CLASS | MEDICATION | BRAND/GENERIC NAME | CCM $3 ADMIN FEE PER RX/ GENERICS READILY AVAIL W/A CCM CARD | PAP $3 ADMIN FEE PER RX (MAY TAKE FROM 3-4 WEEKS) | 340B (1) KINTEGRA FAMILY MEDICINE PATIENTS ($3 ADMIN FEE) | DIRECT RELIEF REPLENISHMENT (FREE TO PT W/ CCM CARD) | DHOPE (FREE TO PT W/ CCM CARD) | WAL-MART $4 GENERIC AVAILABLE AT MOST PHARM. | PUBLIX (FREE TO PATIENT) | Key for classes |
1 | ACETAMINOPHEN | TYLENOL | X | 1. Analgesics/Pain | ||||||
2 | ACYCLOVIR | ZOVIRAX | X | X | 2. Anti-infectives | |||||
10 | ADVAIR | FLUTICASONE/SALMETEROL | X | X | 3. Topicals | |||||
10 | ALBUTEROL SOLN | PROAIR, VENTOLIN, PROVENTIL | X | 4. Eye/Nose/Ear | ||||||
6 | ALDACTONE | SPIRONOLACTONE | X | 5. Anti-Platelets | ||||||
13 | ALENDRONATE | FOSAMAX | X | X | 6. Cardiovascular | |||||
1 | ALLOPURINOL | ZYLOPRIM | X | X | X | 7. Gastrointestinal | ||||
11 | AMANTADINE | SYMMETREL | X | 8. Gynecological | ||||||
6 | AMIODARONE | CORDARON | X | X | 9. Urological | |||||
7 | AMITIZA | LUBIPROSTONE | X | 10. Asthma/Allergy | ||||||
11 | AMITRIPTYLINE | ELAVIL | X | X | X | x | 11. Central Nervous Sys | |||
6 | AMLODIPINE | NORVASC | X | X | X | x | 12. Endocrine | |||
2 | AMOX-CLV | AUGMENTIN | X | X | 13. Osteoporosis | |||||
2 | AMOXICILLIN | AMOXIL | X | X | x | 14. Supplements | ||||
2 | AMPICILLIN | OMNIPEN | x | 15. Miscellaneous | ||||||
10 | ANORO ELIPTA | UMECLIDINIUM | X | |||||||
12 | APIDRA | INSULIN GLULISINE | X | |||||||
11 | ARIPIPRAZOLE | ABILIFY | X | X | ||||||
12 | ARMOUR THYROID | DESSICATED THYROID | X | |||||||
10 | ASMANEX TWISTHALER | MOMETASONE | X | |||||||
6 | ASPIRIN | ECOTRIN | X | X | X | |||||
6 | ATENOLOL* | TENORMIN | X | X | X | x | ||||
11 | ATOMOXETINE | STRATTERA | X | |||||||
6 | ATORVASTATIN | LIPITOR | X | X | X | |||||
10 | ATROVENT HFA (IPRATROPIUM SOLN) | IPRATROPIUM | X | X | ||||||
7, 15 | AZASAN | AZATHIOPRINE | X | |||||||
2 | AZITHROMYCIN | ZITHROMAX | X | X | ||||||
4 | AZOPT | BRINZOLAMIDE | X | |||||||
1 | BACLOFEN | LIORESAL | X | X | X | |||||
6 | BENAZEPRIL | LOTENSIN | X | X | x | |||||
6 | BENICAR | OLMESARTAN | X | |||||||
6 | BENICAR/HCTZ | OLMESARTAN/HCTZ | X | |||||||
10,15 | BENZONATATE | TESSALON PERLES | X | X | ||||||
2,3 | BENZOYL PEROXIDE 10% | ACETOXYL | X | |||||||
11 | BENZTROPINE | COGENTIN | X | X | ||||||
6 | BETAPACE | SOTALOL | X | |||||||
10 | BEVESPI | GLYCOPYRROLATE/FORMOTEROL | X | |||||||
6 | BISOPROLOL-HCTZ | ZIAC | X | |||||||
