseOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|242679-abacavir300MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|905269-TrihexyphenidylHydrochloride2MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|465355-voriconazole40MG/MLOralSuspension|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|403930-Isotretinoin30MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|905225-HydralazineHydrochloride25MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|403879-imatinib400MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|403878-imatinib100MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|2043322-1.33MLibalizumab-uiyk150MG/MLInjection[Trogarzo]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|759473-20ACTUATZanamivir5MG/ACTUATDryPowderInhaler[Relenza]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1426600-{24(EthinylEstradiol0.02MG/norethindroneacetate1MGChewableTablet)/4(Ferrousfumarate75MGOralTablet)}Pack|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|242446-Ofloxacin3MG/MLOticSolution|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|905222-HydralazineHydrochloride100MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|403818-moxifloxacin5MG/MLOphthalmicSolution|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|403811-aprepitant125MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|905199-HydralazineHydrochloride10MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|351276-Oxandrolone10MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|351109-Budesonide0.25MG/MLInhalationSuspension|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|241834-cyclosporine,modified100MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|905158-Sirolimus0.5MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|349435-voriconazole50MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|349434-voriconazole200MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|904932-ibandronicacid150MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|349410-Treprostinil5MG/MLInjectableSolution|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|349409-Treprostinil2.5MG/MLInjectableSolution|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1421461-{24(EthinylEstradiol0.02MG/norethindroneacetate1MGOralCapsule)/4(Ferrousfumarate75MGOralCapsule)}Pack|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|240209-Betamethasone0.5MG/MLTopicalLotion|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|904481-PravastatinSodium80MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|349408-Treprostinil10MG/MLInjectableSolution|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|349407-Treprostinil1MG/MLInjectableSolution|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|904475-PravastatinSodium40MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|349253-bosentan62.5MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|349094-Budesonide0.125MG/MLInhalationSuspension|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|240029-Cholecalciferol0.125MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|904467-PravastatinSodium20MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|348719-Tobramycin60MG/MLInhalationSolution|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|318179-ergoloidmesylates,USP1MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|904458-PravastatinSodium10MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|317160-temozolomide100MGOralCapsule|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|314153-orlistat120MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|748857-Yasmin28DayPack|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|141963-Azithromycin40MG/MLOralSuspension|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|239238-Griseofulvin25MG/MLOralSuspension|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|904431-Alendronicacid70MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|313472-Trientinehydrochloride250MGOralCapsule|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|313447-Tranylcypromine10MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|904396-Alendronicacid35MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|313211-temozolomide5MGOralCapsule|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|313210-temozolomide250MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|239191-Amoxicillin50MG/MLOralSuspension|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|903891-FluvoxamineMaleate50MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|313209-temozolomide20MGOralCapsule|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|313165-0.5MLSumatriptan12MG/MLInjection|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|903887-FluvoxamineMaleate25MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|311204-Itraconazole100MGOralCapsule|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|310599-Granisetron1MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|141935-Haloperidol2MG/MLOralSolution|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|238920-Betamethasone0.5MG/MLTopicalCream|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|903884-FluvoxamineMaleate100MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|310437-Galantamine8MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|310436-Galantamine4MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|903703-liothyroninesodium0.05MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|308429-Atovaquone150MG/MLOralSuspension|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|308345-apraclonidine5MG/MLOphthalmicSolution|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|238600-seleniumsulfide25MG/MLMedicatedShampoo|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|903697-liothyroninesodium0.025MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|283317-Hydrochlorothiazide12.5MG/telmisartan80MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|283316-Hydrochlorothiazide12.5MG/telmisartan40MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|903456-liothyroninesodium0.005MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|2606490-pirfenidone534MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|260218-modafinil100MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|1433879-dolutegravir50MGOralTablet[Tivicay]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|202301-Estrogens,Conjugated(USP)1.25MGOralTablet[Premarin]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|748856-Yaz28DayPack|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1376336-prednisoloneacetate10MG/MLOphthalmicSuspension|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|238154-Acetaminophen325MG/butalbital50MG/Caffeine40MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|900575-Ritonavir100MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|252559-Budesonide0.5MG/MLInhalationSuspension|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|250820-Vigabatrin500MGPowderforOralSolution|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|898723-Benazeprilhydrochloride5MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|245136-72HRFentanyl0.1MG/HRTransdermalSystem|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|245135-72HRFentanyl0.05MG/HRTransdermalSystem|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|238151-mesalamine66.7MG/MLEnema|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|898719-Benazeprilhydrochloride40MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|245134-72HRFentanyl0.025MG/HRTransdermalSystem|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|240912-Granisetron1MG/MLInjectableSolution|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|898690-Benazeprilhydrochloride20MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|2123194-PulmonaryHypertensiontadalafil20MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|2105413-3MLNeostigmineMethylsulfate1MG/MLPrefilledSyringe|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1373745-24HRNevirapine100MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|237776-vitaminB121MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|898687-Benazeprilhydrochloride10MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|2056929-5MLpalonosetron0.05MG/MLPrefilledSyringe|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|205328-Lamivudine100MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|898378-Benazeprilhydrochloride5MG/Hydrochlorothiazide6.25MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|205324-modafinil200MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|205316-topiramate15MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|237723-Ergocalciferol0.2MG/MLOralSolution|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|898372-Benazeprilhydrochloride20MG/Hydrochlorothiazide25MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|205315-topiramate25MGOralCapsule|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|200328-capecitabine500MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|898367-Benazeprilhydrochloride20MG/Hydrochlorothiazide12.5MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|200327-capecitabine150MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|200220-tolcapone100MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|744846-raltegravir400MGOralTablet[ISENTRESS]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1373503-{7(EthinylEstradiol0.01MGOralTablet)/42(EthinylEstradiol0.02MG/Levonorgestrel0.15MGOralTablet)/21(EthinylEstradiol0.0|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|226343-Dexamethasonephosphate1MG/MLOphthalmicSolution|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|898362-Benazeprilhydrochloride10MG/Hydrochlorothiazide12.5MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|199672-Albendazole200MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|199521-Vigabatrin500MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|898359-Amlodipine5MG/Benazeprilhydrochloride40MGOralCapsule|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1988980-24HRpregabalin82.5MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1988977-24HRpregabalin330MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|206842-IsosorbideDinitrate20MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|898356-Amlodipine5MG/Benazeprilhydrochloride20MGOralCapsule|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1988974-24HRpregabalin165MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|198243-Temazepam7.5MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|898353-Amlodipine5MG/Benazeprilhydrochloride10MGOralCapsule|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|198228-Sulfadiazine500MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|198200-Rifabutin150MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1367436-21DAYEthinylEstradiol0.000625MG/HR/Etonogestrel0.005MG/HRVaginalSystem|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|205305-telmisartan80MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|898350-Amlodipine2.5MG/Benazeprilhydrochloride10MGOralCapsule|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|198182-Pyrimethamine25MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|198070-Penicillamine250MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|898346-Amlodipine10MG/Benazeprilhydrochloride40MGOralCapsule|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|198056-Oxandrolone2.5MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|197975-Methyltestosterone10MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|205304-telmisartan40MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|898342-Amlodipine10MG/Benazeprilhydrochloride20MGOralCapsule|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|197929-Meprobamate400MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|197928-Meprobamate200MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|897722-Verapamilhydrochloride40MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|197845-Isotretinoin40MGOralCapsule|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|197844-Isotretinoin20MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|2003255-Lamivudine300MG/Tenofovirdisoproxilfumarate300MGOralTablet[Cimduo]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|723827-fosamprenavir50MG/MLOralSuspension[Lexiva]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1367410-Ergocalciferol1.25MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|205292-efavirenz50MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|897683-Verapamilhydrochloride80MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|197843-Isotretinoin10MGOralCapsule|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|197730-Furosemide10MG/MLOralSolution|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|897666-Verapamilhydrochloride120MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|197696-72HRFentanyl0.075MG/HRTransdermalSystem|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|197556-Danazol50MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|205290-efavirenz200MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|897659-Verapamilhydrochloride120MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|197555-Danazol200MGOralCapsule|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|197554-Danazol100MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|897649-Verapamilhydrochloride240MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|197366-Amoxapine50MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|197365-Amoxapine25MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1362720-MexiletineHydrochloride250MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|205285-leflunomide20MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|897640-Verapamilhydrochloride180MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|197364-Amoxapine150MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|197363-Amoxapine100MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|897624-24HRVerapamilhydrochloride240MGExtendedReleaseOralCapsule|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1947301-2MLpalonosetron0.125MG/MLInjection|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1923828-deferasirox180MGOralGranules|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|205284-leflunomide10MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|897618-24HRVerapamilhydrochloride180MGExtendedReleaseOralCapsule|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1923826-deferasirox360MGOralGranules|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1923822-deferasirox90MGOralGranules|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|897612-24HRVerapamilhydrochloride120MGExtendedReleaseOralCapsule|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1918042-abirateroneacetate500MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1874559-24HRdesvenlafaxinesuccinate50MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|705008-Cefixime40MG/MLOralSuspension[Suprax]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1362712-MexiletineHydrochloride200MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|204844-Azithromycin600MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|897596-24HRVerapamilhydrochloride300MGExtendedReleaseOralCapsule|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1874553-24HRdesvenlafaxinesuccinate100MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1868018-pirfenidone801MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|897590-24HRVerapamilhydrochloride200MGExtendedReleaseOralCapsule|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1868014-pirfenidone267MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1860157-Abuse-Deterrent12HROxycodoneHydrochloride10MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|204423-Hydrocortisone10MG/ML/Neomycin3.5MG/ML/PolymyxinB10000UNT/MLOticSolution|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|897584-24HRVerapamilhydrochloride100MGExtendedReleaseOralCapsule|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1860148-Abuse-Deterrent12HROxycodoneHydrochloride80MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1860137-Abuse-Deterrent12HROxycodoneHydrochloride40MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|896766-Labetalolhydrochloride300MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1860129-Abuse-Deterrent12HROxycodoneHydrochloride20MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1811180-icosapentethyl500MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1362706-MexiletineHydrochloride150MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|204135-Desonide0.0005MG/MGTopicalOintment|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|896762-Labetalolhydrochloride200MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1799212-sofosbuvir400MG/velpatasvir100MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1793916-0.5MLSumatriptan8MG/MLAuto-Injector|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|896758-Labetalolhydrochloride100MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1745091-Lidocaine0.05MG/MGMedicatedPatch|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1737461-PamidronateDisodium90MGInjection|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|203105-Hydrocortisone0.01MG/MGTopicalOintment|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|896004-120ACTUATFluticasonepropionate0.22MG/ACTUATMeteredDoseInhaler|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1737459-PamidronateDisodium30MGInjection|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1734399-1MLGranisetron1MG/MLInjection|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|895999-120ACTUATFluticasonepropionate0.11MG/ACTUATMeteredDoseInhaler|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1731077-fosaprepitant150MGInjection|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1728055-5MLpalonosetron0.05MG/MLInjection|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|1147337-emtricitabine200MG/Rilpivirine25MG/Tenofovirdisoproxilfumarate300MGOralTablet[Complera]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|1426601-Minastrin24FeChewable28DayPack|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|1999673-bictegravir50MG/emtricitabine200MG/tenofoviralafenamide25MGOralTablet[Biktarvy]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|688242-Estrogens,Conjugated(USP)0.625MG/MLVaginalCream[Premarin]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1360304-Budesonide0.08MG/ACTUAT/formoterolfumarate0.0045MG/ACTUATMeteredDoseInhaler|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|200371-Citalopram20MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|895994-120ACTUATFluticasonepropionate0.044MG/ACTUATMeteredDoseInhaler|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1657173-0.5MLSumatriptan8MG/MLCartridge|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1657160-0.5MLSumatriptan12MG/MLCartridge|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|895987-Fluticasonepropionate0.5MG/MLTopicalCream|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1648788-30ACTUATfluticasonefuroate0.2MG/ACTUAT/vilanterol0.025MG/ACTUATDryPowderInhaler|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1607796-deferasirox90MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|200346-cefdinir300MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|895487-Fluticasonepropionate0.00005MG/MGTopicalOintment|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1607792-deferasirox360MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1607784-deferasirox180MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|886671-FlecainideAcetate150MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1607617-24HRdesvenlafaxinesuccinate25MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1599949-60ACTUATTestosterone30MG/ACTUATTopicalSolution|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1359861-Budesonide0.16MG/ACTUAT/formoterolfumarate0.0045MG/ACTUATMeteredDoseInhaler|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|200257-repaglinide0.5MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|886666-FlecainideAcetate100MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1597129-5000MGTestosterone0.01MG/MGTopicalGel|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1596779-14ACTUATBudesonide2MG/ACTUATRectalFoam|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|886662-FlecainideAcetate50MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1592279-pirfenidone267MGOralCapsule|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1591943-ledipasvir90MG/sofosbuvir400MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|200256-repaglinide1MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|885857-Balsalazidedisodium750MGOralCapsule|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1550940-Colchicine0.6MGOralCapsule|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1547565-Isotretinoin35MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|885219-benztropinemesylate0.5MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1547561-Isotretinoin25MGOralCapsule|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|153823-candesartancilexetil8MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|644304-Tamoxifen2MG/MLOralSolution[Soltamox]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1359859-Fluticasonepropionate0.25MG/ACTUAT/salmeterol0.05MG/ACTUATDryPowderInhaler|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|2001424-efavirenz400MG/Lamivudine300MG/Tenofovirdisoproxilfumarate300MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|885213-benztropinemesylate1MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|153822-candesartancilexetil4MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1487361-1MLglatirameracetate40MG/MLPrefilledSyringe|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|885209-benztropinemesylate2MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1487074-DiclofenacSodium20MG/MLTopicalSolution|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1437969-Cyclophosphamide50MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|200133-12HRCarbamazepine200MGExtendedReleaseOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|884707-Estradiol0.01MGVaginalInsert|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1437968-Cyclophosphamide25MGOralCapsule|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1428947-lenalidomide20MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|884308-Nystatin100UNT/MGTopicalOintment|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1424899-14ACTUATfluticasonefuroate0.1MG/ACTUAT/vilanterol0.025MG/ACTUATDryPowderInhaler|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1373497-{14(dimethylfumarate120MGDelayedReleaseOralCapsule)/46(dimethylfumarate240MGDelayedReleaseOralCapsule)}Pack|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1359858-Fluticasonepropionate0.5MG/ACTUAT/salmeterol0.05MG/ACTUATDryPowderInhaler|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|200132-Acarbose25MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|884189-ClonidineHydrochloride0.3MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1373491-dimethylfumarate240MGDelayedReleaseOralCapsule|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1373483-dimethylfumarate120MGDelayedReleaseOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|884185-ClonidineHydrochloride0.2MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1366550-24HRBudesonide9MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1310533-teriflunomide7MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|200131-12HRCarbamazepine300MGExtendedReleaseOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|884173-ClonidineHydrochloride0.1MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1310525-teriflunomide14MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1308569-24HRrivastigmine0.554MG/HRTransdermalSystem|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|866924-MetoprololTartrate25MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1307427-sildenafil10MG/MLOralSuspension|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1307061-Buprenorphine12MG/Naloxone3MGSublingualFilm|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|1999026-Balcoltra28DayPack|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|617333-Amoxicillin25MG/ML/Clavulanate6.25MG/MLOralSuspension[Augmentin]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1359779-Fluticasonepropionate0.1MG/ACTUAT/salmeterol0.05MG/ACTUATDryPowderInhaler|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|200082-Lamivudine150MG/Zidovudine300MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|866514-MetoprololTartrate50MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1307056-Buprenorphine4MG/Naloxone1MGSublingualFilm|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1304979-icosapentethyl1000MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|866511-MetoprololTartrate100MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1299917-Tiagabinehydrochloride4MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1299911-Tiagabinehydrochloride2MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|200064-letrozole2.5MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|866436-24HRmetoprololsuccinate50MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1299909-Tiagabinehydrochloride16MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1299903-Tiagabinehydrochloride12MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|866427-24HRmetoprololsuccinate25MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1291085-hydrocortisoneacetate30MGRectalSuppository|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1251903-EthacrynicAcid25MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1359132-{5(EthinylEstradiol0.02MG/norethindroneacetate1MGOralTablet)/7(EthinylEstradiol0.03MG/norethindroneacetate1MGOralTabl|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|200060-mycophenolatemofetil500MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|866419-24HRmetoprololsuccinate200MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1242231-lenalidomide2.5MGOralCapsule|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1146690-24HRlamotrigine250MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|866412-24HRmetoprololsuccinate100MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1119400-everolimus7.5MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1111641-1MLglatirameracetate20MG/MLPrefilledSyringe|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|200033-carvedilol25MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|866144-Cyproheptadinehydrochloride4MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1100075-abirateroneacetate250MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1098608-24HRlamotrigine300MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|866111-buspironehydrochloride7.5MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1095229-FlavoxateHydrochloride100MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1092357-rufinamide40MG/MLOralSuspension|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|616444-mycophenolatemofetil200MG/MLOralSuspension[Cellcept]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1359028-{21(EthinylEstradiol0.03MG/norethindroneacetate1.5MGOralTablet)}Pack|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|200032-carvedilol12.5MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|866094-buspironehydrochloride5MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1091839-Roflumilast0.5MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1085728-TriamcinoloneAcetonide0.001MG/MGOralPaste|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|866090-buspironehydrochloride30MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1012895-fingolimod0.5MGOralCapsule|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1011739-aliskiren300MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|200031-carvedilol6.25MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|866083-buspironehydrochloride10MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1011736-aliskiren150MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1010604-Buprenorphine8MG/Naloxone2MGSublingualFilm|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|866021-Cyproheptadinehydrochloride0.4MG/MLOralSolution|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1010600-Buprenorphine2MG/Naloxone0.5MGSublingualFilm|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1001004-PilocarpineHydrochloride7.5MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1359023-{21(EthinylEstradiol0.03MG/norethindroneacetate1.5MGOralTablet)/7(Ferrousfumarate75MGOralTablet)}Pack|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|199903-Hydrochlorothiazide12.5MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|866018-buspironehydrochloride15MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1000913-PilocarpineHydrochloride5MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Generic|1000001-Amlodipine5MG/Hydrochlorothiazide25MG/Olmesartanmedoxomil40MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|865123-FluphenazineHydrochloride2.5MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|996633-NamendaXR28DayTitrationPack|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|993456-1MLdenosumab60MG/MLPrefilledSyringe[Prolia]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|199890-topiramate200MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|865117-FluphenazineHydrochloride1MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|979115-0.6MLMethylnaltrexonebromide20MG/MLInjection[Relistor]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|903855-2MLPyridostigmineBromide5MG/MLInjection[Regonol]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|864661-efavirenz600MG/Lamivudine300MG/Tenofovirdisoproxilfumarate300MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|901614-Aztreonam75MG/MLInhalationSolution[Cayston]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|897126-3MLliraglutide6MG/MLPenInjector[Victoza]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|1373504-Quartette91-DayPack|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|1998774-Breath-Actuated120ACTUATBeclomethasoneDipropionate0.04MG/ACTUATMeteredDoseInhaler[Qvar]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|616148-emtricitabine10MG/MLOralSolution[Emtriva]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1358776-{21(EthinylEstradiol0.02MG/norethindroneacetate1MGOralTablet)}Pack|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|199889-topiramate100MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|863669-Tamsulosinhydrochloride0.4MGOralCapsule|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|884619-eltrombopag75MGOralTablet[Promacta]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|867506-pazopanib200MGOralTablet[Votrient]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|863664-Oxybutyninchloride5MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|864820-Oxybutyninchloride0.1MG/MGTopicalGel[Gelnique]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|864110-1.5MLSomatropin3.3MG/MLCartridge[Omnitrope]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|199888-topiramate25MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|863636-24HROxybutyninchloride5MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|861966-Iloprost0.02MG/MLInhalationSolution[Ventavis]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|861045-1.5MLpramlintideacetate1MG/MLPenInjector[Symlin]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|863628-24HROxybutyninchloride15MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|861043-2.7MLpramlintideacetate1MG/MLPenInjector[Symlin]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|860244-interferonbeta-1b0.3MGInjection[Extavia]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1358763-{21(EthinylEstradiol0.02MG/norethindroneacetate1MGOralTablet)/7(Ferrousfumarate75MGOralTablet)}Pack|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|199885-Levofloxacin500MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|863619-24HROxybutyninchloride10MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|858366-KetorolacTromethamine4.5MG/MLOphthalmicSolution[Acuvail]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|858074-0.25MLpaliperidonepalmitate156MG/MLPrefilledSyringe[Invega]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|863599-Oxybutyninchloride1MG/MLOralSolution|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|858057-0.75MLpaliperidonepalmitate156MG/MLPrefilledSyringe[Invega]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|858055-1MLpaliperidonepalmitate156MG/MLPrefilledSyringe[Invega]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|199884-Levofloxacin250MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|861848-FluphenazineHydrochloride5MG/MLOralSolution|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|858053-1.5MLpaliperidonepalmitate156MG/MLPrefilledSyringe[Invega]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|858051-0.5MLpaliperidonepalmitate156MG/MLPrefilledSyringe[Invega]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|861753-Glyburide5MG/Metforminhydrochloride500MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|858044-saxagliptin2.5MGOralTablet[Onglyza]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|858040-saxagliptin5MGOralTablet[Onglyza]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|608934-Metronidazole0.0075MG/MGVaginalGel[Vandazole]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1298066-Cyclopentolatehydrochloride10MG/MLOphthalmicSolution|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|199703-cabergoline0.5MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|861748-Glyburide2.5MG/Metforminhydrochloride500MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|857799-Treprostinil0.6MG/MLInhalationSolution[Tyvaso]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|856666-rifaximin550MGOralTablet[XIFAXAN]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|861743-Glyburide1.25MG/Metforminhydrochloride250MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|854852-lisdexamfetaminedimesylate50MGOralCapsule[Vyvanse]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|854848-lisdexamfetaminedimesylate60MGOralCapsule[Vyvanse]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|199663-Zidovudine300MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|861657-24HRNitroglycerin0.1MG/HRTransdermalSystem|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|854844-lisdexamfetaminedimesylate70MGOralCapsule[Vyvanse]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|854840-lisdexamfetaminedimesylate40MGOralCapsule[Vyvanse]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|861495-ClobetasolPropionate0.5MG/MLTopicalCream|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|854836-lisdexamfetaminedimesylate30MGOralCapsule[Vyvanse]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|854832-lisdexamfetaminedimesylate20MGOralCapsule[Vyvanse]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1291082-hydrocortisoneacetate25MGRectalSuppository|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|199425-Melatonin1MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|861448-ClobetasolPropionate0.0005MG/MGTopicalOintment|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|854302-1.5MLSomatropin6.67MG/MLCartridge[Omnitrope]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|853356-1MLustekinumab90MG/MLPrefilledSyringe[Stelara]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|861430-PropafenoneHydrochloride300MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|853354-0.5MLustekinumab90MG/MLPrefilledSyringe[Stelara]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|849599-1MLcertolizumabpegol200MG/MLPrefilledSyringe[Cimzia]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|199422-Nevirapine200MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|861427-PropafenoneHydrochloride225MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|848164-0.5MLgolimumab100MG/MLPrefilledSyringe[Simponi]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|847917-60ACTUATexenatide0.005MG/ACTUATPenInjector[Byetta]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|861424-PropafenoneHydrochloride150MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|847913-60ACTUATexenatide0.01MG/ACTUATPenInjector[Byetta]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|845512-everolimus10MGOralTablet[Afinitor]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|1998772-Breath-Actuated120ACTUATBeclomethasoneDipropionate0.08MG/ACTUATMeteredDoseInhaler[Qvar]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|603378-tipranavir250MGOralCapsule[Aptivus]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1252016-Viorele28DayPack|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|199390-Etodolac500MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|861416-Azithromycin1000MGPowderforOralSuspension|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|828703-1.2MLPlerixafor20MG/MLInjection[Mozobil]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|828696-Zolpidemtartrate5MG/ACTUATOralSpray[Zolpimist]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|861200-Brimonidinetartrate2MG/MLOphthalmicSolution|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|828364-hydrocortisoneacetate10MG/ML/Pramoxinehydrochloride10MG/MLRectalFoam[Proctofoam-HC]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|825429-eltrombopag50MGOralTablet[Promacta]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|199387-Risperidone1MG/MLOralSolution|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|861171-12HRPropafenoneHydrochloride425MGExtendedReleaseOralCapsule|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|825425-eltrombopag25MGOralTablet[Promacta]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|825170-HumiraPen40MG/0.8ML-Crohn'sDiseaseStarterPack|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|861164-12HRPropafenoneHydrochloride325MGExtendedReleaseOralCapsule|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|809159-0.5MLEtanercept50MG/MLPrefilledSyringe[Enbrel]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|802652-1MLEtanercept50MG/MLPrefilledSyringe[Enbrel]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1250490-hydrocortisoneacetate5MG/MLTopicalCream|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|199378-12HRCarbamazepine100MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|861156-12HRPropafenoneHydrochloride225MGExtendedReleaseOralCapsule|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|799830-dasatinib100MGOralTablet[Sprycel]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|795749-RebifTitrationPack|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|861132-24HRAlfuzosinhydrochloride10MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|795085-certolizumabpegol200MGInjection[Cimzia]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|763106-poliovirusvaccineinactivated,type1(Mahoney)80UNT/ML/poliovirusvaccineinactivated,type2(MEF-1)16UNT/ML/poliovirusvaccin|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|199353-trandolapril1MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|861064-Sertraline20MG/MLOralSolution|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|758032-0.5MLInterferonbeta-1a0.044MG/MLPrefilledSyringe[Rebif]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|758027-0.5MLInterferonbeta-1a0.088MG/MLPrefilledSyringe[Rebif]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|861010-Metforminhydrochloride850MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|751970-0.5MLInterferongamma-1b0.2MG/MLInjection[Actimmune]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|748740-Topotecan1MGOralCapsule[Hycamtin]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|542370-Nelfinavir625MGOralTablet[Viracept]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1245919-Marlissa28DayPack|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|199352-trandolapril4MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|861007-Metforminhydrochloride500MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|748738-Topotecan0.25MGOralCapsule[Hycamtin]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|746609-nilotinib200MGOralCapsule[Tasigna]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|861004-Metforminhydrochloride1000MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|731328-0.5MLpeginterferonalfa-2a0.36MG/MLPrefilledSyringe[Pegasys]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|731250-0.3MLdarbepoetinalfa0.2MG/MLPrefilledSyringe[Aranesp]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|199351-trandolapril2MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|860981-24HRMetforminhydrochloride750MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|731245-0.42MLdarbepoetinalfa0.06MG/MLPrefilledSyringe[Aranesp]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|731241-1MLdarbepoetinalfa0.5MG/MLPrefilledSyringe[Aranesp]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|860975-24HRMetforminhydrochloride500MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|731235-0.4MLdarbepoetinalfa0.5MG/MLPrefilledSyringe[Aranesp]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|731231-0.3MLdarbepoetinalfa0.5MG/MLPrefilledSyringe[Aranesp]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1243585-Flurbiprofensodium0.3MG/MLOphthalmicSolution|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|199247-glimepiride4MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|860918-FluphenazineHydrochloride5MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|731229-0.6MLdarbepoetinalfa0.5MG/MLPrefilledSyringe[Aranesp]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|731227-0.4MLdarbepoetinalfa0.1MG/MLPrefilledSyringe[Aranesp]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|860805-Azelastinehydrochloride0.5MG/MLOphthalmicSolution|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|730046-0.5MLdarbepoetinalfa0.2MG/MLPrefilledSyringe[Aranesp]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|727816-0.5MLInterferonbeta-1a0.06MG/MLPrefilledSyringe[Avonex]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|199246-glimepiride2MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|860225-MegestrolAcetate40MG/MLOralSuspension|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|727714-0.67MLanakinra149MG/MLPrefilledSyringe[Kineret]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|727705-0.8MLadalimumab50MG/MLPrefilledSyringe[Humira]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|860221-MegestrolAcetate40MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|724156-24HRRotigotine0.25MG/HRTransdermalSystem[Neupro]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|724142-24HRRotigotine0.167MG/HRTransdermalSystem[Neupro]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|1048452-ColestipolHydrochloride5000MGGranulesforOralSuspension[Colestid]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|1113046-amylase15000UNT/lipase3000UNT/protease9500UNTDelayedReleaseOralCapsule[Creon]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|1373327-amylase180000UNT/lipase36000UNT/protease114000UNTDelayedReleaseOralCapsule[Creon]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|1995479-amylase168000UNT/lipase40000UNT/protease126000UNTDelayedReleaseOralCapsule[Zenpep]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|404550-Estrogens,Conjugated(USP)0.45MGOralTablet[Premarin]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1242787-Alyacen7/7/7Kit|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|199245-glimepiride1MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|860215-MegestrolAcetate20MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|723846-orlistat60MGOralCapsule[Alli]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|722256-24HRRotigotine0.0833MG/HRTransdermalSystem[Neupro]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|859841-FluphenazineHydrochloride10MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|706872-Azithromycin10MG/MLOphthalmicSolution[AzaSite]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|706831-Risperidone25MGInjection[Risperdal]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|199224-anastrozole1MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|859835-FluphenazineHydrochloride0.5MG/MLOralSolution|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|706829-Risperidone50MGInjection[Risperdal]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|706827-Risperidone37.5MGInjection[Risperdal]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|859751-Rosuvastatincalcium20MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|706825-Risperidone12.5MGInjection[Risperdal]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|700418-Thalidomide150MGOralCapsule[Thalomid]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1242786-Alyacen1/3528-DayKit|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|199193-famciclovir250MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|859747-Rosuvastatincalcium10MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|668606-Vorinostat100MGOralCapsule[Zolinza]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|645884-Somatropin5MG/MLInjectableSolution[Omnitrope]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|859424-Rosuvastatincalcium5MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|643722-lenalidomide25MGOralCapsule[Revlimid]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|643714-lenalidomide15MGOralCapsule[Revlimid]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|199192-famciclovir125MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|859419-Rosuvastatincalcium40MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|643177-dasatinib70MGOralTablet[Sprycel]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|643175-dasatinib50MGOralTablet[Sprycel]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|859193-selegilinehydrochloride5MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|643173-dasatinib20MGOralTablet[Sprycel]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|616292-sunitinib50MGOralCapsule[Sutent]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|404492-5MLLaronidase0.58MG/MLInjection[Aldurazyme]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1234571-PhenylephrineHydrochloride100MG/MLOphthalmicSolution|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|199168-Phenobarbital64.8MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|859186-selegilinehydrochloride5MGOralCapsule|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|616287-sunitinib25MGOralCapsule[Sutent]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|616283-sunitinib12.5MGOralCapsule[Sutent]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|858828-EnalaprilMaleate10MG/Hydrochlorothiazide25MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|616116-lenalidomide5MGOralCapsule[Revlimid]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|616114-lenalidomide10MGOralCapsule[Revlimid]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|199167-Phenobarbital32.4MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|858824-EnalaprilMaleate5MG/Hydrochlorothiazide12.5MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|616018-abatacept250MGInjection[Orencia]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|607579-entecavir0.05MG/MLOralSolution[Baraclude]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|858817-EnalaprilMaleate10MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|603978-nepafenac1MG/MLOphthalmicSuspension[Nevanac]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|582595-Iloprost0.01MG/MLInhalationSolution[Ventavis]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1193362-100MLLevetiracetam5MG/MLInjection|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|199164-Phenobarbital97.2MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|858813-EnalaprilMaleate5MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|540181-alosetron0.5MGOralTablet[Lotronex]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|539789-rifaximin200MGOralTablet[XIFAXAN]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|858810-EnalaprilMaleate20MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|404450-Thalidomide200MGOralCapsule[Thalomid]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|404449-Thalidomide100MGOralCapsule[Thalomid]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|199163-Melatonin3MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|858804-EnalaprilMaleate2.5MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|402092-Cyclosporine0.5MG/MLOphthalmicSuspension[Restasis]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|352297-1MLpeginterferonalfa-2a0.18MG/MLInjection[Pegasys]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|858747-Ursodiol300MGOralCapsule|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|352047-1MLdarbepoetinalfa0.1MG/MLInjection[Aranesp]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|352046-1MLdarbepoetinalfa0.06MG/MLInjection[Aranesp]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|1989506-dolutegravir50MG/Rilpivirine25MGOralTablet[Juluca]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|404476-Azathioprine100MGOralTablet[Azasan]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1193360-100MLLevetiracetam15MG/MLInjection|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|199159-Tretinoin10MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|858616-Nicardipinehydrochloride30MGOralCapsule|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|352045-1MLdarbepoetinalfa0.04MG/MLInjection[Aranesp]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|352044-1MLdarbepoetinalfa0.025MG/MLInjection[Aranesp]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|858613-Nicardipinehydrochloride20MGOralCapsule|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2630671-OrenitramMonth3TitrationKit|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2630669-OrenitramMonth2TitrationKit|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|199150-Acarbose100MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|857683-TerbutalineSulfate5MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2630667-OrenitramMonth1TitrationKit|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2627722-0.8MLadalimumab-atto50MG/MLAuto-Injector[Amjevita]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|857677-TerbutalineSulfate2.5MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2626385-fingolimod0.5MGDisintegratingOralTablet[Tascenso]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2619428-voxelotor300MGOralTablet[Oxbryta]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1193358-100MLLevetiracetam10MG/MLInjection|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|199149-Acarbose50MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|857461-ClemastineFumarate2.68MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2613769-0.6MLpegfilgrastim-fpgk10MG/MLPrefilledSyringe[Stimufend]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2613759-1.2MLrisankizumab-rzaa150MG/MLCartridge[Skyrizi]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|857416-ClemastineFumarate1.34MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|261362-alosetron1MGOralTablet[Lotronex]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2613569-tadalafil4MG/MLOralSuspension[Tadliq]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|199148-Lamivudine10MG/MLOralSolution|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|857340-BethanecholChloride50MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2611460-ivacaftor94MG/lumacaftor75MGOralGranules[ORKAMBI]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2610302-fingolimod0.25MGDisintegratingOralTablet[Tascenso]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|857336-BethanecholChloride5MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2604628-2.4MLrisankizumab-rzaa150MG/MLCartridge[Skyrizi]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2604622-10MLrisankizumab-rzaa60MG/MLInjection[Skyrizi]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|404475-Azathioprine75MGOralTablet[Azasan]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1191315-FluocinoloneAcetonide0.25MG/MLTopicalCream|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|199147-Lamivudine150MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|857328-BethanecholChloride25MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2602787-0.6MLpegfilgrastim-pbbk10MG/MLPrefilledSyringe[Fylnetra]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2596960-24HRupadacitinib45MGExtendedReleaseOralTablet[Rinvoq]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|857321-BethanecholChloride10MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2596445-0.4MLmepolizumab100MG/MLPrefilledSyringe[Nucala]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2594797-Mayzent1MGStarterPack|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|199143-Niacin250MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|857305-ClomipramineHydrochloride75MGOralCapsule|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2594608-siponimod1MGOralTablet[Mayzent]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2590054-24HRupadacitinib30MGExtendedReleaseOralTablet[Rinvoq]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|857301-ClomipramineHydrochloride50MGOralCapsule|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2588074-voxelotor300MGTabletforOralSuspension[Oxbryta]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2584475-corticotropin80UNT/MLInjectableSolution[Cortrophin]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1191256-FluocinoloneAcetonide0.00025MG/MGTopicalOintment|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|199058-mycophenolatemofetil250MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|857297-ClomipramineHydrochloride25MGOralCapsule|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2583635-0.67MLdupilumab150MG/MLPrefilledSyringe[Dupixent]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2572371-varenicline0.03MG/ACTUATNasalSpray[Tyrvaya]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|857187-FosinoprilSodium40MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2559707-1.14MLdupilumab175MG/MLAuto-Injector[Dupixent]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2557910-glecaprevir50MG/pibrentasvir20MGOralPellet[Mavyret]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|199047-Famotidine10MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|857183-FosinoprilSodium20MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2557216-trikafta50MG/37.5MG/25MGand75MGPack|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2550713-0.5MLsecukinumab150MG/MLPrefilledSyringe[Cosentyx]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|857169-FosinoprilSodium10MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2541237-24HRmirabegron8MG/MLExtendedReleaseSuspension[Myrbetriq]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2540699-1MLrisankizumab-rzaa150MG/MLPrefilledSyringe[Skyrizi]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|1366339-Levonorgestrel0.000583MG/HRIntrauterineSystem[Skyla]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|1989117-0.3MLEpinephrine1MG/MLPrefilledSyringe[Symjepi]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|402110-fosamprenavir700MGOralTablet[Lexiva]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1191013-Proparacainehydrochloride5MG/MLOphthalmicSolution|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198760-Niacin50MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|856853-AmitriptylineHydrochloride75MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2540695-1MLrisankizumab-rzaa150MG/MLAuto-Injector[Skyrizi]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2536758-24HRviloxazine200MGExtendedReleaseOralCapsule[Qelbree]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|856845-AmitriptylineHydrochloride50MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2536752-24HRviloxazine150MGExtendedReleaseOralCapsule[Qelbree]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2536742-baloxavirmarboxil80MGOralTablet[Xofluza]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198759-Niacin100MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|856840-AmitriptylineHydrochloride50MG/Perphenazine4MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2536554-24HRviloxazine100MGExtendedReleaseOralCapsule[Qelbree]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2532351-Ponvory14DayPack|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|856834-AmitriptylineHydrochloride25MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2532320-ponesimod20MGOralTablet[Ponvory]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2531134-HumiraPen80MG/0.8ML-StarterPackageforPediatricUlcerativeColitis(4count)|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1190655-AtropineSulfate10MG/MLOphthalmicSolution|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198741-MagnesiumOxide400MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|856825-AmitriptylineHydrochloride25MG/Perphenazine4MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2478437-tofacitinib1MG/MLOralSolution[Xeljanz]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2475860-vericiguat5MGOralTablet[Verquvo]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|856797-AmitriptylineHydrochloride25MG/Perphenazine2MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2475856-vericiguat2.5MGOralTablet[Verquvo]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2475852-vericiguat10MGOralTablet[Verquvo]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198707-Hydrocortisone5MG/MLTopicalCream|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|856783-AmitriptylineHydrochloride10MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2475406-voclosporin7.9MGOralCapsule[Lupkynis]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2474007-olopatadine7MG/MLOphthalmicSolution[Pataday]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|856773-AmitriptylineHydrochloride150MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2473042-ponatinib10MGOralTablet[Iclusig]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2467575-berotralstat110MGOralCapsule[Orladeyo]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|352210-Mesna400MGOralTablet[Mesnex]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1190572-AtropineSulfate0.025MG/DiphenoxylateHydrochloride2.5MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198630-ferrousgluconate324MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|856762-AmitriptylineHydrochloride100MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2467571-berotralstat150MGOralCapsule[Orladeyo]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2463737-epoetinalfa-epbx20000UNT/MLInjectableSolution[Retacrit]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|856733-PropranololHydrochloride8MG/MLOralSolution|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2463733-epoetinalfa-epbx10000UNT/MLInjectableSolution[Retacrit]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2395775-30ACTUATfluticasonefuroate0.2MG/ACTUAT/umeclidinium0.0625MG/ACTUAT/vilanterol0.025MG/ACTUATDryPowderInhaler[Trelegy]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198429-lamotrigine200MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|856724-PropranololHydrochloride4MG/MLOralSolution|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2393593-monomethylfumarate95MGDelayedReleaseOralCapsule[Bafiertam]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2392142-0.5MLetanercept50MG/MLInjection[Enbrel]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|856720-AmitriptylineHydrochloride10MG/Perphenazine4MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2390954-0.4MLofatumumab50MG/MLPenInjector[Kesimpta]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2387331-120ACTUATbudesonide0.16MG/ACTUAT/formoterolfumarate0.0048MG/ACTUAT/glycopyrrolate0.009MG/ACTUATMeteredDoseInhaler[Bre|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1190570-AtropineSulfate0.01MG/MGOphthalmicOintment|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198428-lamotrigine150MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|856706-AmitriptylineHydrochloride10MG/Perphenazine2MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2375329-2MLdupilumab150MG/MLAuto-Injector[Dupixent]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2373941-bedaquiline20MGOralTablet[Sirturo]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|856578-PropranololHydrochloride80MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2371768-Oriahnn28DayKit|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2362182-opicapone50MGOralCapsule[Ongentys]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198427-lamotrigine100MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|856556-PropranololHydrochloride60MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2362178-opicapone25MGOralCapsule[Ongentys]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2359358-24HRempagliflozin5MG/linagliptin2.5MG/metforminhydrochloride1000MGExtendedReleaseOralTablet[Trijardy]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|856519-PropranololHydrochloride40MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2359353-24HRempagliflozin25MG/linagliptin5MG/metforminhydrochloride1000MGExtendedReleaseOralTablet[Trijardy]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2359290-24HRempagliflozin12.5MG/linagliptin2.5MG/metforminhydrochloride1000MGExtendedReleaseOralTablet[Trijardy]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|1926069-Ritonavir100MGOralPowder[Norvir]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|351750-podofilox0.005MG/MGTopicalGel[Condylox]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1190568-AtropineSulfate0.005MG/ML/DiphenoxylateHydrochloride0.5MG/MLOralSolution|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198382-famciclovir500MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|856457-PropranololHydrochloride20MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2359285-24HRempagliflozin10MG/linagliptin5MG/metforminhydrochloride1000MGExtendedReleaseOralTablet[Trijardy]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2288433-Zeposia7-DayStarterPack|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|856448-PropranololHydrochloride10MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2288431-ZepsoiaStarterKit(7-DayStarterPackand0.92MG30countBottle)|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2288412-ozanimod0.92MGOralCapsule[Zeposia]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198378-Tacrolimus5MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|856429-Hydrochlorothiazide25MG/PropranololHydrochloride80MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2287905-1.5MLfremanezumab-vfrm150MG/MLAuto-Injector[Ajovy]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2283236-bempedoicacid180MG/ezetimibe10MGOralTablet[Nexlizet]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|856422-Hydrochlorothiazide25MG/PropranololHydrochloride40MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2282414-bempedoicacid180MGOralTablet[Nexletol]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2282320-Rimegepant75MGDisintegratingOralTablet[Nurtec]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1150836-LevobunololHydrochloride5MG/MLOphthalmicSolution|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198377-Tacrolimus1MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|856377-TrazodoneHydrochloride50MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2273115-24HRtofacitinib22MGExtendedReleaseOralTablet[Xeljanz]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2268231-ubrogepant50MGOralTablet[Ubrelvy]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|856373-TrazodoneHydrochloride100MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2268227-ubrogepant100MGOralTablet[Ubrelvy]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2265689-Voxelotor500MGOralTablet[Oxbryta]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198372-torsemide5MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|856364-TrazodoneHydrochloride150MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2262731-MicronizedIsotretinoin8MGOralCapsule[Absorica]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2262727-MicronizedIsotretinoin32MGOralCapsule[Absorica]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|855926-DiclofenacSodium75MGDelayedReleaseOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2262719-MicronizedIsotretinoin24MGOralCapsule[Absorica]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2262713-MicronizedIsotretinoin16MGOralCapsule[Absorica]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|285028-abacavir300MG/Lamivudine150MG/Zidovudine300MGOralTablet[Trizivir]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1117531-chloroquinephosphate250MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198371-torsemide20MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|855906-DiclofenacSodium50MGDelayedReleaseOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2261794-Diroximelfumarate231MGDelayedReleaseOralCapsule[Vumerity]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2260709-0.6MLpegfilgrastim-bmez10MG/MLPrefilledSyringe[Ziextenzo]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|855818-prasugrel5MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2257013-trikafta100MG/50MG/75MGand150MGTabletPack|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2256947-lasmiditan50MGOralTablet[Reyvow]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198370-torsemide100MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|855812-prasugrel10MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2256943-lasmiditan100MGOralTablet[Reyvow]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2205634-1MLbenralizumab30MG/MLAuto-Injector[Fasenra]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|855664-DiclofenacSodium25MGDelayedReleaseOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2203897-ledipasvir45MG/sofosbuvir200MGOralTablet[Harvoni]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2203893-sofosbuvir200MGOralTablet[Sovaldi]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1116758-chloroquinephosphate500MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198369-torsemide10MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|855480-alclometasonedipropionate0.0005MG/MGTopicalOintment|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2201540-romiplostim0.125MGInjection[Nplate]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2199685-tenapanor50MGOralTablet[Ibsrela]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|855474-alclometasonedipropionate0.5MG/MLTopicalCream|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2196900-24HRupadacitinib15MGExtendedReleaseOralTablet[Rinvoq]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2196592-120ACTUATformoterolfumarate0.005MG/ACTUAT/mometasonefuroate0.05MG/ACTUATMeteredDoseInhaler[Dulera]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198365-Prochlorperazine10MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|855344-WarfarinSodium7.5MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2182340-1MLEtanercept50MG/MLCartridge[Enbrel]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2174390-symdeko50MG/75MGand75MGPack|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|855338-WarfarinSodium6MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2173822-1MLmepolizumab100MG/MLPrefilledSyringe[Nucala]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2170993-1MLmepolizumab100MG/MLAuto-Injector[Nucala]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|1111011-Etonogestrel68MGDrugImplant[Nexplanon]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|1359271-darunavir800MGOralTablet[Prezista]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|1924315-raltegravir600MGOralTablet[Isentress]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|284595-Methotrexate15MGOralTablet[Trexall]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1116150-bacitracinzinc0.4UNT/MG/hydrocortisoneacetate0.01MG/MG/NeomycinSulfate0.0035MG/MG/PolymyxinBSulfate10UNT/MGOphthalmic|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198352-Zidovudine100MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|855332-WarfarinSodium5MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2170613-1MLgalcanezumab-gnlm100MG/MLPrefilledSyringe[Emgality]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2169276-dapagliflozin5MG/saxagliptin5MGOralTablet[Qtern]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|855324-WarfarinSodium4MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2168596-ivabradine1MG/MLOralSolution[Corlanor]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2166401-ivacaftor25MGOralGranules[Kalydeco]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198335-Sulfamethoxazole800MG/Trimethoprim160MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|855318-WarfarinSodium3MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|213475-1MLEpoetinAlfa40000UNT/MLInjection[Procrit]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|213360-Thalidomide50MGOralCapsule[Thalomid]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|855312-WarfarinSodium2.5MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|213197-Becaplermin0.0001MG/MGTopicalGel[Regranex]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2123314-Mayzent2MGStarterPack|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1099870-DivalproexSodium500MGDelayedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198334-Sulfamethoxazole400MG/Trimethoprim80MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|855302-WarfarinSodium2MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2122661-Mavenclad10TabletPack|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2122659-Mavenclad4TabletPack|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|855296-WarfarinSodium10MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2122657-Mavenclad5TabletPack|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2122655-Mavenclad6TabletPack|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198332-Trimethoprim100MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|855288-WarfarinSodium1MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2122650-Mavenclad7TabletPack|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2122648-Mavenclad8TabletPack|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|855172-levocetirizinedihydrochloride5MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2122642-Mavenclad9TabletPack|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|212219-EpoetinAlfa20000UNT/MLInjectableSolution[Procrit]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|284594-Methotrexate7.5MGOralTablet[Trexall]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1099687-ValproicAcid50MG/MLOralSolution|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198325-Trifluoperazine5MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|855168-levocetirizinedihydrochloride0.5MG/MLOralSolution|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|212218-EpoetinAlfa20000UNT/MLInjectableSolution[Epogen]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2121100-siponimod2MGOralTablet[Mayzent]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|854919-BisoprololFumarate5MG/Hydrochlorothiazide6.25MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2121096-siponimod0.25MGOralTablet[Mayzent]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2121061-ceritinib150MGOralTablet[Zykadia]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198324-Trifluoperazine2MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|854916-BisoprololFumarate2.5MG/Hydrochlorothiazide6.25MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2120195-1MLerenumab-aooe140MG/MLAuto-Injector[Aimovig]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2119481-Cetirizine2.4MG/MLOphthalmicSolution[Zerviate]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|854908-BisoprololFumarate10MG/Hydrochlorothiazide6.25MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2119391-Spravato56MGDoseKit|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2119389-Spravato84MGDoseKit|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1099681-ValproicAcid250MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198323-Trifluoperazine10MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|854905-BisoprololFumarate5MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2107355-prucalopride2MGOralTablet[Motegrity]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2107351-prucalopride1MGOralTablet[Motegrity]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|854901-BisoprololFumarate10MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2106362-rifamycinSV194MGDelayedReleaseOralTablet[Aemcolo]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2106075-0.9MLtocilizumab180MG/MLAuto-Injector[Actemra]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198322-Trifluoperazine1MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|854801-DiclofenacSodium1MG/MLOphthalmicSolution|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2102705-0.6MLpegfilgrastim-cbqv10MG/MLPrefilledSyringe[Udenyca]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2100100-Xofluza80MGDosePack(2x40MGTablets)|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|852913-QuinidineSulfate300MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|208083-sargramostim0.25MG/MLInjectableSolution[Leukine]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|207370-Penicillamine250MGOralTablet[Depen]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|1857917-maraviroc75MGOralTablet[Selzentry]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|284593-Methotrexate10MGOralTablet[Trexall]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1099678-DivalproexSodium250MGDelayedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198316-Hydrochlorothiazide25MG/Triamterene37.5MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|852877-QuinidineSulfate200MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|207059-interferonbeta-1b0.3MGInjection[Betaseron]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|206791-mesalamine250MGExtendedReleaseOralCapsule[Pentasa]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|849515-DesmopressinAcetate0.1MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|205924-1MLEpoetinAlfa4000UNT/MLInjection[Procrit]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|205923-1MLEpoetinAlfa4000UNT/MLInjection[Epogen]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198275-Thioridazine50MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|849506-DesmopressinAcetate0.01MG/ACTUATNasalSpray|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|205922-1MLEpoetinAlfa3000UNT/MLInjection[Procrit]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|205921-1MLEpoetinAlfa3000UNT/MLInjection[Epogen]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|849395-AmantadineHydrochloride100MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2059189-amikacinliposomal70.3MG/MLInhalationSuspension[Arikayce]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|205918-1MLEpoetinAlfa2000UNT/MLInjection[Procrit]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1099648-5MLValproicAcid100MG/MLInjection|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198274-Thioridazine25MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|849389-AmantadineHydrochloride100MGOralCapsule|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|205917-1MLEpoetinAlfa2000UNT/MLInjection[Epogen]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|205913-EpoetinAlfa10000UNT/MLInjectableSolution[Procrit]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|848176-AugmentedBetamethasone0.5MG/MLTopicalCream|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|205912-EpoetinAlfa10000UNT/MLInjectableSolution[Epogen]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2058950-0.5MLomalizumab150MG/MLPrefilledSyringe[Xolair]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198270-Thioridazine100MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|836358-IpratropiumBromide0.2MG/MLInhalationSolution|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2058946-1MLomalizumab150MG/MLPrefilledSyringe[Xolair]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2058906-cannabidiol100MG/MLOralSolution[Epidiolex]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|835925-cyclosporine,modified50MGOralCapsule|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2058887-1MLgalcanezumab-gnlm120MG/MLPrefilledSyringe[Emgality]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2058877-1MLgalcanezumab-gnlm120MG/MLAuto-Injector[Emgality]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|284592-Methotrexate5MGOralTablet[Trexall]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1099625-DivalproexSodium125MGDelayedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198240-Tamoxifen10MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|835913-MefloquineHydrochloride250MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2057219-1.6MLfilgrastim-aafi0.3MG/MLInjection[Nivestym]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2057212-1MLfilgrastim-aafi0.3MG/MLInjection[Nivestym]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|835894-cyclosporine,modified25MGOralCapsule|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2057205-0.5MLfilgrastim-aafi0.6MG/MLPrefilledSyringe[Nivestym]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2056700-1.5MLfremanezumab-vfrm150MG/MLPrefilledSyringe[Ajovy]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198239-Sulindac200MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|835726-Acamprosatecalcium333MGDelayedReleaseOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|205532-DornaseAlfa1MG/MLInhalationSolution[Pulmozyme]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2055026-Cyclosporine0.9MG/MLOphthalmicSolution[Cequa]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|835593-ImipramineHydrochloride10MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2054995-lusutrombopag3MGOralTablet[Mulpleta]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2053519-ivacaftor188MG/lumacaftor150MGOralGranules[ORKAMBI]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1099569-24HRDivalproexSodium500MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198238-Sulindac150MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|835568-ImipramineHydrochloride50MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2053512-ivacaftor125MG/lumacaftor100MGOralGranules[ORKAMBI]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2048568-tofacitinib10MGOralTablet[Xeljanz]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|835564-ImipramineHydrochloride25MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2048025-0.6MLpegfilgrastim-jmdb10MG/MLPrefilledSyringe[Fulphila]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2047623-1MLepoetinalfa-epbx40000UNT/MLInjection[Retacrit]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198232-Sulfasalazine500MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|834127-chlorhexidinegluconate1.2MG/MLMouthwash|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2047614-1MLepoetinalfa-epbx4000UNT/MLInjection[Retacrit]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2047608-1MLepoetinalfa-epbx3000UNT/MLInjection[Retacrit]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|834102-PenicillinVPotassium500MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2047602-1MLepoetinalfa-epbx2000UNT/MLInjection[Retacrit]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2047596-1MLepoetinalfa-epbx10000UNT/MLInjection[Retacrit]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|1359031-Loestrin1.5/3021DayPack|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|1857913-maraviroc25MGOralTablet[Selzentry]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|284551-nilutamide150MGOralTablet[Nilandron]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1099563-24HRDivalproexSodium250MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198224-Hydrochlorothiazide25MG/Spironolactone25MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|834061-PenicillinVPotassium250MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2045959-Doptelet40MGDailyDoseCartonPack|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2045638-1MLerenumab-aooe70MG/MLAuto-Injector[Aimovig]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|834046-PenicillinVPotassium25MG/MLOralSolution|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2003767-1.14MLsarilumab175MG/MLAuto-Injector[Kevzara]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2003757-1.14MLsarilumab132MG/MLAuto-Injector[Kevzara]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198223-Spironolactone50MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|834040-PenicillinVPotassium50MG/MLOralSolution|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|2001321-Roflumilast0.25MGOralTablet[Daliresp]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1999389-symdeko100MG/150MGand150MGPack|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|833528-Amiodaronehydrochloride200MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1999316-hydroxyurea1000MGOralTablet[Siklos]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1999314-hydroxyurea100MGOralTablet[Siklos]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1099316-DesipramineHydrochloride75MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198222-Spironolactone100MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|833217-DiltiazemHydrochloride30MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1990869-0.85MLexenatide2.35MG/MLAuto-Injector[Bydureon]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1989109-1MLbenralizumab30MG/MLPrefilledSyringe[Fasenra]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|833008-DesmopressinAcetate0.2MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1989085-bosentan32MGTabletforOralSuspension[Tracleer]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1946522-4-Month1.5MLLeuprolideAcetate20MG/MLPrefilledSyringe[Lupron]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