|
LABETALOL TAB 100MG |
60.00 |
HEART/HIGH BLOOD PRESSURE MEDICATIONS |
TIER2 |
|
LABETALOL TAB 200MG |
60.00 |
HEART/HIGH BLOOD PRESSURE MEDICATIONS |
TIER2 |
|
LABETALOL TAB 300MG |
60.00 |
HEART/HIGH BLOOD PRESSURE MEDICATIONS |
TIER3 |
|
LACRI-LUBE OIN S.O.P. |
3.50 |
OPHTHALMIC AGENTS |
TIER2 |
|
LACTOCAL-F TAB |
30.00 |
PRENATAL VITAMINS |
TIER2 |
|
LAGESIC TAB 66-600MG |
90.00 |
ANALGESICS |
TIER4 |
|
LAMICTAL CHW 25MG |
30.00 |
ANTICONVULSANTS |
TIER4 |
|
LAMICTAL CHW 5MG |
30.00 |
ANTICONVULSANTS |
TIER4 |
|
LAMICTAL TAB 100MG |
30.00 |
ANTICONVULSANTS |
TIER4 |
|
LAMICTAL TAB 150MG |
30.00 |
ANTICONVULSANTS |
TIER4 |
|
LAMICTAL TAB 200MG |
30.00 |
ANTICONVULSANTS |
TIER4 |
|
LAMICTAL TAB 25MG |
60.00 |
ANTICONVULSANTS |
TIER4 |
|
LAMICTAL ODT TAB 100MG |
30.00 |
ANTICONVULSANTS |
TIER4 |
|
LAMICTAL ODT TAB 200MG |
30.00 |
ANTICONVULSANTS |
TIER4 |
|
LAMICTAL ODT TAB 25MG |
30.00 |
ANTICONVULSANTS |
TIER4 |
|
LAMICTAL ODT TAB 50MG |
30.00 |
ANTICONVULSANTS |
TIER4 |
|
LAMICTAL XR TAB 100MG |
30.00 |
ANTICONVULSANTS |
TIER4 |
|
LAMICTAL XR TAB 200MG |
30.00 |
ANTICONVULSANTS |
TIER4 |
|
LAMICTAL XR TAB 25MG |
30.00 |
ANTICONVULSANTS |
TIER4 |
|
LAMICTAL XR TAB 50MG |
30.00 |
ANTICONVULSANTS |
TIER4 |
|
LAMISIL TAB 250MG |
30.00 |
ANTIFUNGALS |
TIER4 |
|
LAMOTRIGINE CHW 25MG |
30.00 |
ANTICONVULSANTS |
TIER4 |
|
LAMOTRIGINE CHW 5MG |
30.00 |
ANTICONVULSANTS |
TIER4 |
|
LAMOTRIGINE TAB 100MG |
30.00 |
ANTICONVULSANTS |
TIER4 |
|
LAMOTRIGINE TAB 150MG |
30.00 |
ANTICONVULSANTS |
TIER4 |
|
LAMOTRIGINE TAB 200MG |
30.00 |
ANTICONVULSANTS |
TIER4 |
|
LAMOTRIGINE TAB 25MG |
60.00 |
ANTICONVULSANTS |
TIER4 |
|
LANOLIN OIN ALCOHOL |
1.00 |
MISCELLANEOUS PRODUCTS |
TIER1 |
|
LANOLIN ANHY OIN |
1.00 |
MISCELLANEOUS PRODUCTS |
TIER1 |
|
LANOLIN/UREA OIN BASE |
1.00 |
MISCELLANEOUS PRODUCTS |
TIER1 |
|
LANOXIN TAB 0.125MG |
30.00 |
HEART/HIGH BLOOD PRESSURE MEDICATIONS |
TIER1 |
|
LANOXIN TAB 0.25MG |
30.00 |
HEART/HIGH BLOOD PRESSURE MEDICATIONS |
TIER2 |
|
LANSOPRAZOLE CAP 15MG |
30.00 |
GASTROINTESTINAL AGENTS |
TIER4 |
|
LANSOPRAZOLE CAP 30MG |
30.00 |
GASTROINTESTINAL AGENTS |
TIER4 |
|
LASIX TAB 20MG |
30.00 |
DIURETICS |
TIER2 |
|
LASIX TAB 40MG |
30.00 |
DIURETICS |
TIER2 |