12 | BLOOD GLUCOSE METERS N/C | X (ZERO FEE) | $3.00 | |||||||
12 | BLOOD GLUCOSE TEST STRIPS | $5.75 PER BOX OF 50 (PRICE MAY VARY) | $9.08 PER BOX OF 50 (PRICE MAY VARY) | |||||||
10 | BREO ELIPTA | FLUTICASONE/VILANTEROL | X | |||||||
5 | BRILINTA | TICAGRELOR | X | |||||||
10 | BUDESONIDE SOLN | PULMICORT | X | |||||||
11 | BUPROPION | WELLBUTRIN | X | X | ||||||
11 | BUPROPION XL | WELLBUTRIN XL | X | X | ||||||
11 | BUPROPION SR | WELLBUTRIN SR | X | X | ||||||
11 | BUSPIRONE | BUSPAR | X | X | X | x | ||||
1 | BUTALBITAL/APAP | FIORICET | X | |||||||
1 | BUTALBITAL/APAP/CAFFEINE | FIORICET | X | |||||||
12 | BYDUREON | EXENATIDE | X | |||||||
12 | BYETTA | EXENATIDE | X | |||||||
6 | BYSTOLIC | NEBIVOLOL | X | X | ||||||
6 | CADUET | ATORVASTATIN/AMLODIPINE | X | |||||||
6 | CALAN SR | VERAPAMIL | X | |||||||
7 | CARAFATE | SUCRALFATE | X | |||||||
11 | CARBAMAZEPINE | TEGRETOL | X | |||||||
6 | CARDIZEM CD | DILTIAZEM | X | |||||||
6 | CARDIZEM LA | DILTIAZEM | X | X | ||||||
6 | CARVEDILOL | COREG | X | X | X | x | ||||
2 | CEFDINIR | OMNICEF | X | |||||||
2 | CEFUROXIME | CEFTIN/ZINACEF | X | |||||||
1 | CELEBREX | CELECOXIB | X | X | ||||||
1 | CELECOXIB | CELEBREX | X | X | ||||||
2 | CEPHALEXIN | KEFLEX | X | X | ||||||
10 | CETIRIZINE | ZYRTEC | X | |||||||
15 | CHANTIX | VARENICLINE | X | |||||||
2 | CHLORHEXIDINE | PERIDEX | X | |||||||
6 | CHLORTHALIDONE | HYGROTON | X | X | ||||||
9, 15 | CIALIS | TADALAFIL | X | |||||||
5 | CILOSTAZOL | PLETAL | X | X | ||||||
2 | CIPROFLOXACIN | CIPRO | X | X | ||||||
11 | CITALOPRAM* | CELEXA | X | X | X | X | ||||
10 | CLARINEX | DESLORATADINE | X | |||||||
2 | CLARITHROMYCIN | BIAXIN | X | |||||||
8 | CLIMARA | ESTRIDIOL (PATCH) | X | |||||||
2 | CLINDAMYCIN (ORAL) | CLEOCIN | X | X | ||||||
2,3 | CLINDAMYCIN PHOS. TOP SOL | CLINDACIN/CLINDAGEL | X | |||||||
2, 3 | CLINDAMYCIN + BENZOYL PEROXIDE | BENZACLIN | X | |||||||
10 | CLOBETASOL PROPIONATE | CLOBEX | X | |||||||
6 | CLONIDINE (ORAL) | CATAPRES | X | X | X | X | ||||
5 | CLOPIDOGREL | PLAVIX | X | X | ||||||
2,3 | CLOTRIMAZOLE/BETAMETH 0.05% CRM (LIMIT 15 GRAMS PER MONTH) | LOTRISONE | X | |||||||
4 | CROMOLYN OPHLAMIC SOLUTION | X | ||||||||
12 | CYANCOBALMIN INJECTION | X | ||||||||
1 | CYCLOBENZAPRINE* | FLEXERIL | X | X | ||||||
11 | CYMBALTA | DULOXETINE | X | X | ||||||
10 | CYPROHEPTADINE | PERIACTIN | X | |||||||
12 | CYTOMEL | LIOTHYRONINE | X | |||||||
11 | DEPAKOTE ER | VALPROATE ER | X | X | ||||||