198215-SodiumFluoride0.55MGChewableTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|831359-24HRDiltiazemHydrochloride420MGExtendedReleaseOralCapsule|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1946520-3-Month1.5MLLeuprolideAcetate20MG/MLPrefilledSyringe[Lupron]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1945048-30ACTUATfluticasonefuroate0.1MG/ACTUAT/umeclidinium0.0625MG/ACTUAT/vilanterol0.025MG/ACTUATDryPowderInhaler[Trelegy]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|831261-CromolynSodium20MG/MLOralSolution|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1940498-24HRdapagliflozin2.5MG/Metforminhydrochloride1000MGExtendedReleaseOralTablet[Xigduo]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1927290-infliximab-abda100MGInjection[Renflexis]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|2625912-Sunlenca927MG2-VialKit|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1099304-DesipramineHydrochloride50MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198211-Simvastatin40MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|831109-CromolynSodium40MG/MLOphthalmicSolution|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1925504-dapagliflozin10MG/saxagliptin5MGOralTablet[Qtern]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1925257-0.7MLabatacept125MG/MLPrefilledSyringe[Orencia]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|831103-DiltiazemHydrochloride60MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1925255-0.4MLabatacept125MG/MLPrefilledSyringe[Orencia]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1923347-1.14MLsarilumab175MG/MLPrefilledSyringe[Kevzara]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198202-Rifampin300MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|831102-DiltiazemHydrochloride90MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1923338-1.14MLsarilumab132MG/MLPrefilledSyringe[Kevzara]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1921468-HumiraPen80MG/0.8MLand40MG/0.4ML-Psoriasis/UveitisStarterPackage(3count)|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|831054-DiltiazemHydrochloride120MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1921245-HumiraPen80MG/0.8ML-StarterPackageforCrohn'sDisease,UlcerativeColitisorHidradenitisSuppurativa(3count)|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1921240-0.8MLadalimumab100MG/MLAuto-Injector[Humira]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1099300-DesipramineHydrochloride25MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198201-Rifampin150MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|830861-24HRDiltiazemHydrochloride120MGExtendedReleaseOralCapsule|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1921081-1.56MLabaloparatide2MG/MLPenInjector[Tymlos]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1921017-0.2MLadalimumab100MG/MLPrefilledSyringe[Humira]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|830845-24HRDiltiazemHydrochloride180MGExtendedReleaseOralCapsule|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1921010-0.1MLadalimumab100MG/MLPrefilledSyringe[Humira]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1876609-naldemedine0.2MGOralTablet[Symproic]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198181-Pyrazinamide500MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|830837-24HRDiltiazemHydrochloride240MGExtendedReleaseOralCapsule|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1873765-plecanatide3MGOralTablet[Trulance]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1873087-HumiraPrefilledSyringe80MG/0.8MLStarterPack-PediatricCrohn'sDisease(3count)|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|830801-24HRDiltiazemHydrochloride300MGExtendedReleaseOralCapsule|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1872980-0.4MLadalimumab100MG/MLAuto-Injector[Humira]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1871469-lisdexamfetaminedimesylate50MGChewableTablet[Vyvanse]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|1856546-Levonorgestrel0.000729MG/HRIntrauterineSystem[Kyleena]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|2625900-Sunlenca5-TabletPack|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1099296-DesipramineHydrochloride150MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198175-Propylthiouracil50MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|830795-24HRDiltiazemHydrochloride360MGExtendedReleaseOralCapsule|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1871467-lisdexamfetaminedimesylate60MGChewableTablet[Vyvanse]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1871465-lisdexamfetaminedimesylate10MGChewableTablet[Vyvanse]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|828348-Cyclobenzaprinehydrochloride10MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1871463-lisdexamfetaminedimesylate20MGChewableTablet[Vyvanse]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1871461-lisdexamfetaminedimesylate30MGChewableTablet[Vyvanse]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198153-Colchicine0.5MG/Probenecid500MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|828320-Cyclobenzaprinehydrochloride5MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1871459-lisdexamfetaminedimesylate40MGChewableTablet[Vyvanse]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1870968-deflazacort22.75MG/MLOralSuspension[Emflaza]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|810096-{7(EthinylEstradiol0.01MGOralTablet)/84(EthinylEstradiol0.02MG/Levonorgestrel0.1MGOralTablet)}Pack|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1870960-deflazacort36MGOralTablet[Emflaza]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1870956-deflazacort18MGOralTablet[Emflaza]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1099292-DesipramineHydrochloride100MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198152-Probenecid500MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|763185-{21(Prednisone10MGOralTablet)}Pack|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1870952-deflazacort30MGOralTablet[Emflaza]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1870950-deflazacort6MGOralTablet[Emflaza]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|763181-{21(Prednisone5MGOralTablet)}Pack|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1864414-Buprenorphine0.7MG/Naloxone0.18MGSublingualTablet[Zubsolv]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1858833-12HRTreprostinil5MGExtendedReleaseOralTablet[Orenitram]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198150-Primidone50MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|762675-{21(Methylprednisolone4MGOralTablet)}Pack|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1858267-tenofoviralafenamide25MGOralTablet[Vemlidy]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1855527-HumiraPediatricCrohn'sDiseaseStarterPackage(2count)|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|759743-{21(Desogestrel0.15MG/EthinylEstradiol0.02MGOralTablet)/5(EthinylEstradiol0.01MGOralTablet)/2(InertIngredients1MGOralT|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1812470-ivacaftor125MG/lumacaftor100MGOralTablet[ORKAMBI]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1806942-carfilzomib60MGInjection[Kyprolis]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|261353-Trimethoprim10MG/MLOralSolution[Primsol]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1099288-DesipramineHydrochloride10MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198148-Prednisone50MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|756209-Zidovudine10MG/MLOralSolution|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1801840-lifitegrast50MG/MLOphthalmicSolution[Xiidra]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1801519-Methylnaltrexonebromide150MGOralTablet[Relistor]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|755497-Albuterol0.4MG/MLOralSolution|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1801278-HumiraPsoriasisStarterPack40MG/0.8MLPen(4count)|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1799230-1MLabatacept125MG/MLAuto-Injector[Orencia]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198146-Prednisone2.5MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|754761-etravirine100MGOralTablet|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1797880-Nafarelin0.2MG/ACTUATMeteredDoseNasalSpray[Synarel]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1796096-24HRLinagliptin5MG/Metforminhydrochloride1000MGExtendedReleaseOralTablet[Jentadueto]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|751901-{84(EthinylEstradiol0.03MG/Levonorgestrel0.15MGOralTablet)/7(InertIngredients1MGOralTablet)}Pack|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1796091-24HRLinagliptin2.5MG/Metforminhydrochloride1000MGExtendedReleaseOralTablet[Jentadueto]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1790546-infliximab-dyyb100MGInjection[Inflectra]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1098134-24HRNiacin1000MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198145-Prednisone10MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|751553-{28(EthinylEstradiol0.02MG/Levonorgestrel0.09MGOralTablet)}Pack|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1790146-bromfenac0.75MG/MLOphthalmicSolution[Bromsite]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1747194-0.4MLMethotrexate56.3MG/MLAuto-Injector[Otrexup]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|749860-{21(EthinylEstradiol0.035MG/norgestimate0.25MGOralTablet)/7(InertIngredients1MGOralTablet)}Pack|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1747187-0.4MLMethotrexate43.8MG/MLAuto-Injector[Otrexup]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1747181-0.4MLMethotrexate31.3MG/MLAuto-Injector[Otrexup]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198144-Prednisone1MGOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|749848-{21(Desogestrel0.15MG/EthinylEstradiol0.03MGOralTablet)/7(InertIngredients1MGOralTablet)}Pack|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1746898-10MLreslizumab10MG/MLInjection[Cinqair]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1745114-1MLixekizumab80MG/MLPrefilledSyringe[Taltz]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|749784-{7(EthinylEstradiol0.035MG/norgestimate0.18MGOralTablet)/7(EthinylEstradiol0.035MG/norgestimate0.215MGOralTablet)/7(Et|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1745108-1MLixekizumab80MG/MLAuto-Injector[Taltz]|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1741049-24HRtofacitinib11MGExtendedReleaseOralTablet[Xeljanz]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|1000158-0.65MLmedroxyprogesteroneacetate160MG/MLPrefilledSyringe[depo-subQprovera]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|1000487-Premphase28DayPack|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|1000497-Prempro0.45/1.528DayPack|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|1037185-LoLoestrinFe28DayPack|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|1102277-Rilpivirine25MGOralTablet[Edurant]|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|1359026-LoestrinFe1.5/3028DayPack|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|1809905-Taytulla1MG/20MCG28DayPack|IHSSCOBRA
636|1003|N|N|N||Preferred Brand|2598352-abacavir60MG/dolutegravir5MG/lamivudine30MGTabletforOralSuspension[Triumeq]|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|1095712-24HRNevirapine400MGExtendedReleaseOralTablet|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|198141-Prazosin5MGOralCapsule|IHSSCOBRA
636|1003|N|N|N||Preferred Generic|749783-{6(Azithromycin250MGOralTablet)}Pack|IHSSCOBRA
636|1003|Y|N|N||Preferred Brand|1734642-elbasvir50MG/grazoprevir100MGOralTablet[Zepatier]|IHSSCOBRA