|
LASIX TAB 80MG |
30.00 |
DIURETICS |
TIER3 |
|
LEENA TAB |
28.00 |
CONTRACEPTIVES |
TIER3 |
|
LEFLUNOMIDE TAB 10MG |
30.00 |
ANALGESICS |
TIER3 |
|
LEFLUNOMIDE TAB 20MG |
30.00 |
ANALGESICS |
TIER4 |
|
LEMOHIST CAP PLUS |
90.00 |
COUGH/COLD/ALLERGY PRODUCTS |
TIER3 |
|
LESCOL CAP 20MG |
30.00 |
CHOLESTEROL-LOWERING AGENTS |
TIER4 |
|
LESCOL CAP 40MG |
30.00 |
CHOLESTEROL-LOWERING AGENTS |
TIER4 |
|
LESCOL XL TAB 80MG |
30.00 |
CHOLESTEROL-LOWERING AGENTS |
TIER4 |
|
LESSINA-28 TAB |
28.00 |
CONTRACEPTIVES |
TIER3 |
|
LEUCOVOR CA TAB 10MG |
120.00 |
ANTINEOPLASTIC AGENTS |
TIER4 |
|
LEUCOVOR CA TAB 5MG |
4.00 |
ANTINEOPLASTIC AGENTS |
TIER1 |
|
LEUKERAN TAB 2MG |
15.00 |
ANTINEOPLASTIC AGENTS |
TIER4 |
|
LEVACET TAB |
20.00 |
ANALGESICS |
TIER3 |
|
LEVAQUIN TAB 250MG |
3.00 |
ANTIBIOTICS |
TIER3 |
|
LEVAQUIN TAB 500MG |
10.00 |
ANTIBIOTICS |
TIER4 |
|
LEVAQUIN TAB 750MG |
5.00 |
ANTIBIOTICS |
TIER4 |
|
LEVAQUIN TAB LEVA-PAK |
5.00 |
ANTIBIOTICS |
TIER4 |
|
LEVATOL TAB 20MG |
30.00 |
HEART/HIGH BLOOD PRESSURE MEDICATIONS |
TIER4 |
|
LEVBID TAB 0.375 ER |
60.00 |
GASTROINTESTINAL AGENTS |
TIER4 |
|
LEVETIRACETA TAB 1000MG |
60.00 |
ANTICONVULSANTS |
TIER4 |
|
LEVETIRACETA TAB 250MG |
60.00 |
ANTICONVULSANTS |
TIER4 |
|
LEVETIRACETA TAB 500MG |
60.00 |
ANTICONVULSANTS |
TIER4 |
|
LEVETIRACETA TAB 750MG |
60.00 |
ANTICONVULSANTS |
TIER4 |
|
LEVITRA TAB 10MG |
10.00 |
IMPOTENCE AGENTS |
TIER4 |
|
LEVITRA TAB 2.5MG |
10.00 |
IMPOTENCE AGENTS |
TIER4 |
|
LEVITRA TAB 20MG |
6.00 |
IMPOTENCE AGENTS |
TIER4 |
|
LEVITRA TAB 5MG |
2.00 |
IMPOTENCE AGENTS |
TIER3 |
|
LEVORA-28 TAB 0.15/30 |
28.00 |
CONTRACEPTIVES |
TIER3 |
|
LEVORPHANOL TAB 2MG |
120.00 |
ANALGESICS |
TIER4 |
|
LEVOTHROID TAB 100MCG |
30.00 |
THYROID MEDICATION |
TIER1 |
|
LEVOTHROID TAB 112MCG |
30.00 |
THYROID MEDICATION |
TIER2 |
|
LEVOTHROID TAB 125MCG |
30.00 |
THYROID MEDICATION |
TIER2 |
|
LEVOTHROID TAB 137MCG |
30.00 |
THYROID MEDICATION |
TIER2 |
|
LEVOTHROID TAB 150MCG |
30.00 |
THYROID MEDICATION |
TIER2 |
|
LEVOTHROID TAB 175MCG |
30.00 |
THYROID MEDICATION |
TIER2 |
|
LEVOTHROID TAB 200MCG |
30.00 |
THYROID MEDICATION |
TIER2 |
|
LEVOTHROID TAB 25MCG |
30.00 |
THYROID MEDICATION |
TIER1 |
|
LEVOTHROID TAB 300MCG |