10 | DESLORATADINE | CLARINEX | X | |||||||
9 | DETROL LA | TOLTERIDONE ER | X | X | ||||||
7 | DEXILANT | LANSOPRAZOLE | X | X | ||||||
1 | DICLOFENAC (ORAL) | CATAFLAM/ZORVOLEX | X | X | X | |||||
1,3 | DICLOFENAC GEL | VOLTAREN GEL/FLECTOR PATCH | X | |||||||
7 | DICYCLOMINE | BENTYL | X | X | X | |||||
6 | DIGOXIN | DIGITEK/LANOXIN | X | X | ||||||
11 | DILANTIN | PHENYTOIN | X | |||||||
6 | DILTIAZEM ER CAPS | CARDIZEM LA, CARTIA XT | X | X | ||||||
6 | DILTIAZEM TABS (CARDIZEM) | CARDIZEM | X | |||||||
6 | DIOVAN | VALSARTAN | X | |||||||
10 | DIPHENHYDRAMINE | BENADRYL | X | X | ||||||
11 | DIVALPROEX EC/DR | DEPAKOTE EC/DR | X | X | X | |||||
11 | DIVALPROEX SODIUM | DEPAKOTE | X | |||||||
11 | DONEPEZIL | ARICEPT | X | |||||||
6,9 | DOXAZOSIN | CARDURA | X | |||||||
11 | DOXEPIN | SILENOR | X | X | X | |||||
2 | DOXYCYCLINE | VIBRAMYCIN/MONODOX | X | X | X | |||||
10 | DULERA | MOMETASONE/FORMOTEROL | X | |||||||
11 | DULOXETINE | CYMBALTA | X | X | X | |||||
4 | DUREZOL OPTH | DIFLUPREDNATE | X | |||||||
6 | EDARBI | AZILSARTAN | X | |||||||
11 | EFFEXOR XR | VENLAFAXINE ER | X | |||||||
1 | ELETRIPTAN | RELPAX | X | |||||||
5 | ELIQUIS | APIXABAN | X | |||||||
1, 9 | ELMIRON | PENTOSAN | X | |||||||
7 | EMEND | APREPITANT | X | |||||||
6 | ENALAPRIL | VASOTEC | X | |||||||
6 | ENTRESTO | SACUBITRIL/VALSARTAN | X | |||||||
2 | EPCLUSA | SOFOSBUVIR/VELPATASVIR | X | |||||||
10 | EPINEPHRINE | EPI-PEN 2 PAK | X | X | ||||||
2,4 | ERYTHROMYCIN OPTH OINT | ROMYCIN | X | |||||||
11 | ESCITALOPRAM | LEXAPRO | X | X | X | |||||
7 | ESOMEPRAZOLE | NEXIUM | X | X | ||||||
3, 8 | ESTRACE VAG CREAM | ESTRIDIOL | X | |||||||
8 | ESTRADIOL (ORAL) | ALORA | X | X | X | |||||
13 | EVISTA | RALOXIFENE | X | |||||||
7 | FAMOTIDINE | PEPCID | X | |||||||
12 | FARXIGA | DAPAGLIFLOZIN | X | |||||||
6 | FENOFIBRATE | TRICOR | X | X | ||||||
14 | FERROUS SULFATE | FER-IN-SOL | X | |||||||
9 | FINASTERIDE | PROPECIA/PROSCAR | X | X | ||||||
1, 4 | FLAREX | FLUOROMETHOLONE | X | |||||||
6 | FLECAINIDE | TAMBOCOR | X | |||||||
1, 3 | FLECTOR PATCH | DICLOFENAC | X | |||||||
10 | FLOVENT HFA | FLUTICASONE | X | |||||||
2 | FLUCONAZOLE | DIFLUCAN | X | X | X | |||||
11 | FLUOXETINE | PROZAC | X | X | X | x | ||||
11 | FLUPHENAZINE HYDROCHLORIDE | MODECATE | X | |||||||
4,10 | FLUTICASONE NASAL INH | FLONASE | X | |||||||
14 | FOLIC ACID | FOLVITE | X | X | x | |||||
6 | FUROSEMIDE* | LASIX | X | X | X | x | ||||
1,11 | GABAPENTIN | NEURONTIN | X | X | ||||||