30.00 |
THYROID MEDICATION |
TIER2 |
|
LEVOTHROID TAB 50MCG |
30.00 |
THYROID MEDICATION |
TIER1 |
|
LEVOTHROID TAB 75MCG |
30.00 |
THYROID MEDICATION |
TIER2 |
|
LEVOTHROID TAB 88MCG |
30.00 |
THYROID MEDICATION |
TIER2 |
|
LEVOTHYROXIN TAB 100MCG |
30.00 |
THYROID MEDICATION |
TIER1 |
|
LEVOTHYROXIN TAB 112MCG |
30.00 |
THYROID MEDICATION |
TIER2 |
|
LEVOTHYROXIN TAB 125MCG |
30.00 |
THYROID MEDICATION |
TIER2 |
|
LEVOTHYROXIN TAB 137MCG |
30.00 |
THYROID MEDICATION |
TIER2 |
|
LEVOTHYROXIN TAB 150MCG |
30.00 |
THYROID MEDICATION |
TIER2 |
|
LEVOTHYROXIN TAB 175MCG |
30.00 |
THYROID MEDICATION |
TIER2 |
|
LEVOTHYROXIN TAB 200MCG |
30.00 |
THYROID MEDICATION |
TIER2 |
|
LEVOTHYROXIN TAB 25MCG |
30.00 |
THYROID MEDICATION |
TIER1 |
|
LEVOTHYROXIN TAB 300MCG |
30.00 |
THYROID MEDICATION |
TIER2 |
|
LEVOTHYROXIN TAB 50MCG |
30.00 |
THYROID MEDICATION |
TIER1 |
|
LEVOTHYROXIN TAB 75MCG |
30.00 |
THYROID MEDICATION |
TIER2 |
|
LEVOTHYROXIN TAB 88MCG |
30.00 |
THYROID MEDICATION |
TIER2 |
|
LEVOXYL TAB 100MCG |
30.00 |
THYROID MEDICATION |
TIER1 |
|
LEVOXYL TAB 112MCG |
30.00 |
THYROID MEDICATION |
TIER2 |
|
LEVOXYL TAB 125MCG |
30.00 |
THYROID MEDICATION |
TIER2 |
|
LEVOXYL TAB 137MCG |
30.00 |
THYROID MEDICATION |
TIER2 |
|
LEVOXYL TAB 150MCG |
30.00 |
THYROID MEDICATION |
TIER2 |
|
LEVOXYL TAB 175MCG |
30.00 |
THYROID MEDICATION |
TIER2 |
|
LEVOXYL TAB 200MCG |
30.00 |
THYROID MEDICATION |
TIER2 |
|
LEVOXYL TAB 25MCG |
30.00 |
THYROID MEDICATION |
TIER1 |
|
LEVOXYL TAB 50MCG |
30.00 |
THYROID MEDICATION |
TIER1 |
|
LEVOXYL TAB 75MCG |
30.00 |
THYROID MEDICATION |
TIER2 |
|
LEVOXYL TAB 88MCG |
30.00 |
THYROID MEDICATION |
TIER2 |
|
LEVSIN TAB 0.125MG |
40.00 |
GASTROINTESTINAL AGENTS |
TIER4 |
|
LEXAPRO TAB 10MG |
30.00 |
ANTIDEPRESSANTS |
TIER4 |
|
LEXAPRO TAB 20MG |
30.00 |
ANTIDEPRESSANTS |
TIER4 |
|
LEXAPRO TAB 5MG |
30.00 |
ANTIDEPRESSANTS |
TIER4 |
|
LEXIVA TAB 700MG |
60.00 |
ANTIVIRALS |
TIER4 |
|
LIALDA TAB 1.2GM |
60.00 |
GASTROINTESTINAL AGENTS |
TIER4 |
|
LIBRAX CAP 5-2.5MG |
60.00 |
GASTROINTESTINAL AGENTS |
TIER4 |
|
LIDOCAINE OIN 5% |
35.00 |
DERMATOLOGICALS |
TIER2 |
|
LIMBREL CAP 250MG |
60.00 |
NUTRITIONAL PRODUCTS |
TIER4 |
|
LIMBREL CAP 500MG |