6 | GEMFIBROZIL | LOPID | X | X | ||||||
12 | GLIMEPIRIDE | AMARYL | X | X | x | |||||
12 | GLIPIZIDE | GLUCOTROL | X | X | X | x | ||||
12 | GLIPIZIDE XL | GLUCOTROL XL | X | |||||||
12 | GLUCAGON ER KIT | GLUCAGON | X | |||||||
12 | GLYBURIDE | DIABETA/GLYNASE | X | X | ||||||
6,11 | GUANFACINE ER | INTUNIV | X | |||||||
11 | HALOPERIDOL | HALDOL | X | |||||||
2 | HARVONI | LEDIPASVIR/SOFOSBUVIR | X | |||||||
12 | HUMALOG | INSULIN LISPRO | X | X | X | |||||
1 | HUMIRA | ADALIMUMAB | X | |||||||
12 | HUMULIN N, R, 70/30 U-500 | INSULIN LISPRO | X | X | ||||||
6 | HYDRALAZINE | APRESOLINE | X | X | x | |||||
6 | HYDROCHLOROTHIAZIDE* | MICROZIDE | X | X | X | x | ||||
1,3 | HYDROCORTISONE CREAM 2.5% (LIMIT 20 GRAMS PER MONTH) | X | ||||||||
12 | HYDROXYCHLOROQUINE | PLAQUENIL | X | |||||||
11 | HYDROXYZINE PAM | VISTARIL | X | X | ||||||
11 | HYDROXYZINE HCL | ATARAX | X | X | ||||||
7 | HYOSCYAMINE SULF | LEVBID/LEVSIN | X | X | ||||||
1 | IBUPROFEN* | MOTRIN | X | X | X | |||||
1, 4 | ILEVRO | NEPAFENAC | X | |||||||
6 | INDAPAMIDE | LOZIDE | x | |||||||
1 | INDOMETHACIN | TIVORBEX | X | X | ||||||
11 | INTUNIV | GUANFACINE | X | |||||||
11 | INVEGA ER | PALIPERIDONE | X | |||||||
12 | INVOKAMET | CANAGLIFLOZIN | X | |||||||
12 | INVOKANA | CANAGLIFLOZIN | X | X | ||||||
10 | IPRATROPIUM SOLN | ATROVENT HFA | X | X | ||||||
10 | IPRATROPIUM NASAL SOLN | ATROVENT | X | |||||||
10 | IPRATROPIUM/ALBUT INH SOLN | DUONEB | X | |||||||
6 | IRBESARTAN | AVAPRO | X | X | ||||||
6 | ISOSORBIDE DN | ISORDIL | X | |||||||
6 | ISOSORBIDE MN | IMDUR | X | X | x | |||||
12 | JANUMET | SITAGLIPTIN/METFORMIN | X | |||||||
12 | JANUMET XR | SITAGLIPTIN/METFORMIN | X | X | ||||||
12 | JANUVIA | SITAGLIPTIN | X | X | ||||||
14 | K-TAB | POTASSIUM CHLORIDE | X | |||||||
11 | KEPPRA | LEVETIRACETAM | X | |||||||
11 | KEPPRA XR | LEVETIRACETAM XR | X | |||||||
2,3 | KETOCONAZOLE SHAMPOO | X | ||||||||
12 | KOMBIGLYZE | SAXAGLIPTIN/METFORMIN | X | |||||||
6 | LABETALOL | TRANDATE | X | |||||||
7 | LACTULOSE SOLN | KRISTALOSE | X | |||||||
11 | LAMICTAL | LAMOTRIGINE | X | X | ||||||
11 | LAMOTRIGINE | LAMICTAL | X | X | ||||||
12 | LANTUS | INSULIN GLARGINE | X | |||||||
11 | LATUDA | LURASIDONE | X | |||||||
8 | LARISSIA | ETHINYLESTRIDIOL/LEVONORGESTREL | X | |||||||
4 | LATANOPROST | XALATAN | X | |||||||
12 | LEVEMIR | INSULIN DETEMIR | X | X | ||||||
11 | LEVETIRACETAM | KEPPRA | X | X | X | |||||
10 | LEVOCETIRIZINE | XYZAL | X | |||||||