60.00 |
NUTRITIONAL PRODUCTS |
TIER4 |
|
LIMBREL250 CAP 250-50MG |
30.00 |
NUTRITIONAL PRODUCTS |
TIER4 |
|
LIMBREL500 CAP 500-50MG |
30.00 |
NUTRITIONAL PRODUCTS |
TIER4 |
|
LIMBREL525 CAP 525-50MG |
30.00 |
NUTRITIONAL PRODUCTS |
TIER4 |
|
LIOTHYRONINE TAB 25MCG |
30.00 |
THYROID MEDICATION |
TIER3 |
|
LIOTHYRONINE TAB 50MCG |
30.00 |
THYROID MEDICATION |
TIER4 |
|
LIOTHYRONINE TAB 5MCG |
30.00 |
THYROID MEDICATION |
TIER3 |
|
LIPITOR TAB 10MG |
30.00 |
CHOLESTEROL-LOWERING AGENTS |
TIER4 |
|
LIPITOR TAB 20MG |
30.00 |
CHOLESTEROL-LOWERING AGENTS |
TIER4 |
|
LIPITOR TAB 40MG |
30.00 |
CHOLESTEROL-LOWERING AGENTS |
TIER4 |
|
LIPITOR TAB 80MG |
30.00 |
CHOLESTEROL-LOWERING AGENTS |
TIER4 |
|
LIPOFEN CAP 150MG |
30.00 |
CHOLESTEROL-LOWERING AGENTS |
TIER4 |
|
LIPOFEN CAP 50MG |
30.00 |
CHOLESTEROL-LOWERING AGENTS |
TIER4 |
|
LIPRAM-UL12 CAP |
90.00 |
DIGESTIVE AIDS |
TIER4 |
|
LIPRAM-UL18 CAP |
90.00 |
DIGESTIVE AIDS |
TIER4 |
|
LIPRAM-UL20 CAP |
300.00 |
DIGESTIVE AIDS |
TIER4 |
|
LISINOP/HCTZ TAB 10-12.5 |
30.00 |
HEART/HIGH BLOOD PRESSURE MEDICATIONS |
TIER2 |
|
LISINOP/HCTZ TAB 20-12.5 |
30.00 |
HEART/HIGH BLOOD PRESSURE MEDICATIONS |
TIER2 |
|
LISINOP/HCTZ TAB 20-25MG |
30.00 |
HEART/HIGH BLOOD PRESSURE MEDICATIONS |
TIER2 |
|
LISINOPRIL TAB 10MG |
30.00 |
HEART/HIGH BLOOD PRESSURE MEDICATIONS |
TIER1 |
|
LISINOPRIL TAB 2.5MG |
30.00 |
HEART/HIGH BLOOD PRESSURE MEDICATIONS |
TIER1 |
|
LISINOPRIL TAB 20MG |
30.00 |
HEART/HIGH BLOOD PRESSURE MEDICATIONS |
TIER1 |
|
LISINOPRIL TAB 30MG |
30.00 |
HEART/HIGH BLOOD PRESSURE MEDICATIONS |
TIER2 |
|
LISINOPRIL TAB 40MG |
30.00 |
HEART/HIGH BLOOD PRESSURE MEDICATIONS |
TIER2 |
|
LISINOPRIL TAB 5MG |
30.00 |
HEART/HIGH BLOOD PRESSURE MEDICATIONS |
TIER1 |
|
LISTER-V CAP |
30.00 |
NUTRITIONAL PRODUCTS |
TIER4 |
|
LITHIUM CARB CAP 150MG |
30.00 |
ANTIPSYCHOTICS |
TIER1 |
|
LITHIUM CARB CAP 300MG |
90.00 |
ANTIPSYCHOTICS |
TIER2 |
|
LITHIUM CARB CAP 600MG |
60.00 |
ANTIPSYCHOTICS |
TIER3 |
|
LITHIUM CARB TAB 300MG |
90.00 |
ANTIPSYCHOTICS |
TIER2 |
|
LITHIUM CARB TAB 300MG ER |
60.00 |
ANTIPSYCHOTICS |
TIER3 |
|
LITHIUM CARB TAB 450MG ER |
60.00 |
ANTIPSYCHOTICS |
TIER3 |
|
LITHOBID TAB 300MG CR |
60.00 |
ANTIPSYCHOTICS |
TIER4 |
|
LITHOSTAT TAB 250MG |
90.00 |
GENITOURINARY PRODUCTS |
TIER4 |
|
LO/OVRAL-28 TAB |
28.00 |
CONTRACEPTIVES |
TIER4 |
|
LOCOID OIN 0.1% |
15.00 |
CORTICOSTEROIDS - TOPICAL |
TIER4 |
|
LODOSYN TAB 25MG |
30.00 |
PARKINSONS DRUGS |
TIER4 |
|
LODRANE 12D TAB 6-45MG |
14.00 |
COUGH/COLD/ALLERGY PRODUCTS |
TIER1 |
|
LODRANE 12HR TAB |
60.00 |
ANTIHISTAMINES |
TIER3 |
|
LODRANE 24 CAP |
20.00 |
ANTIHISTAMINES |
TIER3 |
|
LODRANE 24D CAP 12-90MG |
60.00 |
COUGH/COLD/ALLERGY PRODUCTS |
TIER4 |
|
LOESTRIN TAB 1/20-21 |
21.00 |
CONTRACEPTIVES |
TIER4 |
|
LOESTRIN 21 TAB 1.5/30 |
21.00 |
CONTRACEPTIVES |
TIER4 |
|
LOESTRIN 24 TAB FE |
28.00 |
CONTRACEPTIVES |
TIER4 |
|
LOESTRIN FE TAB 1.5/30 |
28.00 |
CONTRACEPTIVES |
TIER4 |
|
LOESTRIN FE TAB 1/20 |
28.00 |
CONTRACEPTIVES |
TIER4 |
|
LOFENE TAB 2.5MG |
30.00 |
ANTIDIARRHEALS |
TIER1 |
|
LOFIBRA CAP 134MG |
30.00 |
CHOLESTEROL-LOWERING AGENTS |
TIER4 |
|
LOFIBRA CAP 200MG |
30.00 |
CHOLESTEROL-LOWERING AGENTS |
TIER4 |
|
LOFIBRA CAP 67MG |
30.00 |
CHOLESTEROL-LOWERING AGENTS |
TIER3 |
|
LOFIBRA TAB 160MG |
30.00 |
CHOLESTEROL-LOWERING AGENTS |
TIER4 |
|
LOFIBRA TAB 54MG |
30.00 |
CHOLESTEROL-LOWERING AGENTS |
TIER3 |
|
LOHIST-12 TAB 12 HOUR |
60.00 |
ANTIHISTAMINES |
TIER3 |
|
LOHIST-12D TAB 6-45MG |
14.00 |
COUGH/COLD/ALLERGY PRODUCTS |
TIER1 |
|
LOMOTIL TAB 2.5MG |
30.00 |
ANTIDIARRHEALS |
TIER3 |
|
LONOX TAB 2.5MG |
30.00 |
ANTIDIARRHEALS |
TIER1 |
|
LOPERAMIDE CAP 2MG |
30.00 |
ANTIDIARRHEALS |
TIER1 |
|
LOPID TAB 600MG |
60.00 |
CHOLESTEROL-LOWERING AGENTS |
TIER4 |
|
LOPRESS HCT TAB 100/25MG |
30.00 |
HEART/HIGH BLOOD PRESSURE MEDICATIONS |
TIER4 |
|
LOPRESS HCT TAB 50-25MG |
30.00 |
HEART/HIGH BLOOD PRESSURE MEDICATIONS |
TIER4 |
|
LOPRESSOR TAB 100MG |
60.00 |
HEART/HIGH BLOOD PRESSURE MEDICATIONS |
TIER4 |
|
LOPRESSOR TAB 50MG |
60.00 |
HEART/HIGH BLOOD PRESSURE MEDICATIONS |
TIER4 |
|
LORATADINE SYP 5MG/5ML |
150.00 |
ANTIHISTAMINES |
TIER2 |
|
LORATADINE TAB 10MG |
30.00 |
ANTIHISTAMINES |
TIER2 |
|
LORATA-DINE TAB D 24HR |
30.00 |
COUGH/COLD/ALLERGY PRODUCTS |
TIER3 |
|
LORATADINE-D TAB 24 HOUR |
30.00 |
COUGH/COLD/ALLERGY PRODUCTS |
TIER3 |
|
LORAZEPAM TAB 0.5MG |
30.00 |
ANTIANXIETY AGENTS |
TIER1 |
|
LORAZEPAM TAB 1MG |
30.00 |