2 | LEVOFLOXACIN | LEVAQUIN | X | X | ||||||
12 | LEVOTHYROXINE | SYNTHROID/TIROSINT/LEVOXYL | X | X | x | |||||
12 | LEVOXYL | LEVOTHYROXINE | X | |||||||
7 | LIALDA | MESALAMINE | X | |||||||
7 | LINZESS | LINACLOTIDE | X | X | ||||||
6 | LISINOPRIL* | PRINIVIL | X | X | x | x | ||||
6 | LISINOPRIL-HCTZ | PRINZIDE | X | X | x | |||||
11 | LITHIUM | LITHOBID/ESKALITH | X | X | X | x | ||||
6 | LOSARTAN | COZAAR | X | X | ||||||
6 | LOSARTAN/HCTZ | HYZAAR | X | X | x | |||||
6 | LOVASTATIN | MEVACOR | X | X | ||||||
5 | LOVENOX | ENOXAPARIN | X | |||||||
4 | LUMIGAN | BIMATOPROST | X | |||||||
2 | MACROBID | NITROFURANTOIN | X | |||||||
1 | MAXALT | RIZATRIPTAN | X | |||||||
7 | MECLIZINE | BONINE/DRAMAMINE | X | X | X | |||||
1, 10 | MEDROL DOSEPAK | METHYLPREDNISOLONE | X | |||||||
8 | MEDROXYPROGESTERONE | DEPOPROVERA | X | X | ||||||
7,12 | MEGESTROL | MEGACE | X | |||||||
7,12 | MEGESTROL | MEGACE ES ORAL SUSP | X | |||||||
1 | MELOXICAM* | MOBIC | X | X | ||||||
12 | METFORMIN* | GLUCOPHAGE | X | X | x | x | ||||
12 | METFORMIN ER | GLUCOPHAGE XR | X | X | x | |||||
12 | METHIMAZOLE | NORTHYX | X | X | ||||||
1 | METHOCARBAMOL | ROBAXIN | X | X | ||||||
1,15 | METHOTREXATE | TREXALL | X | X | X | |||||
10,15 | METHYLPREDNISOLONE | MEDROL | X | X | X | |||||
1,10 | METHYLPREDNISOLONE | MEDROL DOSEPAK | X | |||||||
7 | METOCLOPRAMIDE (ORAL) | REGLAN | X | x | ||||||
6 | METOPROLOL SUCC | TOPROL XL | X | X | X | |||||
6 | METOPROLOL TARTRATE* (LOPRESSOR) | LOPRESSOR | X | X | x | |||||
2 | METRONIDAZOLE | FLAGYL | X | X | X | |||||
6 | MICARDIS | TELMISARTAN | X | |||||||
6 | MICARDIS/HCTZ | TELMISARTAN/HCTZ | X | |||||||
11 | MIRTAZAPINE | REMERON | X | X | ||||||
10 | MONTELUKAST | SINGULAIR | X | X | ||||||
2, 3 | MUPIROCIN 2% OINTMENT (LIMIT 22 GRAMS PER MONTH) | BACTROBAN | X | X | ||||||
9 | MYRBETRIQ | MIRABEGRON | X | |||||||
1 | NABUMETONE | RELAFEN | X | |||||||
11 | NAMENDA XR | MEMANTINE | X | |||||||
11 | NAMZARIC | MEMANTINE/DONEPEZIL | X | |||||||
1 | NAPROXEN* | ALEVE | X | X | X | |||||
4, 10 | NASONEX NASAL INH | MOMETASONE | X | X | ||||||
2, 4 | NEO-POLY-DEX OPTH SUSP/OINT | MAXITROL | X | |||||||
12 | NESINA | ALOGLIPTIN | X | |||||||
1, 4 | NEVANAC | NEPAFENAC | X | |||||||
15 | NICOTINE INHALER | NICOTROL | X | |||||||
2 | NITROFURANTOIN MONO | MACROBID/MACRODANTIN | X | |||||||
6 | NITROGLYCERIN SL TAB | NITROSTAT | X | X | ||||||
11 | NORTRIPTYLINE (ORAL) | PAMELOR | X | x | ||||||
12 | NOVOLIN N, R, 70/30 | INSULIN ASPART | X | X | ||||||
12 | NOVOLOG | INSULIN ASPART | X | X | ||||||
12 | NOVOLOG 70/30 | INSULIN ASPART | X | X | ||||||
2, 3 | NYSTATIN TOPICAL POWDER | NYAMYC | X | |||||||
2, 3 | NYSTATIN TOPICAL CREAM (LIMIT 15 GRAMS PER MONTH) | NYAMYC | X | |||||||
11 | OLANZAPINE | ZYPREXA | X | X | ||||||
6 | OLMESARTAN | BENICAR | X | X | X | |||||
6 | OLMESARTAN/HCTZ | BENICAR-HCTZ | X | |||||||
4 | OLOPATADINE OPTH SOLUTION | PATADAY/PATANOL/PAZEO | X | |||||||
7 | OMEPRAZOLE | PRILOSEC | X | X | ||||||
7 | ONDANSETRON | ZOFRAN | X | X | ||||||
12 | ONGLYZA | SAXAGLIPTAN | X | X | ||||||
11 | ORAP | PIMOZIDE | X | |||||||
2 | OSELTAMIVIR | TAMIFLU | x | X | ||||||
9 | OXYBUTYNIN | DITROPAN | X | x | X | |||||
9 | OXYBUTYNIN ER | DITROPAN ER | x | |||||||
11 | OXCARBAZEPINE | TRILEPTAL | X | |||||||
7 | PANTOPRAZOLE | PROTONIX | X | X | X | |||||
11 | PAROXETINE HCL | PAXIL | X | X | X | x | ||||
4, 10 | PATADAY | OLOPATADINE | X | |||||||
4, 10 | PAZEO | OLOPATADINE | X | |||||||
12 | PEN NEEDLES | ZERO FEE W/ DIABETIC RX | $11.31 FOR BOX OF 100 (PRICE MAY VARY) | |||||||
2 | PENICILLIN VK | PENICILLIN V | X | x | x | |||||
1, 3 | PENNSAID 2% | DICLOFENAC | X | |||||||
6,12 | PENTOXIFYLLINE | PENTOXIL | X | |||||||
15 | PERMETHRIN CREAM 5% | NIX | X | |||||||
11 | PHENYTOIN ER | DILANTIN | X | X | ||||||
12 | PIOGLITAZONE | ACTOS | X | X | ||||||
2, 4 | POLYMYXIN B/TRIMETHOPRIM DROPS | POLYTRIM | X | |||||||
6,14 | POTASSIUM CHLORIDE CAPS | KLOR-CON | X | X | ||||||
6,14 | POTASSIUM CHLORIDE TABS* | KLOR-CON | X | X | ||||||
5, 6 | PRASUGREL | EFFIENT | X | |||||||
1,15 | PRAMIPEXOLE | MIRAPEX | X | X | ||||||
6 | PRAVASTATIN | PRAVACHOL | X | X | ||||||
6,9,11 | PRAZOSIN | MINIPRESS | X | X | X | |||||
1,10,15 | PREDNISONE | DELTASONE | X | X | X | |||||
1, 4 | PRED FORTE | PREDNISOLONE | X | X | ||||||
8 | PREMARIN | ESTROGENS | X | |||||||
8 | PREMARIN VAGINAL CREAM | ESTROGENS | X | |||||||
8 | PREMPHASE | ESTROGENS | X | |||||||
8 | PREMPRO | ESTROGENS | X | |||||||
11 | PRIMIDONE | MYSOLINE | X | |||||||
11 | PRISTIQ | DESVENLAFAXINE | X | X | ||||||
10 | PROAIR | ALBUTEROL | X | X | ||||||
6 | PROCARDIA XL | NIFEDIPINE ER | X | |||||||
7, 11 | PROCHLORPERAZINE | COMPRO | X | |||||||
7 | PROMETHAZINE | PHENEGRAN | X | X | X | |||||
7 | PROMETHAZINE DM SYRUP | PHENEGRAN | X | |||||||
6 | PROPRANOLOL | INDERAL | X | X | ||||||
7 | PROTONIX | PANTOPRAZOLE | X | |||||||
10 | PROVENTIL HFA | ALBUTEROL | X | X | ||||||