ANTIANXIETY AGENTS |
TIER1 |
|
LORAZEPAM TAB 2MG |
30.00 |
ANTIANXIETY AGENTS |
TIER1 |
|
LORCET TAB 10/650 |
120.00 |
ANALGESICS |
TIER4 |
|
LORCET PLUS TAB 7.5-650 |
60.00 |
ANALGESICS |
TIER4 |
|
LORTAB 10 TAB |
120.00 |
ANALGESICS |
TIER4 |
|
LORTAB 5 TAB |
30.00 |
ANALGESICS |
TIER3 |
|
LORTAB 7.5 TAB |
60.00 |
ANALGESICS |
TIER4 |
|
LOSARTAN POT TAB 100MG |
30.00 |
HEART/HIGH BLOOD PRESSURE MEDICATIONS |
TIER4 |
|
LOSARTAN POT TAB 25MG |
30.00 |
HEART/HIGH BLOOD PRESSURE MEDICATIONS |
TIER4 |
|
LOSARTAN POT TAB 50MG |
30.00 |
HEART/HIGH BLOOD PRESSURE MEDICATIONS |
TIER4 |
|
LOSARTAN/HCT TAB 100-12.5 |
30.00 |
HEART/HIGH BLOOD PRESSURE MEDICATIONS |
TIER4 |
|
LOSARTAN/HCT TAB 100-25 |
30.00 |
HEART/HIGH BLOOD PRESSURE MEDICATIONS |
TIER4 |
|
LOSARTAN/HCT TAB 50-12.5 |
30.00 |
HEART/HIGH BLOOD PRESSURE MEDICATIONS |
TIER4 |
|
LOSEASONIQUE TAB |
30.00 |
CONTRACEPTIVES |
TIER4 |
|
LOTENSIN TAB 10MG |
30.00 |
HEART/HIGH BLOOD PRESSURE MEDICATIONS |
TIER4 |
|
LOTENSIN TAB 20MG |
30.00 |
HEART/HIGH BLOOD PRESSURE MEDICATIONS |
TIER4 |
|
LOTENSIN TAB 40MG |
30.00 |
HEART/HIGH BLOOD PRESSURE MEDICATIONS |
TIER4 |
|
LOTENSIN TAB 5MG |
30.00 |
HEART/HIGH BLOOD PRESSURE MEDICATIONS |
TIER4 |
|
LOTENSIN HCT TAB 10-12.5 |
30.00 |
HEART/HIGH BLOOD PRESSURE MEDICATIONS |
TIER4 |
|
LOTENSIN HCT TAB 20-12.5 |
30.00 |
HEART/HIGH BLOOD PRESSURE MEDICATIONS |
TIER4 |
|
LOTENSIN HCT TAB 20-25MG |
30.00 |
HEART/HIGH BLOOD PRESSURE MEDICATIONS |
TIER4 |
|
LOTENSIN HCT TAB 5-6.25MG |
30.00 |
HEART/HIGH BLOOD PRESSURE MEDICATIONS |
TIER4 |
|
LOTREL CAP 10-20MG |
30.00 |
HEART/HIGH BLOOD PRESSURE MEDICATIONS |
TIER4 |
|
LOTREL CAP 10-40MG |
30.00 |
HEART/HIGH BLOOD PRESSURE MEDICATIONS |
TIER4 |
|
LOTREL CAP 2.5-10MG |
30.00 |
HEART/HIGH BLOOD PRESSURE MEDICATIONS |
TIER4 |
|
LOTREL CAP 5-10MG |
30.00 |
HEART/HIGH BLOOD PRESSURE MEDICATIONS |
TIER4 |
|
LOTREL CAP 5-20MG |
30.00 |
HEART/HIGH BLOOD PRESSURE MEDICATIONS |
TIER4 |
|
LOTREL CAP 5-40MG |
30.00 |
HEART/HIGH BLOOD PRESSURE MEDICATIONS |
TIER4 |
|
LOTRONEX TAB 0.5MG |
60.00 |
GASTROINTESTINAL AGENTS |
TIER4 |
|
LOTRONEX TAB 1MG |
30.00 |
GASTROINTESTINAL AGENTS |
TIER4 |
|
LOVASTATIN TAB 10MG |
30.00 |
CHOLESTEROL-LOWERING AGENTS |
TIER2 |
|
LOVASTATIN TAB 20MG |
30.00 |
CHOLESTEROL-LOWERING AGENTS |
TIER2 |
|
LOVASTATIN TAB 40MG |
30.00 |
CHOLESTEROL-LOWERING AGENTS |
TIER3 |
|
LOVAZA CAP 1GM |
120.00 |
CHOLESTEROL-LOWERING AGENTS |
TIER4 |
|
LOW-OGESTREL TAB |
28.00 |
CONTRACEPTIVES |
TIER3 |
|
LOXAPINE CAP 10MG |
30.00 |
ANTIPSYCHOTICS |
TIER3 |
|
LOXAPINE CAP 25MG |
30.00 |
ANTIPSYCHOTICS |
TIER3 |
|
LOXAPINE CAP 50MG |
60.00 |
ANTIPSYCHOTICS |
TIER4 |
|
LOXAPINE CAP 5MG |
30.00 |
ANTIPSYCHOTICS |
TIER2 |
|
LOXITANE CAP 10MG |
30.00 |
ANTIPSYCHOTICS |
TIER4 |
|
LOXITANE CAP 25MG |
30.00 |
ANTIPSYCHOTICS |
TIER4 |
|
LOXITANE CAP 50MG |
60.00 |
ANTIPSYCHOTICS |
TIER4 |
|
LOXITANE CAP 5MG |
30.00 |
ANTIPSYCHOTICS |
TIER4 |
|
LUDENT CHW 0.25MG F |
30.00 |
DENTAL/FLUORIDE AGENTS |
TIER1 |
|
LUDENT CHW 0.5MG F |
30.00 |
DENTAL/FLUORIDE AGENTS |
TIER1 |
|
LUDENT CHW 1MG F |
30.00 |
DENTAL/FLUORIDE AGENTS |
TIER1 |
|
LUFYLLIN TAB 200MG |
120.00 |
ANTIASTHMATIC & RESPIRATORY AGENTS |
TIER4 |
|
LUFYLLIN TAB 400MG |
120.00 |
ANTIASTHMATIC & RESPIRATORY AGENTS |
TIER4 |
|
LUNESTA TAB 1MG |
30.00 |
HYPNOTIC & SEDATIVE AGENTS |
TIER4 |
|
LUNESTA TAB 2MG |
30.00 |
HYPNOTIC & SEDATIVE AGENTS |
TIER4 |
|
LUNESTA TAB 3MG |
30.00 |
HYPNOTIC & SEDATIVE AGENTS |
TIER4 |
|
LURIDE CHW 0.25MG F |
30.00 |
DENTAL/FLUORIDE AGENTS |
TIER1 |
|
LURIDE CHW 0.5MG F |
30.00 |
DENTAL/FLUORIDE AGENTS |
TIER1 |
|
LURIDE CHW 1MG F |
30.00 |
DENTAL/FLUORIDE AGENTS |
TIER1 |
|
LUTERA TAB |
28.00 |
CONTRACEPTIVES |
TIER3 |
|
LUVOX CR CAP 100MG |
30.00 |
ANTIDEPRESSANTS |
TIER4 |
|
LUVOX CR CAP 150MG |
30.00 |
ANTIDEPRESSANTS |
TIER4 |
|
LYBREL TAB 90-20MCG |
28.00 |
CONTRACEPTIVES |
TIER4 |
|
LYRICA CAP 100MG |
90.00 |
ANTICONVULSANTS |
TIER4 |
|
LYRICA CAP 150MG |
60.00 |
ANTICONVULSANTS |
TIER4 |
|
LYRICA CAP 200MG |
90.00 |
ANTICONVULSANTS |
TIER4 |
|
LYRICA CAP 225MG |
60.00 |
ANTICONVULSANTS |
TIER4 |
|
LYRICA CAP 25MG |
60.00 |
ANTICONVULSANTS |
TIER4 |
|
LYRICA CAP 300MG |
60.00 |
ANTICONVULSANTS |
TIER4 |
|
LYRICA CAP 50MG |
90.00 |
ANTICONVULSANTS |
TIER4 |
|
LYRICA CAP 75MG |
60.00 |
ANTICONVULSANTS |
TIER4 |
|
LYSIPLEX TAB PLUS |
30.00 |
VITAMINS & MINERALS |
TIER1 |
|
LYSODREN TAB 500MG |
15.00 |
ANTINEOPLASTIC AGENTS |
TIER4 |