11 | PROZAC | FLUOXETINE | X | X | X | |||||
10 | PULMICORT | BUDESONIDE | X | |||||||
11 | QUETIAPINE | SEROQUEL | X | X | X | |||||
11 | QUETIAPINE XR | SEROQUEL XR | X | |||||||
10 | QVAR | BECLOMETHASONE | X | |||||||
7 | RABEPRAZOLE | ACIPHEX | X | |||||||
6 | RAMIPRIL | ALTACE | X | x | ||||||
9 | RAPAFLO | SILODOSIN | X | |||||||
1 | RELPAX | ELETRIPTAN | X | X | ||||||
4 | RESTASIS | CYCLOSPORINE | X | |||||||
11 | RISPERDAL | RISPERIDONE | X | |||||||
11 | RISPERIDONE | RISPERDAL | X | X | x | |||||
1 | RIZATRIPTAN | MAXALT, MAXALT MLT | X | X | ||||||
11,15 | ROPINIROLE | REQUIP | X | X | X | |||||
6 | ROSUVASTATIN | CRESTOR | X | X | X | |||||
11 | SAPHRIS | ASENAPINE | x | |||||||
1, 11 | SAVELLA | MILNACIPRAN | x | |||||||
3 | SELENIUM SULFIDE SHAMPOO | SELSUN BLUE | X | |||||||
12 | SENISPAR | CINACALCET | x | |||||||
10 | SEREVENT | SALMETEROL | x | |||||||
11 | SEROQUEL XR | VENLAFAXINE ER | X | |||||||
11 | SERTRALINE | ZOLOFT | X | X | ||||||
6,9,15 | SILDENAFIL | VIAGRA/REVATIO | X | X | X | |||||
3 | SILVER SULFADIAZINE 1% CRM | SILVADENE | X | |||||||
4 | SIMBRINZA OPTH DROPS | BRINZOLAMIDE/BRIMONIDINE | x | |||||||
6 | SIMVASTATIN* | ZOCOR | X | X | X | |||||
1 | SKELAXIN | METAXOLONE | x | |||||||
2 | SMZ-TMP DS | BACTRIM | X | X | X | x | ||||
2 | SMZ-TMP SS | BACTRIM | X | |||||||
15 | SODIUM POLYSTYENE | KAYEXALATE/KIONEX | X | |||||||
6 | SOTALOL | BETAPACE | X | X | ||||||
10 | SPIRIVA | TIOTROPIUM | X | |||||||
6 | SPIRONOLACTONE | ALDACTONE | X | X | X | |||||
11 | STRATTERA | ATOMOXETINE | x | |||||||
2 | STROMECTOL | IVERMECTIN | x | |||||||
7 | SUCRALAFATE | CARAFATE | X | |||||||
1,7 | SULFASALAZINE | AZULFIDINE | X | |||||||
1 | SUMATRIPTAN | IMITREX | X | |||||||
10 | SYMBICORT | BUDESONIDE/FORMOTEROL | x | |||||||
11 | SYMBYAX | OLANZAPINE/FLUOXETINE | x | |||||||
12 | SYMLIN | PRAMLINTIDE | x | |||||||
12 | SYNTHROID | LEVOTHYROXINE | x | X | ||||||
12 | SYRINGES | ZERO FEE W/RX | $11.06 FOR BOX OF 100 (PRICE MAY VARY) | |||||||
9,15 | TADALAFIL | CIALIS | X | X | ||||||
9 | TAMSULOSIN | FLOMAX | X | X | ||||||
2,8 | TAMOXIFEN CITRATE | SOLTAMOX | X | |||||||
11 | TEGRETOL | CARBAMAZEPINE | x | X | ||||||
11 | TEGRETOL XR | CARBAMAZEPINE | x | X | X | |||||
6 | TELMISARTAN | MICARDIS | X | X | ||||||
6,9 | TERAZOSIN | HYTRIN | X | X | X | |||||
2 | TERBINAFINE | LAMISIL | X | X | ||||||
2 | TETRACYCLINE | X | ||||||||
1 | TIZANIDINE | ZANAFLEX | X | X | X | |||||
9 | TOLTERIDONE ER | DETROL LA | X | |||||||
1,11 | TOPIRAMATE | TOPAMAX | X | X | X | |||||
6 | TORSEMIDE | DEMADEX | X | X | ||||||
12 | TOUJEO | INSULIN GLARGINE | x | |||||||
9 | TOVIAZ | FESOTERODINE | x | |||||||
4 | TRAVATAN Z OPTH DROPS | TRAVOPROST | x | |||||||
11 | TRAZODONE | OLEPTRO | X | X | X | x | ||||
12 | TRESIBA | INSULIN DEGLUDEC | x | |||||||
1,3 | TRIAMCINOLONE 0.1% CRM/OINT (LIMIT 15 GRAMS PER MONTH) | X | ||||||||
1,3 | TRIAMCINOLONE 0.025% & 0.5% CRM (LIMIT 15 GRAMS PER MONTH) | X | ||||||||
6 | TRIAMTERENE/HCTZ TABS | MAXIDE | X | X | x | |||||
11 | TRIHEXYPHENIDYL | ARETANE | x | |||||||
11 | TRILEPTAL | OXCARBAZEPINE | x | |||||||
11 | TRINTELLIX | VORTIOXETINE | x | |||||||
12 | TRULICITY | DULAGLUTIDE | x | |||||||
12 | TRUMETRIX PRO STRIPS | 5.75 PER BOX OF 50 (PRICE MAY VARY) | 9.08 PER BOX OF 50 (PRICE MAY VARY) | |||||||
4 | TRUSOPT OPTH DROPS | DORZOLAMIDE | x | |||||||
10 | TRUDORZA | ACLIDINIUM | x | |||||||
1, 15 | ULORIC | FEBUXOSTAT | x | |||||||
12 | UNITHROID | LEVOTHYROXINE | X | |||||||
2 | VALCYCLOVIR | VALTREX | X | |||||||
6 | VALSARTAN/HCTZ | DIOVAN/HCTZ | X | |||||||
11 | VENLAFAXINE | EFFEXOR | X | X | ||||||
11 | VENLAFAXINE ER | EFFEXOR XR | X | X | ||||||
10 | VENTOLIN HFA | ALBUTEROL | x | |||||||
6 | VERAPAMIL ER | CALAN ER | X | |||||||
6 | VERAPAMIL TABS | CALAN | 53415 | X | ||||||
9 | VESICARE | SOLIFENACIN | 53415 | X | ||||||
9,15 | VIAGRA | SILDENAFIL | x | X | ||||||
7 | VIBERZI | ELUXADOLINE | x | |||||||
12 | VICTOZA | LIRAGLUTIDE | x | |||||||
2, 4 | VIGAMOX OPTH DROPS | MOXIFLOXACIN | x | |||||||
11 | VIIBRYD | VILAZODONE | x | |||||||
14 | VITAMIN D2 50000 UNITS | ERGOCALCIFEROL | X | X | ||||||
11 | VRAYLAR | CARIPRAZINE | x | |||||||
6 | VYTORIN | EZETIMIBE/SIMVASTATIN | x | |||||||
5 | WARFARIN | COUMADIN | X | X | x | |||||
11 | WELLBUTRIN XL | BUPROPION | X | |||||||
11 | WELLBUTRIN SR | BUPROPION | X | |||||||
5 | XARELTO | RIVAROXABAN | x | X | X | |||||
14 | XENICAL | ORLISTAT | X | |||||||
2, 7 | XIFAXAN | RIFAXIMIN | x | |||||||
12 | XIGDUO XR | DAPAGLIFLOZIN/METFORMIN | x | |||||||
7 | ZEGERID | OMEPRAZOLE | X | |||||||
12 | ZENPEP | PANCREALIPASE | x | |||||||
6 | ZETIA | EZETIMIBE | x | X | ||||||
4 | ZIOPTAN OPTH DROPS | TAFLUPROST | x | |||||||
6 | ZIAC | BISOPROLOL/HCTZ | X | |||||||
11 | ZIPRASADONE | GEODON | ||||||||
11 | ZOLOFT | SERTRALINE | X | |||||||
2, 3 | ZOVIRAX OINT | ACYCLOVIR | x | X | ||||||
11 | ZYPREXA | OLANZAPINE | x | X | ||||||